Objective To explore the scheme for the deployment and withdrawal of the surgical module of the new-type tent hospital system.Methods A set of standardized scheme for deploying and withdrawing the surgical module of the new-type tent hosital system was proposed and implemented in terms of labor division,operation precedure,operation technique and precaution.The operating time,number of operational errors and number of equipment damages were recorded for each of the five deployment and withdrawal operations before and after the program was executed,and the team members'immediate heart rate,percentage of maximum heart rate(MHR)and rating of perceived exercise(RPE)at the end of the operation were recorded after the program was implemented.SPSS 26.0 software was used for statistical analysis.Results The standardized scheme had the deployment time shortened from(85.15±11.430)min to(58.23±8.513)min,withdrawal time decreased from(65.36±9.369)min to(48.92±7.129)min,with the differences being statistically significant(P＜0.05);the numbers of operatio-nal errors and equipment damages were both reduced when compared with those before the implementation of the schemce;the immediate heart rate of the team members at the end of the operation ranged from 43 to 157 beats/min,with an average value of 151.1 beats/min,the individual MHR percentages were from 75％to 87％,with an average value of 81.1％,and the RPE scores were from 14 to 17,with an average value of 15.3,which all could be categorized as moderate-operation intensity.Condusion The standardized deployment and withdrawal scheme for the surgical module meets the needs of actual combat and training assessment,and thus is worthy promoting in medical institutions equipped with the surgical module of the new-type tent hosital system.[Chinese Medical Equipment Journal,2025,46(2):74-79]

Objective:To explore the application value of dynamic monitoring of serum thyroid hormone(THs)levels in assessing the condition changes and prognosis of elderly patients with sepsis.Methods:Using a retrospective cohort study,a total of 120 elderly critically ill patients hospitalized in the Department of Critical Care Medicine from April 2020 to April 2023 were selected as research subjects,divided into a sepsis group(60 cases)and a non-sepsis group(60 cases).Sepsis patients were further divided into a survival group(43 cases)and a death group(17 cases)based on 28-day survival status.Serum THs,PCT,IL-6,and Lac were measured on the 1st,5th,and 10th days of hospitalization(d1,d5,dl0)for sepsis patients,and the Sequential Organ Failure Assessment(SOFA)score and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were recorded.The datas of non-sepsis patients were sampled on d1.The incidence of non-thyroidal illness syndrome(NTIS)was statistically analyzed,and the dynamic changes of serum THs among different groups were compared.The correlation between THs and disease severity,as well as the predictive value of THs for 28-day mortality in sepsis,was analyzed.Results:①The incidence of NTIS was 78.33％(94/120),with a significantly higher incidence in sepsis patients(96.67％,58/60)compared to non-sepsis patients(60.00％),with statistical significance(P＜0.05).②Compared to non-sepsis patients,sepsis patients had significantly lower levels of TSH,T3,FT3,and T4 on d1,while rT3 was significantly elevated,with statistical significance(P＜0.05);the difference in FT4 levels was not statistically significant(P＞0.05).Pearson correlation analysis showed that T3 and T4 were negatively correlated with SOFA and APACHE Ⅱ scores(P＜0.05),while other THs indicators showed no correlation with SOFA and APACHE Ⅱ scores(P＞0.05).ANOVA results indicated that there was no statistically significant difference in T4 levels at the three time points,and its changes showed no obvious linear trend over time(P＞0.05);T3 was significantly lower on d1 than on d5 and d10,and showed an increasing trend with longer hospitalization,while SOFA and APACHE Ⅱ scores were significantly higher on d1 than on d5 and d10,showing a decreasing trend with longer hospitalization(all P＜0.05).③Compared to the survival group of sepsis patients,the death group had significantly higher levels of PCT on d10,IL-6 on d5 and d10,and Lac on d1,d5,and d10(P＜0.05).The death group had significantly lower levels of T3 and T4 on d1,significantly lower levels of TSH,T3,T4,and FT4 on d5,and significantly lower levels of TSH,T3,FT3,T4,and FT4 on d10,with statistical significance(P＜0.05).④Logistic regression analysis showed that independent risk factors for 28-day mortality in sepsis patients included T3 on d1 and T3,FT3,T4,FT4,and IL-6 on d10,with statistical significance(P＜0.05).ROC curve analysis indicated that serum levels of T3,FT3,T4,and FT4 on d10 had certain predictive value for 28-day mortality in sepsis patients(all P＜0.05),with T3,FT3,and FT4 showing good predictive value,and their AUCs were 0.875,0.872,and 0.861,respectively.The combined AUC for predicting 28-day mortality in sepsis patients using T3,FT3,and FT4 on d10 increased to 0.902.Conclusion:The incidence of NTIS was high in elderly sepsis patients,and the serum THs levels and their dynamic changes were closely related to the patients'condition changes.Continuous dynamic monitoring of serum THs levels could help to assess the progression of sepsis,and T3 may serve as an indicator for evaluating the progression and prognosis of sepsis.

