Objective:To investigate the impact of different ventilation modalities during initial resuscitation on short-term outcomes in adult patients with in-hospital cardiac arrest (IHCA).Methods:This retrospective study included adult patients (age ≥18 years) admitted to the emergency resuscitation or observation units of our hospital from September 2019 to December 2021. Demographic data, comorbidities, and short-term outcomes of IHCA patients who underwent airway management during resuscitation were recorded. Participants were stratified into non-advanced airway and advanced airway groups based on ventilation modality. The primary outcome was defined as sustained return of spontaneous circulation (ROSC) ≥20 min, and secondary outcomes included survival to discharge and favorable neurological status at discharge. Logistic regression analyses were performed to assess the impact of different ventilation modalities on short-term outcomes among adult IHCA patients. and developed a prediction model of ROSC for adult IHCA patients, and its predictive performance was evaluated by the area under the curve (AUC) of the receiver operating characteristic.Results:Among 285 IHCA patients (non-advanced airway: n=75; advanced airway: n=210), 127 achieved ROSC ≥20 min, 51 survived to discharge, and 35 had favorable neurological outcomes. Logistic regression identified ventilation modality, epinephrine dose, and arrest location as independent predictors of ROSC in adult IHCA patients. Advanced airway management demonstrated significantly higher ROSC rates compared to non-advanced interventions ( OR=3.698, 95% CI:1.844-7.419, P<0.001). However, no significant associations were observed between ventilation modalities and survival to discharge ( OR=1.097, 95% CI:0.506-2.376, P=0.815) or favorable neurological outcomes at discharge ( OR=0.548, 95% CI:0.224-1.339, P=0.187). Ventilation modality, epinephrine dose, and arrest location were incorporated as predictors in a multivariable logistic regression model to develop a ROSC prediction model for adult IHCA patients. The discriminative ability of model was evaluated through receiver operating characteristic (ROC) curve analysis, yielding an AUC of 0.735 (95% CI:0.678-0.793). Subgroup analyses demonstrated that early advanced airway management significantly enhanced ROSC rates in noncardiac etiology cases, whereas no such benefit was observed in cardiac etiology cases, while this intervention correlated with decreased survival to discharge rates and deteriorated neurological outcomes among survivors. Conclusions:Advanced airway management demonstrated improved ROSC rates in adult IHCA cases, while showing no significant improvement in survival rates or favorable neurological outcomes at discharge. Ventilation modality, epinephrine dose, and arrest location are independent predictors of ROSC. A model integrating these factors exhibits moderate predictive utility for IHCA outcomes.

OBJECTIVE To explore the association of postoperative urinary tract infections with peripheral blood in-tercellular adhesion molecule-1(ICAM-1)gene polymorphisms in the patients with menopausal stress urinary in-continence.METHODS A total of 132 patients with menopausal stress urinary incontinence who received mid-ure-thral suspension surgery in the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Med-icine from Sep.2020 to Sep.2023 were recruited as the research subjects and were divided into the infection group with 25 cases and the non-infection group with 107 cases according to the status of postoperative urinary tract in-fections.The distribution of pathogens isolated from the infection group was statistically analyzed.The peripheral blood ICAM-1 gene polymorphisms and the levels of soluble triggering receptor expressed on myeloid cells(sTREM-1),high-mobility group box 1(HMGB1)and monocyte chemoattractant protein-1(MCP-1)were ob-served and compared between the two groups.The values of the three markers in diagnosis of the postoperative u-rinary tract infections in the patients with menopausal stress urinary incontinence were analyzed.RESULTS Totally 34 strains of pathogens were isolated from the 25 patients of the infection group,21(61.76％)of which were gram-negative bacteria,Escherichia coli(11 strains,32.35％)was the predominant species of the gram-negative bacteria.The frequencies of KK genotype at K469E locus of ICAM-1 gene and K allele of the infection group were higher than those of the non-infection group,while the frequencies of EE genotype and E allele of the infection group were lower than those of the non-infection group(P＜0.05).There were significant differences in the levels of serum sTREM-1,HMGB1 and MCP-1 between the infection group and the non-infection group(P＜0.05);the MCP-1 level of the infection group was(63.68±20.63)pg/ml,higher than that of the non-infection group(t=6.472,P＜0.001).The area under the curve(AUC)value of the single detection of the three markers was lower in diagnosis of the postoperative urinary tract infections in the patients with menopausal stress urinary in-continence than that of the joint detection of the three markers(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the menopausal stress urinary incontinence patients with postoperative urinary tract infections.The patients show the increased expressions of sTREM-1,HMGB1 and MCP-1;the joint detection of the three markers has more advantages in auxiliary diagnosis of the postoperative u-rinary tract infections.The susceptibility to the postoperative urinary tract infections is associated with the ICAM-1 gene polymorphisms.

