ObjectiveTo evaluate the clinical efficacy of acupuncture in the treatment of adolescent depression and to explore its potential mechanisms based on functional magnetic resonance imaging （fMRI） and serum proteomics. MethodsA randomized， double-blind， sham acupuncture-controlled trial design was conducted. A total of 100 adolescents with depression were enrolled and randomly assigned to an acupuncture group and a sham acupuncture group， with 50 participants in each group. In addition， 20 healthy subjects were recruited as healthy controls. Participants in the acupuncture group received acupuncture at Baihui （GV 20）， Yintang （GV 29）， Zhongwan （CV 12）， Qihai （CV 6）， bilateral Tianshu （ST 25）， bilateral Neiguan （PC 6）， bilateral Zusanli （ST 36）， and bilateral Taichong （LR3）. The sham acupuncture group received intervention using a blunt placebo needle without skin penetration. Both groups received 30-min treatments three times per week for 4 weeks. The primary outcome was the reduction rate of the 24-item Hamilton Depression Rating Scale （HAMD-24） score. Secondary outcomes included changes in HAMD-24 scores before and after treatment， covering nine factors （anxiety/somatization， cognitive impairment， sleep disturbance， psychomotor retardation， hopelessness， fatigue， weight change， diurnal mood variation， and suicidal ideation）， response rate and remission rate after treatment， and symptom severity before and after treatment. Subgroup analyses of total HAMD-24 scores were performed according to concomitant medication use and the number of medications taken. During the study period， all adverse events were monitored and recorded to evaluate safety. Patients who volunteered and met the eligibility criteria for imaging examinations were selected to undergo brain fMRI scanning and serum proteomic analysis to investigate changes in functional connectivity among brain regions and differential proteins. ResultsA total of 49 participants in the acupuncture group and 50 participants in the sham acupuncture group were included in the efficacy analysis. Among them， 20 participants in the acupuncture group and 21 in the sham acupuncture group completed fMRI scans， while 19 participants in the acupuncture group and 21 in the sham acupuncture group completed serum proteomic analyses. After 4 weeks of treatment， the mean reduction rate of HAMD-24 score in the acupuncture group was significantly higher than that in the sham acupuncture group ［（58±24）% vs.（26±19）%， P＜0.01］. Compared to baseline， scores for anxiety/somatization， cognitive impairment， psychomotor retardation， and hopelessness， and the total HAMD-24 score significantly decreased in both groups. In addition， the acupuncture group showed significant reductions in sleep disturbance， fatigue， and suicidal ideation scores （P＜0.01）. After treatment， the response rate and remission rate were 67.35% （33/49） and 24.48% （12/49） in the acupuncture group， respectively， significantly higher than 6.00% （3/50） and 0 in the sham acupuncture group （P＜0.01）. The proportion of participants with moderate symptoms was lower， whereas the proportion with mild symptoms was higher in the acupuncture group than the sham acupuncture group （P＜0.01）. Among those receiving acupuncture alone， acupuncture combined with medication， or fewer than three medications， the total HAMD-24 scores decreased after treatment in both the acupuncture subgroup and the sham acupuncture subgroup， with significantly lower scores in the acupuncture subgroup （P＜0.01）. During the study period， four mild adverse events were reported， including one case in the acupuncture group and three cases in the sham acupuncture group； none of these events affected the continuation of treatment. fMRI results showed that acupuncture enhanced functional connectivity between the prefrontal cortex and cerebellar-limbic system-related brain regions. Proteomic analysis identified 24 differentially expressed proteins associated with acupuncture treatment， mainly enriched in pathways related to neuroinflammation and energy metabolism. ConclusionAcupuncture can significantly improve depressive symptoms in adolescents with depression. Its therapeutic effects may be achieved by modulating emotion-related brain networks and regulating pathways associated with neuroinflammation and energy metabolism.