AIM To evaluate the quality consistency of Tongmai Granules,Tongmai Tablets,Tongmai Capsules and Tongmai Oral Liquid.METHODS The HPLC fingerprints were established,after which the contents of danshensu,protocatechuic aldehyde,3'-hydroxy puerarin,puerarin,puerarin apioside,daidzin,ferulic acid,salvianolic acid B and salvianolic acid A were determined,and cluster analysis and principal component analysis were adopted in the quality analysis from the perspective of daily intake.RESULTS There were 21 common peaks in the fingerprints for 39 batches of samples with the similarities of 0.765-0.997.Various batches of samples were clustered into 5 categories,2 principal components demonstrated the accumulative variance contribution rate of 83.53％ .The daily intakes of various constituents in different dosage forms exhibited obvious differences,especially for that of salvianolic acid B,which were low in tablets and capsules,and their heterogeneities existed among the same dosage forms.CONCLUSION This simple and accurate method can provide a reference for the quality evaluation of Tongmai preparations from different manufacturers.

Objective To develop an objective and precise prognostic model for assessing severity and prognosis in elderly patients with community-acquired pneumonia(CAP)admitted to the emergency department.Methods A retrospective analysis was conducted on elderly patients with CAP admitted to Department of Emergency,Minhang Hospital,Fudan University between Jun 2018 and Dec 2020.With the primary outcome being the 30-day in-hospital mortality rate of elderly CAP patients,four systemic inflammatory response markers,including the neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)were evaluated using univariate and multivariate Logistic regression analyses.The predictive performance of different scoring systems was compared.Results A total of 421 elderly CAP cases were enrolled.The results of the multivariate Logistic regression analysis demonstrated that NLR was an independent risk factor for elderly inpatients with CAP.We combined NLR with the existing CURB-65 score for joint optimization to construct a scoring system or a clinical prognosis model,by quantifying and assigning optimal cut-off value of 11.4 for NLR,and established the NLR+CURB-65 score.The ROC curve was constructed to compare the areas under the curve of the three different scoring systems(NLR,CURB-65,and NLR+CURB-65).The area under the curve of the NLR+CURB-65 score was significantly higher than that of the CURB-65 score.Based on the optimal cut-off value of 3 for NLR+CURB-65 score,the patients were stratified into high-risk group(n=188)and low-risk group(n=233).The K-M survival curve was utilized and indicated that compared with high-risk group,low-risk group had a lower mortality rate and a higher discharge rate.Conclusion For elderly emergency hospitalized patients with CAP,the combination of NLR and CURB-65 score showed high predictive value for assessing disease severity and prognosis.

