Objective To explore the effects of different serum potassium levels on the 28-day prognosis of elderly patients with sepsis. Methods A retrospective analysis was conducted on the clinical data and laboratory indicators within 24 hours after the diagnosis in 204 elderly patients with sepsis admitted to the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University from January 2018 to January 2022. According to the potassium concentrations in the blood of the patients within 24 hours after admission to intensive care unit (ICU), the patients were divided into the hyperkalemia group (K^＋≥5.3 mmol/L), normokalemia group (K^＋ 3.5–＜5.3 mmol/L), and hypokalemia group (K^＋＜3.5 mmol/L). According to 28-day outcomes, the patients were divided into the death group and survival group. The acute physiological and chronic health evaluation (APACHE) Ⅱ score, sequential organ failure assessment (SOFA) score and laboratory indicators were analyzed. Multivariate logistic regression analysis was used to analyze the risk factors for 28-day mortality in elderly patients with sepsis. Results Compared with the normokalemia group (n＝99), patients in both the hyperkalemia (n＝61) and hypokalemia (n＝44) groups had significantly higher levels of C-reactive protein (CRP) and procalcitonin (PCT), longer duration of mechanical ventilation, longer length of hospital stay and ICU stay, and higher mortality (P ＜ 0.05). The death group (n＝49) had significantly higher APACHE Ⅱ score, SOFA score, white blood cell (WBC) counts, CRP level, and PCT level than the survival group (n＝155, P＜0.05). Multivariate logistic regression analysis showed that increased or decreased serum potassium level, higher SOFA score, and increased WBC counts were independent risk factors for 28-day mortality in elderly patients with sepsis (P＜0.05). Quadratic fitted curve showed a U-shaped association between serum potassium levels and 28-day mortality risk in elderly patients with sepsis, with the lowest mortality risk observed within the intermediate (normal) range, and both hypokalemia and hyperkalemia were associated with an increased mortality risk (P＝0.182). Conclusion Both increased and decreased serum potassium levels are independent risk factors for 28-day mortality in elderly patients with sepsis, which should be given particular attention in clinical management.

Objective To enhance medical service efficiency and optimize healthcare resource utilization,our hospital developed a novel one-stop integrated medical service model combining pre-hospitalization with day surgery.Methods Starting in August 2022,a Class A Tertiary Hospital in Guangzhou implemented a multi-dimensional collaborative mechanism:1.Process reengineering:Standardized workflows shifted preoperative tests and anesthesia evaluations to pre-hospitalization.2.Resource in-tegration:Established a one-stop medical service center as a comprehensive service coordination hub,integrating deposit pay-ment,examination scheduling,testing,medical check-ups,bed allocation,and"one-click admission"into a unified diagnostic and treatment service chain.3.Closed-loop management:Streamlined workflow from outpatient evaluation to follow-up.Results By 2024 vs 2022:Increased annual discharges by 30,000+cases.Reduced preoperative hospitalization by 0.4 days.Im-proved bed occupancy(+10.72％)and turnover(+10.86％).Achieved 94％patient satisfaction.Conclusion This model enhances bed efficiency,reduces hospitalization delays,and offers a scalable framework for healthcare optimization,demonstra-ting both social and operational benefits.

Objective Construction and Practice of a Whole-Process Digitalized Hemodialysis Management System.Methods ① Integrate device data through the Internet of Things(IoT)to enable automatic collection of dialysis parameters and real-time validation of quality control rules.② Build an"intelligent error prevention system"based on Data Analysis,realizing the transformation from patient management to digital quality control management in hemodialysis treatment.③ Implement a closed-loop management system for the entire patient dialysis process.Results The system reduced clinicians' time spent manu-ally filling and verifying documentation by 75％,and increased the adequacy compliance rate for maintenance dialysis patients to 100％per quarter and other goals.Conclusion Traditional hemodialysis management relies on manual records,leading to issues such as fragmented data,delayed quality control,material waste,and high risks of hospital-acquired infections.The entire process,from patient appointment to post-dialysis summary management lacks coordination,and manual calculation of key indica-tors is prone to errors,with insufficient timeliness in quality surveillance warnings.The construction of an information system can break down operational silos and enable"data-driven decision-making",and provides a replicable model for the digital manage-ment of hemodialysis.