Objective:To explore the correlation between the intensity of net ultrafiltration in continuous renal replacement therapy (CRRT) and the survival prognosis in critically ill patients with acute kidney injury (AKI), and provide evidence-based references for establishing optimal net ultrafiltration target during CRRT.Methods:This was a retrospective observational study. Demographic and clinical data of critically ill AKI patients who received CRRT in the Intensive Care Unit of West China Hospital, Sichuan University from May 2021 to September 2023 were collected. Net ultrafiltration was defined as the hourly fluid clearance volume in the 72 hours prior of CRRT. This variable was converted into a categorical variable, including low net ultrafiltration <1.01 ml·kg -1·h -1, moderate net ultrafiltration 1.01-1.38 ml·kg -1·h -1 and high net ultrafiltration >1.38 ml·kg -1·h -1, and the differences of baseline characteristics and clinical treatment conditions among the three groups were compared. Kaplan-Meier survival curve and log-rank test were used to compare the survival conditions among the three groups in patients at 28 days and 60 days after CRRT. Logistic regression analysis method was used to analyze the related factors of mortality in patients 28 days and 60 days after CRRT. Results:This study included a total of 661 critically ill AKI patients who underwent CRRT for more than 72 hours. The age was 56.00 (43.00, 68.00) years, and 488 patients (73.83%) were males. The net ultrafiltration rate was 1.36 (0.94, 1.89) ml·kg -1·h -1. Among them, 188 patients (28.44%) were in the low net ultrafiltration group, 152 patients (23.00%) were in the medium net ultrafiltration group, and 321 patients (48.56%) were in the high net ultrafiltration group. There were statistically significant differences among the three groups in terms of gender distribution ( χ2=17.81, P<0.001), body mass index ( H=32.37, P<0.001), urine volume 24 hours before admission ( H=9.41, P=0.009), fluid overload ( H=6.02, P=0.049), platelets ( H=13.49, P=0.001), pro-B type natriuretic peptide ( H=14.18, P<0.001), serum creatinine ( H=9.66, P=0.008), lactate ( H=9.83, P=0.007), AKI stage distribution ( χ2=15.51, P=0.004), admission indication ( P<0.001), total CRRT duration ( H=8.45, P=0.015), ultrafiltration ( H=456.10, P<0.001), net ultrafiltration ( H=561.20, P<0.001), and vasoactive-inotropic score at 72 hours of CRRT treatment ( H=10.42, P=0.005). Kaplan-Meier survival analysis showed that there were statistically significant differences in the 28-day (Log-rank test, χ2=10.89, P=0.004) and 60-day (Log-rank test, χ2=8.55, P=0.014) survival rates among the three groups in patients after CRRT. Multivariate logistic regression analysis showed age ( OR=1.03, 95% CI 1.02-1.04, P<0.001), mean arterial pressure ( OR=0.98, 95% CI 0.97-1.00, P=0.011), bilirubin ( OR=3.02,95% CI 1.39-5.59, P=0.006), 72-hour vasoactive-inotropic score ( OR=1.01, 95% CI 1.00-1.02, P=0.004), low net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.66, 95% CI 1.02-2.72, P=0.042), and high net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.78, 95% CI 1.14-2.78, P=0.011) were independent correlated factors of 28-day mortality after CRRT. Age ( OR=1.02，95% CI 1.01-1.04， P<0.001), mean arterial pressure ( OR=0.98，95% CI 0.97-1.00， P=0.016), fluid overload ( OR=1.10, 95% CI 1.02-1.19, P=0.012), bilirubin ( OR=4.96，95% CI 1.00-17.80， P=0.013), 72-hour vasoactive-inotropic score ( OR=1.02，95% CI 1.01-1.03， P=0.003), and high net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.91，95% CI 1.22-3.00， P=0.005) were independent correlated factors of 60-day mortality after CRRT. Conclusions:During the first 72 hours of CRRT, net ultrafiltration > 1.38 ml·kg -1·h -1 and net ultrafiltration < 1.01 ml·kg -1·h -1 are associated with a higher mortality rate at 28 days or 60 days after CRRT. Net ultrafiltration of 1.01-1.38 ml·kg -1·h -1 may be a relatively safe range.