Objective:To explore the application value of dynamic monitoring of serum thyroid hormone(THs)levels in assessing the condition changes and prognosis of elderly patients with sepsis.Methods:Using a retrospective cohort study,a total of 120 elderly critically ill patients hospitalized in the Department of Critical Care Medicine from April 2020 to April 2023 were selected as research subjects,divided into a sepsis group(60 cases)and a non-sepsis group(60 cases).Sepsis patients were further divided into a survival group(43 cases)and a death group(17 cases)based on 28-day survival status.Serum THs,PCT,IL-6,and Lac were measured on the 1st,5th,and 10th days of hospitalization(d1,d5,dl0)for sepsis patients,and the Sequential Organ Failure Assessment(SOFA)score and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were recorded.The datas of non-sepsis patients were sampled on d1.The incidence of non-thyroidal illness syndrome(NTIS)was statistically analyzed,and the dynamic changes of serum THs among different groups were compared.The correlation between THs and disease severity,as well as the predictive value of THs for 28-day mortality in sepsis,was analyzed.Results:①The incidence of NTIS was 78.33％(94/120),with a significantly higher incidence in sepsis patients(96.67％,58/60)compared to non-sepsis patients(60.00％),with statistical significance(P＜0.05).②Compared to non-sepsis patients,sepsis patients had significantly lower levels of TSH,T3,FT3,and T4 on d1,while rT3 was significantly elevated,with statistical significance(P＜0.05);the difference in FT4 levels was not statistically significant(P＞0.05).Pearson correlation analysis showed that T3 and T4 were negatively correlated with SOFA and APACHE Ⅱ scores(P＜0.05),while other THs indicators showed no correlation with SOFA and APACHE Ⅱ scores(P＞0.05).ANOVA results indicated that there was no statistically significant difference in T4 levels at the three time points,and its changes showed no obvious linear trend over time(P＞0.05);T3 was significantly lower on d1 than on d5 and d10,and showed an increasing trend with longer hospitalization,while SOFA and APACHE Ⅱ scores were significantly higher on d1 than on d5 and d10,showing a decreasing trend with longer hospitalization(all P＜0.05).③Compared to the survival group of sepsis patients,the death group had significantly higher levels of PCT on d10,IL-6 on d5 and d10,and Lac on d1,d5,and d10(P＜0.05).The death group had significantly lower levels of T3 and T4 on d1,significantly lower levels of TSH,T3,T4,and FT4 on d5,and significantly lower levels of TSH,T3,FT3,T4,and FT4 on d10,with statistical significance(P＜0.05).④Logistic regression analysis showed that independent risk factors for 28-day mortality in sepsis patients included T3 on d1 and T3,FT3,T4,FT4,and IL-6 on d10,with statistical significance(P＜0.05).ROC curve analysis indicated that serum levels of T3,FT3,T4,and FT4 on d10 had certain predictive value for 28-day mortality in sepsis patients(all P＜0.05),with T3,FT3,and FT4 showing good predictive value,and their AUCs were 0.875,0.872,and 0.861,respectively.The combined AUC for predicting 28-day mortality in sepsis patients using T3,FT3,and FT4 on d10 increased to 0.902.Conclusion:The incidence of NTIS was high in elderly sepsis patients,and the serum THs levels and their dynamic changes were closely related to the patients'condition changes.Continuous dynamic monitoring of serum THs levels could help to assess the progression of sepsis,and T3 may serve as an indicator for evaluating the progression and prognosis of sepsis.