Objective Construction and Practice of a Whole-Process Digitalized Hemodialysis Management System.Methods ① Integrate device data through the Internet of Things(IoT)to enable automatic collection of dialysis parameters and real-time validation of quality control rules.② Build an"intelligent error prevention system"based on Data Analysis,realizing the transformation from patient management to digital quality control management in hemodialysis treatment.③ Implement a closed-loop management system for the entire patient dialysis process.Results The system reduced clinicians' time spent manu-ally filling and verifying documentation by 75％,and increased the adequacy compliance rate for maintenance dialysis patients to 100％per quarter and other goals.Conclusion Traditional hemodialysis management relies on manual records,leading to issues such as fragmented data,delayed quality control,material waste,and high risks of hospital-acquired infections.The entire process,from patient appointment to post-dialysis summary management lacks coordination,and manual calculation of key indica-tors is prone to errors,with insufficient timeliness in quality surveillance warnings.The construction of an information system can break down operational silos and enable"data-driven decision-making",and provides a replicable model for the digital manage-ment of hemodialysis.

Objective To enhance medical service efficiency and optimize healthcare resource utilization,our hospital developed a novel one-stop integrated medical service model combining pre-hospitalization with day surgery.Methods Starting in August 2022,a Class A Tertiary Hospital in Guangzhou implemented a multi-dimensional collaborative mechanism:1.Process reengineering:Standardized workflows shifted preoperative tests and anesthesia evaluations to pre-hospitalization.2.Resource in-tegration:Established a one-stop medical service center as a comprehensive service coordination hub,integrating deposit pay-ment,examination scheduling,testing,medical check-ups,bed allocation,and"one-click admission"into a unified diagnostic and treatment service chain.3.Closed-loop management:Streamlined workflow from outpatient evaluation to follow-up.Results By 2024 vs 2022:Increased annual discharges by 30,000+cases.Reduced preoperative hospitalization by 0.4 days.Im-proved bed occupancy(+10.72％)and turnover(+10.86％).Achieved 94％patient satisfaction.Conclusion This model enhances bed efficiency,reduces hospitalization delays,and offers a scalable framework for healthcare optimization,demonstra-ting both social and operational benefits.

Objective To analyze the factors influencing the early recovery of renal function in patients with sepsis-associated acute kidney injury(SA-AKI).Methods A retrospective analysis was conducted on 86 SA-AKI patients treated in the Intensive Care Unit at Zhongshan Hospital,Fudan University from January 2021 to December 2022,who met both the Sepsis 3.0 diagnostic criteria and the AKI diagnostic standards.Patients were divided into a recovery group and a non-recovery group based on whether their renal function recovered within 7 days after AKI onset.Clinical data and laboratory tests of patients were compared between the two groups.Univariate and multivariate logistic analyses were used to identify risk factors affecting renal function recovery in SA-AKI patients,and ROC curve was utilized to evaluate the predictive value of these factors for early renal function recovery in SA-AKI patients.Results The renal function of 37(43.02％)patients recoveried.Compared with the recovery group,the renal replacement therapy rate,in-hospital mortality and 28-day mortality of patients in the non-recovery group were higher(P＜0.001).The multivariate logistic analysis showed that age,APACHE Ⅱ score,urine output,urine neutrophil gelatinase-associated lipocalin(NGAL),and norepinephrine dose were independent related factors affecting renal function recovery in SA-AKI patients(P＜0.05).The final model logit(P)=-4.091+0.001×urine NGAL-0.001 Xurine volume+0.040 ×age+0.073 × APACHE Ⅱ score+1.906 × norepinephrine dose.The AUC of model predicting early SA-AKI recovery was 0.823,with 73.5％of sensitivity,and 81.1％of specificity.Conclusions In SA-AKI patients,age,APACHE Ⅱ score,urine output,urine NGAL,and the dose of norepinephrine independently affect early renal function recovery,and the combined assessment of these indicators has predictive value for the early renal recovery in these patients.