Objective To explore the therapeutic effect and influencing factors of individualized exercise under continuous glucose profile in patients with typ 2 diabetes mellitus(T2DM).Methods A total of 110 patients with T2DM who were treated in the Department of Endocrinology of our hospital from December 2021 to July 2022 were randomly divided into conventional group and personalized group,with 55 cases in each group.The conventional group was given routine health exercise guidance,the personalized group was given a personalized exercise program.Repeated measurement analysis of variance was used to evaluate the improvement of blood glucose related indicators in the two groups at 3 and 6 months after intervention.Logistic regression was used to analyze the influencing factors of blood glucose(BG)control after 6 months of intervention.Results After 3 and 6 months of intervention,FBG,2 hBG,hemoglobin A1c(HbA1c),mean blood glucose(MBG)and time above target range(TAR)in the personalized group and conventional group were all lower than those before intervention(P<0.05).Time in range(TIR)of glucose within 24 h was higher than that before intervention(P<0.05).After 3 and 6 months of intervention,FBG,2 hBG,HbA1c,MBG and TAR in the personalized group were lower than those in the conventional group at the same time point(P<0.05),and TIR was higher than that in the conventional group at the same time point(P<0.05).After 6 months of intervention,the BG control rate in the personalized group was higher than that in the conventional group(P<0.05).Logistic regression analysis showed that the DM duration,exercise intervention methods and TIR were the influencing factors of BG control.Conclusions Exercise guidance is an effective intervention method to control diabetes.Compared with conventional exercise guidance,personalized exercise program has a better effect on controlling patients'BG level,and has a better effect on patients with short course of disease.

Objective To explore the therapeutic effect and influencing factors of individualized exercise under continuous glucose profile in patients with typ 2 diabetes mellitus(T2DM).Methods A total of 110 patients with T2DM who were treated in the Department of Endocrinology of our hospital from December 2021 to July 2022 were randomly divided into conventional group and personalized group,with 55 cases in each group.The conventional group was given routine health exercise guidance,the personalized group was given a personalized exercise program.Repeated measurement analysis of variance was used to evaluate the improvement of blood glucose related indicators in the two groups at 3 and 6 months after intervention.Logistic regression was used to analyze the influencing factors of blood glucose(BG)control after 6 months of intervention.Results After 3 and 6 months of intervention,FBG,2 hBG,hemoglobin A1c(HbA1c),mean blood glucose(MBG)and time above target range(TAR)in the personalized group and conventional group were all lower than those before intervention(P<0.05).Time in range(TIR)of glucose within 24 h was higher than that before intervention(P<0.05).After 3 and 6 months of intervention,FBG,2 hBG,HbA1c,MBG and TAR in the personalized group were lower than those in the conventional group at the same time point(P<0.05),and TIR was higher than that in the conventional group at the same time point(P<0.05).After 6 months of intervention,the BG control rate in the personalized group was higher than that in the conventional group(P<0.05).Logistic regression analysis showed that the DM duration,exercise intervention methods and TIR were the influencing factors of BG control.Conclusions Exercise guidance is an effective intervention method to control diabetes.Compared with conventional exercise guidance,personalized exercise program has a better effect on controlling patients'BG level,and has a better effect on patients with short course of disease.