OBJECTIVE To explore the association of postoperative urinary tract infections with peripheral blood in-tercellular adhesion molecule-1(ICAM-1)gene polymorphisms in the patients with menopausal stress urinary in-continence.METHODS A total of 132 patients with menopausal stress urinary incontinence who received mid-ure-thral suspension surgery in the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Med-icine from Sep.2020 to Sep.2023 were recruited as the research subjects and were divided into the infection group with 25 cases and the non-infection group with 107 cases according to the status of postoperative urinary tract in-fections.The distribution of pathogens isolated from the infection group was statistically analyzed.The peripheral blood ICAM-1 gene polymorphisms and the levels of soluble triggering receptor expressed on myeloid cells(sTREM-1),high-mobility group box 1(HMGB1)and monocyte chemoattractant protein-1(MCP-1)were ob-served and compared between the two groups.The values of the three markers in diagnosis of the postoperative u-rinary tract infections in the patients with menopausal stress urinary incontinence were analyzed.RESULTS Totally 34 strains of pathogens were isolated from the 25 patients of the infection group,21(61.76％)of which were gram-negative bacteria,Escherichia coli(11 strains,32.35％)was the predominant species of the gram-negative bacteria.The frequencies of KK genotype at K469E locus of ICAM-1 gene and K allele of the infection group were higher than those of the non-infection group,while the frequencies of EE genotype and E allele of the infection group were lower than those of the non-infection group(P＜0.05).There were significant differences in the levels of serum sTREM-1,HMGB1 and MCP-1 between the infection group and the non-infection group(P＜0.05);the MCP-1 level of the infection group was(63.68±20.63)pg/ml,higher than that of the non-infection group(t=6.472,P＜0.001).The area under the curve(AUC)value of the single detection of the three markers was lower in diagnosis of the postoperative urinary tract infections in the patients with menopausal stress urinary in-continence than that of the joint detection of the three markers(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the menopausal stress urinary incontinence patients with postoperative urinary tract infections.The patients show the increased expressions of sTREM-1,HMGB1 and MCP-1;the joint detection of the three markers has more advantages in auxiliary diagnosis of the postoperative u-rinary tract infections.The susceptibility to the postoperative urinary tract infections is associated with the ICAM-1 gene polymorphisms.

Objectiveto investigate the differential expression of intestinal flora and serum metabolites and potential biomarkers in patients with pre-diabetic sputum syndrome. MethodA total of 34 patients with pre-diabetic sputum syndrome were included as the phlegm syndrome group，and 37 healthy people were selected as the normal group. Serum and fecal samples of the two groups were collected，and liquid chromatography-mass spectrometry （LC-MS） non-targeted metabolomics and 16S rRNA high-throughput sequencing technology were used to detect serum metabolites and different intestinal flora of the two groups and explore the relationship among pre-diabetic sputum syndrome，serum metabolites，and intestinal flora. ResultIn the distribution of disease syndrome elements in the phlegm syndrome group，the first five disease syndrome elements in terms of frequency and proportion were dampness （73.53%），Qi stagnation （58.82%），Yin deficiency （50.00%），blood stasis （41.18%），and heat （35.29%）. According to the frequency and proportion of disease location syndrome elements，the first three main disease location syndrome elements were spleen （100.00%），liver （41.18%），and kidney （23.53%）. The results of 16S rRNA high-throughput sequencing showed that there were 44 different intestinal flora between the two groups. In order genus，there were significant differences in Bifidobacterium，Veillonococcus，and Roseococcus between the two groups （P<0.05）. The diversity，abundance，and evenness of intestinal flora in the phlegm syndrome group were lower than those in the normal group，with the difference not statistically significant. There was no significant difference in the community structure between two groups. The results of serum metabolomics showed that there were 13 differential metabolites in the two groups，which were mainly concentrated in