Objective:To observe and evaluate the clinical effect of hyperbaric oxygen combined therapy on patients with non-arteritic anterior ischemic optic neuropathy (NAION).Methods:A total of 110 patients with NAION admitted to the Department of Ophthalmology of Zhengzhou Second Hospital from January 2017 to January 2019 who met the inclusion criteria were selected and divided into control group (55 cases) and hyperbaric oxygen group (55 cases) by random number table method. The control group was given conventional therapies such as hormone shock, microcirculation improvement, and nerve nutrition, while the hyperbaric oxygen group was given conventional treatment and hyperbaric oxygen therapy, with chamber pressure of 2.0 ATA, once a day, 10 times for a course of treatment for 30 days. The visual acuity, mean sensitivity (MS), mean defect (MD), pattern visual evoked potential (PVEP) amplitude, and latency period of the two groups were observed and analyzed to evaluate the efficacy of treatment. The effect of hyperbaric oxygen combined therapy on serum human chondroglycoprotein-39 (chtinase-3-like-1 protein, YKL-40) in patients with NAION was also observed.Results:Before treatment, there were no statistically significant differences in visual acuity, mean sensitivity, mean defect, PVEP amplitude, latency period, and serum YKL-40 between the two groups ( P>0.05). The visual MD in the hyperbaric oxygen group after treatment was lower than that in the control group after treatment and also lower than that before treatment in the same group, and the differences were statistically significant ( P<0.05). The visual acuity and MS in the hyperbaric oxygen group after treatment were higher than those in the control group and also those before treatment in the same group, and the differences were statistically significant ( P<0.05). The PVEP amplitudes of the patients in the hyperbaric oxygen group were higher than those in the control group and also those before treatment in the same group, and the latency period was earlier than that in the control group and also that before treatment in the same group, with statistically significant differences ( P<0.05). The level of serum YKL-40 reached the peak after 7 days of treatment. After 3, 7, 15 and 30 days of treatment, the levels of serum YKL-40 were all lower than those of the control group on the same day, with statistically significant differences ( P<0.05). After treatment, the total effective rate of the hyperbaric oxygen group (83.63%) was higher than that of the control group (74.55%), but there was no statistically significant difference ( P>0.05). Conclusion:Hyperbaric oxygen combined therapy can significantly improve the vision acuity, MS, MD, PVEP amplitude, and latency period of the patients with NAION, and reduce inflammatory response, which is beneficial to improve clinical efficacy.

Objective:To observe the clinical effect of the treatment combined with hyperbaric oxygen (HBO) on patients with herpes zoster.Methods:A total of 72 patients with herpes zoster treated in the Department of Dermatology of Zhengzhou Second Hospital from January 2018 to December 2019 were selected and divided into HBO group and control group by random number table method, with 36 patients in each group. The control group received acyclovir and other conventional treatments, while the HBO group received HBO on the basis of the treatments of the control group. The improvement of the skin lesions, scores of numeric rating scales (NRS) on pain, and efficacy of the two groups were observed and evaluated after treatment. After a 3-month follow-up, the occurrence of postherpetic neuralgia (PHN) was statistically analyzed.Results:The time of blistering relieving, incrustation, and complete incrustation of the HBO group were all lower than those of the control group with statistically significant difference ( P<0.05). The NRS scores of both groups were all lower than those before treatment with significantly statistical difference ( P<0.01); and the NRS scores of the HBO group were significantly lower than those of the control group after treatment ( P<0.05). The total effective rate of the HBO group (91.67%) was significantly higher than that of the control group (83.33%). The difference was statistically significant ( χ2=4.31, P=0.04). After treatment, 3 cases of PHN occurred in the HBO group, while 7 cases in the control group; the PHN incidence of the HBO group was lower than that of the control group with significantly statistical difference ( P<0.05). Conclusion:In treating herpes zoster, the treatment combined with HBO can achieve a satisfactory therapeutic effect, which is worthy of popularization and application in clinic.