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

OBJECTIVE: To observe the effect of Huayu Tongluo moxibustion on the NOD-like receptor protein 3 (NLRP3)/cysteine-aspartic acid protease-1 (Caspase-1)/gasdermin D (GSDMD) signaling pathway in rats with vascular dementia (VD), and to explore its mechanism in improving learning and memory ability and alleviating neuronal injury in the hippocampal CA1 region. METHODS: A total of 80 SPF-grade male Wistar rats were included. Three rats were excluded based on the Morris water maze test. From the remaining rats, 12 were randomly selected as the sham operation group. The rest were used to establish VD models via modified bilateral common carotid artery ligation. Thirty-six successfully modeled rats were randomly divided into a model group, a medication group, and a moxibustion group, with 12 rats in each group. The medication group was treated with nimodipine solution (12 mg/kg) via gavage. The moxibustion group was treated with Huayu Tongluo moxibustion. The suspended moxibustion was applied at Shenting (GV24) and Dazhui (GV14), and aconite cake-separated moxibustion was applied at Baihui (GV20), with each acupoint treated for 20 min. All treatments were administered once daily for 21 consecutive days. Before and after modeling, and after intervention, the Morris water maze test was used to assess cognitive function. After intervention, the activation and morphology of microglia in the hippocampal CA1 region were observed by immunofluorescence. Ultrastructure of hippocampal CA1 neurons was examined by transmission electron microscopy. Western blot was used to detect protein expression of NLRP3, apoptosis-associated speck-like protein (ASC), Caspase-1, GSDMD, and interleukin-1β (IL-1β) in the hippocampal CA1 region. ELISA was used to detect the content of IL-6, IL-8, and tumor necrosis factor-α (TNF-α) in the hippocampal CA1 region. RESULTS: Compared with the sham operation group, the model group showed longer mean escape latency (P<0.01) and fewer platform crossings (P<0.01); the microglial processes in the hippocampal CA1 region were thickened, cytoplasm was hypertrophic, and relative fluorescence intensity of ionized calcium-binding adapter molecule 1 (IBA-1) was increased (P<0.05); the neuronal ultrastructure in the CA1 region was severely damaged, rough endoplasmic reticulum was swollen, mitochondria were deformed and swollen, some cristae were ruptured or dissolved, showing vacuolar changes; the protein expression of NLRP3, ASC, Caspase-1, GSDMD, and IL-1β, as well as levels of IL-6, IL-8, and TNF-α were significantly elevated (P<0.001). Compared with the model group, both the medication group and the moxibustion group showed shortened mean escape latency (P<0.01) and increased platform crossings (P<0.01); the microglial processes were thinner, and IBA-1 fluorescence intensity was decreased (P<0.05); the neuronal ultrastructure in the CA1 region was partially improved; the protein expression of NLRP3, ASC, Caspase-1, GSDMD, and IL-1β, and levels of IL-6, IL-8, and TNF-α were significantly reduced (P<0.001). Compared with the medication group, the moxibustion group showed shortened mean escape latency (P<0.05) and more platform crossings (P<0.05); the IBA-1 fluorescence intensity was decreased (P<0.05); the neuronal ultrastructure in the CA1 region was improved; the protein expression of NLRP3, ASC, Caspase-1, GSDMD, and IL-1β, as well as levels of IL-6, IL-8, and TNF-α, were significantly lower (P<0.001). CONCLUSION The Huayu Tongluo moxibustion could enhance learning and memory abilities in VD rats, inhibit excessive activation of microglia, and alleviate neuronal injury in the hippocampal CA1 region. Its mechanism may involve modulation of the NLRP3/Caspase-1/GSDMD signaling pathway, reduction of inflammatory responses.