amino acid metabolism，bile secretion，bile acid biosynthesis，and lipid metabolism （P<0.05）. The correlation among differential metabolites，intestinal flora，and syndrome elements was analyzed，and the results showed that ① lysine was positively correlated with spleen，Yin deficiency，and blood stasis，while taurocholic acid was positively correlated with liver，kidney，blood stasis，and dampness，and there was a positive correlation between taurocholic acid and yin deficiency and heat. The taurochenodeoxycholic acid was positively correlated with liver and dampness，and there was a negative correlation between arachidonic acid and dampness，as well as a positive correlation between glucose and spleen and blood stasis. ② Clostridium was positively correlated with spleen，kidney，Yin deficiency，and Qi stagnation. Rosepiella was negatively correlated with spleen，and Sutterella was negatively correlated with dampness. Bacteroides was negatively correlated with the spleen and kidney，and Bifidobacterium was negatively correlated with the spleen and dampness. ③ Bifidobacterium was positively correlated with glycine，threonine，lysine，and deoxycholic acid significantly，negatively correlated with cholic acid significantly，and positively correlated with taurochenodeoxycholic acid and pyruvic acid. Clostridium was positively correlated with glycine significantly and positively correlated with threonine and lysine. Lachnospira was negatively correlated with glycine，threonine，and pyruvic acid. Lysine was also negatively correlated with Faecalibacterium and Eubacterium ventriosum and positively correlated with Megamonas. There was a positive correlation between taurocholic acid and glycine bile acid and Campylobacter，between taurochenodeoxycholic acid and Veillonococcus，and between glucose and Rosepiella and Eubacterium ventriosum. There was a negative correlation between pyruvic acid and Escheria-Shigella and between taurochenodeoxycholic acid and Prevotella. Conclusionthere are differences in intestinal flora and serum metabolites between patients with pre-diabetic sputum syndrome and healthy people. The intestinal flora and metabolites have been disturbed in the stage of pre-diabetes，Bifidobacterium，Clostridium，Lachnospira，glycine，threonine，and lysine may be the breakthrough to explore the development of pre-diabetic sputum syndrome.

From the perspective of state differentiation and treatment， it is believed that the pathogenesis of acute respiratory distress syndrome （ARDS） is that evil poisons injured the lungs， and the lung qi suddenly collapsed， then blocked and exhausted， and the qi failure to control blood and liquid， then the fluids overflow outside the vessels， and damp phlegm， stasis， and toxins became knotted up in the body， which ultimately leads to qi dysfunction， and a series of symptom arise， so qi impairment is the principal mechanism of ARDS. A combination of Chinese and Western medicine was proposed to treat ARDS by combining tangible qi and intangible qi， using Chinese herbal medicine to boost qi and relieve collapse， percolate and drain dampness with bland medicinals， resolve toxins and dissolve stasis， and regulate qi， and combining with Western medicine to assist qi circulation to improve qi's consolidation， propulsion， and transformation， so as to make the evil qi go away， the positive qi restored， the viscera qi circulated， qi， blood， yin， and yang connected， and the activities of life maintained， and thus to achieve the goal of treating ARDS by integrated Chinese medicine and Western medicine.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Objective To investigate the effect and monitoring point of continuous veno-venous hemofil-tration (CVVH) in patients with multiple organ dysfunction syndrome (MODS). Methods In 22 patients with MODS,a double lumen catheter was put into the central vein,and the CWH was performed with the BRAUN Diapact CRRT. The level of BUN,Scr,serum potassium and arterial blood gas were measured 30 minutes before and after CVVH. The plasma TNF-α、IL-1、IL-8 were measured by ELISA. Vital signs were monitored dur-hag treatment process. Results The vital signs of all patients` was stable, the levels of BUN,Scr and serum potassium decreased significantly after CVVH. The plasma concentrations of TNF-α,IL-1 and IL-8 gradually decreased. Conclusions CWH can improve the blood biochemical markers,remove inflammatory cytokines in plasma,stsblize the vital signs during treatment,which is suitable for patients with MODS.