Objective:To observe the clinical effect of the treatment combined with hyperbaric oxygen (HBO) on patients with herpes zoster.Methods:A total of 72 patients with herpes zoster treated in the Department of Dermatology of Zhengzhou Second Hospital from January 2018 to December 2019 were selected and divided into HBO group and control group by random number table method, with 36 patients in each group. The control group received acyclovir and other conventional treatments, while the HBO group received HBO on the basis of the treatments of the control group. The improvement of the skin lesions, scores of numeric rating scales (NRS) on pain, and efficacy of the two groups were observed and evaluated after treatment. After a 3-month follow-up, the occurrence of postherpetic neuralgia (PHN) was statistically analyzed.Results:The time of blistering relieving, incrustation, and complete incrustation of the HBO group were all lower than those of the control group with statistically significant difference ( P<0.05). The NRS scores of both groups were all lower than those before treatment with significantly statistical difference ( P<0.01); and the NRS scores of the HBO group were significantly lower than those of the control group after treatment ( P<0.05). The total effective rate of the HBO group (91.67%) was significantly higher than that of the control group (83.33%). The difference was statistically significant ( χ2=4.31, P=0.04). After treatment, 3 cases of PHN occurred in the HBO group, while 7 cases in the control group; the PHN incidence of the HBO group was lower than that of the control group with significantly statistical difference ( P<0.05). Conclusion:In treating herpes zoster, the treatment combined with HBO can achieve a satisfactory therapeutic effect, which is worthy of popularization and application in clinic.

Objective:To observe and evaluate the clinical effect of hyperbaric oxygen combined therapy on patients with non-arteritic anterior ischemic optic neuropathy (NAION).Methods:A total of 110 patients with NAION admitted to the Department of Ophthalmology of Zhengzhou Second Hospital from January 2017 to January 2019 who met the inclusion criteria were selected and divided into control group (55 cases) and hyperbaric oxygen group (55 cases) by random number table method. The control group was given conventional therapies such as hormone shock, microcirculation improvement, and nerve nutrition, while the hyperbaric oxygen group was given conventional treatment and hyperbaric oxygen therapy, with chamber pressure of 2.0 ATA, once a day, 10 times for a course of treatment for 30 days. The visual acuity, mean sensitivity (MS), mean defect (MD), pattern visual evoked potential (PVEP) amplitude, and latency period of the two groups were observed and analyzed to evaluate the efficacy of treatment. The effect of hyperbaric oxygen combined therapy on serum human chondroglycoprotein-39 (chtinase-3-like-1 protein, YKL-40) in patients with NAION was also observed.Results:Before treatment, there were no statistically significant differences in visual acuity, mean sensitivity, mean defect, PVEP amplitude, latency period, and serum YKL-40 between the two groups ( P>0.05). The visual MD in the hyperbaric oxygen group after treatment was lower than that in the control group after treatment and also lower than that before treatment in the same group, and the differences were statistically significant ( P<0.05). The visual acuity and MS in the hyperbaric oxygen group after treatment were higher than those in the control group and also those before treatment in the same group, and the differences were statistically significant ( P<0.05). The PVEP amplitudes of the patients in the hyperbaric oxygen group were higher than those in the control group and also those before treatment in the same group, and the latency period was earlier than that in the control group and also that before treatment in the same group, with statistically significant differences ( P<0.05). The level of serum YKL-40 reached the peak after 7 days of treatment. After 3, 7, 15 and 30 days of treatment, the levels of serum YKL-40 were all lower than those of the control group on the same day, with statistically significant differences ( P<0.05). After treatment, the total effective rate of the hyperbaric oxygen group (83.63%) was higher than that of the control group (74.55%), but there was no statistically significant difference ( P>0.05). Conclusion:Hyperbaric oxygen combined therapy can significantly improve the vision acuity, MS, MD, PVEP amplitude, and latency period of the patients with NAION, and reduce inflammatory response, which is beneficial to improve clinical efficacy.