Objective To investigate the risk factors for pneumonia complicating infectious mononucleosis(IM)in adults and construct a nomogram prediction model.Methods A retrospective analysis was conducted on 198 IM patients admitted to the Second Affiliated Hospital of Air Force Medical University from January 2015 to December 2021.Patients were divided into pneumonia group(n=52)and non-pneumonia group(n=146)based on whether pulmonary infection occurred during hospitalization.The baseline data(age,gender,place of onset,etc.),clinical manifestations(maximum body temperature,lymph node enlargement,splenomegaly,etc.),and inflammatory indicators[white blood cell count(WBC),C-reactive protein(CRP),etc.]were compared between the two groups.Kaplan-Meier curves were plotted to analyze the key indicators affecting the hospital stay of IM patients.Multivariate logistic regression was used to analyze the independent risk factors for pneumonia complicating IM in adults and construct a nomogram prediction model based on the identified risk factors.The predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve and the consistency of the model was assessed using the calibration curve.The fit of the model was evaluated using the Hosmer-Lemeshow test.Additionally,the sensitivity,specificity,and accuracy of the model were assessed using confusion matrix.Results Compared with non-pneumonia group,the pneumonia group had a significantly higher proportion of patients from rural areas,with body mass index(BMI)≥24 kg/m2,smoking history,hepatomegaly,fever duration of≥7 d,as well as increased total hospitalization costs and average daily hospitalization costs,and prolonged hospital stay(P<0.05).The proportion of patients with a history of antibiotic use was lower in the pneumonia group(P<0.05).Kaplan-Meier survival analysis showed that patients from rural areas,with BMI≥24 kg/m2,smoking history,no prophylactic use of antibiotics,fever duration≥7 d,and hepatomegaly had significantly prolonged hospital stays(P<0.05).Multivariate logistic regression analysis revealed that living in a rural area(OR=4.089,P<0.05),hepatomegaly(OR=4.082,P<0.05),and elevated WBC(OR=1.205,P<0.05)were independent risk factors for pneumonia complicating IM in adults,while the prophylactic use of antibiotics(OR=0.142,P<0.05)was an independent protective factor.The area under the ROC curve of the constructed nomogram prediction model was 0.827(95%CI 0.762-0.892),and the slope of the calibration curve was close to 1,and the Hosmer-Lemeshow test showed χ2=5.299,P=0.725,indicating good consistency and fit of the prediction model.The results of the confusion matrix assessment showed that the sensitivity of the model was 0.669(0.624-0.773),the specificity was 0.827(0.724-0.930),and the accuracy was 0.732(0.665-0.793).Conclusion The nomogram prediction model based on place of onset,hepatomegaly,the prophylactic use of antibiotics and WBC has excellent fit and discrimination,providing an effective quantitative tool for prognosis assessment of IM.

AIM To evaluate the quality consistency of Tongmai Granules,Tongmai Tablets,Tongmai Capsules and Tongmai Oral Liquid.METHODS The HPLC fingerprints were established,after which the contents of danshensu,protocatechuic aldehyde,3'-hydroxy puerarin,puerarin,puerarin apioside,daidzin,ferulic acid,salvianolic acid B and salvianolic acid A were determined,and cluster analysis and principal component analysis were adopted in the quality analysis from the perspective of daily intake.RESULTS There were 21 common peaks in the fingerprints for 39 batches of samples with the similarities of 0.765-0.997.Various batches of samples were clustered into 5 categories,2 principal components demonstrated the accumulative variance contribution rate of 83.53％ .The daily intakes of various constituents in different dosage forms exhibited obvious differences,especially for that of salvianolic acid B,which were low in tablets and capsules,and their heterogeneities existed among the same dosage forms.CONCLUSION This simple and accurate method can provide a reference for the quality evaluation of Tongmai preparations from different manufacturers.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

The chemical constituents were systematically separated from the roots of Berberis polyantha by various chromatographic methods, including silica gel column chromatography, HP20 column chromatography, polyamide column chromatography, reversed-phase C_(18) column chromatography, and preparative high-performance liquid chromatography. The structures of the compounds were identified by physicochemical properties and spectroscopic techniques(1D NMR, 2D NMR, UV, MS, and CD). Four phenylpropanoids were isolated from the methanol extract of the roots of B. polyantha, and they were identified as(2R)-1-(4-hydroxy-3,5-dimethoxyphenyl)-1-propanone-O-β-D-glucopyranoside(1), methyl 4-hydroxy-3,5-dimethoxybenzoate(2),(+)-syringaresinol(3), and syringaresinol-4-O-β-D-glucopyranoside(4). Compound 1 was a new compound, and other compounds were isolated from this plant for the first time. The anti-inflammatory activity of these compounds was evaluated based on the release of nitric oxide(NO) in the culture of lipopolysaccharide(LPS)-induced RAW264.7 macrophages. At a concentration of 10 μmol·L~(-1), all the four compounds inhibited the LPS-induced release of NO in RAW264.7 cells, demonstrating potential anti-inflammatory properties.
Plant Roots/chemistry* ; Animals ; Mice ; Berberis/chemistry* ; RAW 264.7 Cells ; Macrophages/immunology* ; Drugs, Chinese Herbal/isolation & purification* ; Nitric Oxide/metabolism* ; Molecular Structure ; Anti-Inflammatory Agents/isolation & purification*