Animals ; Male ; Dementia, Vascular/physiopathology* ; Rats ; Signal Transduction ; Moxibustion ; Rats, Wistar ; CA1 Region, Hippocampal/injuries* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Caspase 1/genetics* ; Memory ; Humans ; Neurons/metabolism* ; Learning

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

Objective:To explore the correlation between the intensity of net ultrafiltration in continuous renal replacement therapy (CRRT) and the survival prognosis in critically ill patients with acute kidney injury (AKI), and provide evidence-based references for establishing optimal net ultrafiltration target during CRRT.Methods:This was a retrospective observational study. Demographic and clinical data of critically ill AKI patients who received CRRT in the Intensive Care Unit of West China Hospital, Sichuan University from May 2021 to September 2023 were collected. Net ultrafiltration was defined as the hourly fluid clearance volume in the 72 hours prior of CRRT. This variable was converted into a categorical variable, including low net ultrafiltration <1.01 ml·kg -1·h -1, moderate net ultrafiltration 1.01-1.38 ml·kg -1·h -1 and high net ultrafiltration >1.38 ml·kg -1·h -1, and the differences of baseline characteristics and clinical treatment conditions among the three groups were compared. Kaplan-Meier survival curve and log-rank test were used to compare the survival conditions among the three groups in patients at 28 days and 60 days after CRRT. Logistic regression analysis method was used to analyze the related factors of mortality in patients 28 days and 60 days after CRRT. Results:This study included a total of 661 critically ill AKI patients who underwent CRRT for more than 72 hours. The age was 56.00 (43.00, 68.00) years, and 488 patients (73.83%) were males. The net ultrafiltration rate was 1.36 (0.94, 1.89) ml·kg -1·h -1. Among them, 188 patients (28.44%) were in the low net ultrafiltration group, 152 patients (23.00%) were in the medium net ultrafiltration group, and 321 patients (48.56%) were in the high net ultrafiltration group. There were statistically significant differences among the three groups in terms of gender distribution ( χ2=17.81, P<0.001), body mass index ( H=32.37, P<0.001), urine volume 24 hours before admission ( H=9.41, P=0.009), fluid overload ( H=6.02, P=0.049), platelets ( H=13.49, P=0.001), pro-B type natriuretic peptide ( H=14.18, P<0.001), serum creatinine ( H=9.66, P=0.008), lactate ( H=9.83, P=0.007), AKI stage distribution ( χ2=15.51, P=0.004), admission indication ( P<0.001), total CRRT duration ( H=8.45, P=0.015), ultrafiltration ( H=456.10, P<0.001), net ultrafiltration ( H=561.20, P<0.001), and vasoactive-inotropic score at 72 hours of CRRT treatment ( H=10.42, P=0.005). Kaplan-Meier survival analysis showed that there were statistically significant differences in the 28-day (Log-rank test, χ2=10.89, P=0.004) and 60-day (Log-rank test, χ2=8.55, P=0.014) survival rates among the three groups in patients after CRRT. Multivariate logistic regression analysis showed age ( OR=1.03, 95% CI 1.02-1.04, P<0.001), mean arterial pressure ( OR=0.98, 95% CI 0.97-1.00, P=0.011), bilirubin ( OR=3.02,95% CI 1.39-5.59, P=0.006), 72-hour vasoactive-inotropic score ( OR=1.01, 95% CI 1.00-1.02, P=0.004), low net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.66, 95% CI 1.02-2.72, P=0.042), and high net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.78, 95% CI 1.14-2.78, P=0.011) were independent correlated factors of 28-day mortality after CRRT. Age ( OR=1.02，95% CI 1.01-1.04， P<0.001), mean arterial pressure ( OR=0.98，95% CI 0.97-1.00， P=0.016), fluid overload ( OR=1.10, 95% CI 1.02-1.19, P=0.012), bilirubin ( OR=4.96，95% CI 1.00-17.80， P=0.013), 72-hour vasoactive-inotropic score ( OR=1.02，95% CI 1.01-1.03， P=0.003), and high net ultrafiltration group (medium net ultrafiltration group as a reference, OR=1.91，95% CI 1.22-3.00， P=0.005) were independent correlated factors of 60-day mortality after CRRT. Conclusions:During the first 72 hours of CRRT, net ultrafiltration > 1.38 ml·kg -1·h -1 and net ultrafiltration < 1.01 ml·kg -1·h -1 are associated with a higher mortality rate at 28 days or 60 days after CRRT. Net ultrafiltration of 1.01-1.38 ml·kg -1·h -1 may be a relatively safe range.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.