Objective:To investigate the predictive value of refeeding syndrome (RFS) and its influencing factors for 30-day intensive care unit (ICU) readmission in critically ill patients.Methods:A prospective cohort study was conducted. Critically ill patients admitted to the department of critical care medicine, department of respiratory and critical care medicine, and department of neurology at Tianjin Medical University General Hospital from January to April in 2025 were enrolled. Patients were assessed for RFS according to the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria. General information within 24 hours of ICU admission was collected via the electronic medical record system. Treatment details and 30-day ICU readmission status were dynamically recorded. Participants were divided into readmission and non-readmission groups based on whether ICU readmission occurred within 30 days. Intergroup comparisons were performed to identify differences. Multivariate Logistic regression was used to analyze the relationship between RFS and its influencing factors with 30-day ICU readmission. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of risk factors.Results:A total of 196 critically ill patients were enrolled, among whom 25 (12.76%) were readmitted to ICU within 30 days and 171 (87.24%) were not. Significant differences were observed in the readmission group compared with the non-readmission group, including significantly higher rates of nasogastric decompression, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, a higher incidence of RFS, and a longer duration of nasogastric decompression. Multivariate Logistic regression analysis showed that RFS was an independent risk factor for 30-day ICU readmission [odds ratio ( OR) = 5.756, 95% confidence interval (95% CI) was 1.603-20.670, P = 0.007]. APACHEⅡ score showed a positive correlation trend with 30-day ICU readmission ( OR = 1.057, 95% CI was 0.991-1.127, P = 0.092). ROC curve analysis showed that the combined prediction model incorporating RFS and APACHEⅡ score had an area under the ROC curve (AUC) of 0.766 (95% CI was 0.668-0.864), with a sensitivity of 88.0% and a specificity of 62.0%, which was significantly superior to a single indicator (the AUC of RFS and APACHEⅡ score was 0.639 and 0.624, respectively). Conclusions:RFS significantly increases the risk of 30-day ICU readmission in critically ill patients. A combined model incorporating RFS and APACHEⅡ score demonstrates good predictive efficacy for 30-day ICU readmission in critically ill patients.

Objective:To investigate the predictive value of refeeding syndrome (RFS) and its influencing factors for 30-day intensive care unit (ICU) readmission in critically ill patients.Methods:A prospective cohort study was conducted. Critically ill patients admitted to the department of critical care medicine, department of respiratory and critical care medicine, and department of neurology at Tianjin Medical University General Hospital from January to April in 2025 were enrolled. Patients were assessed for RFS according to the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria. General information within 24 hours of ICU admission was collected via the electronic medical record system. Treatment details and 30-day ICU readmission status were dynamically recorded. Participants were divided into readmission and non-readmission groups based on whether ICU readmission occurred within 30 days. Intergroup comparisons were performed to identify differences. Multivariate Logistic regression was used to analyze the relationship between RFS and its influencing factors with 30-day ICU readmission. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of risk factors.Results:A total of 196 critically ill patients were enrolled, among whom 25 (12.76%) were readmitted to ICU within 30 days and 171 (87.24%) were not. Significant differences were observed in the readmission group compared with the non-readmission group, including significantly higher rates of nasogastric decompression, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, a higher incidence of RFS, and a longer duration of nasogastric decompression. Multivariate Logistic regression analysis showed that RFS was an independent risk factor for 30-day ICU readmission [odds ratio ( OR) = 5.756, 95% confidence interval (95% CI) was 1.603-20.670, P = 0.007]. APACHEⅡ score showed a positive correlation trend with 30-day ICU readmission ( OR = 1.057, 95% CI was 0.991-1.127, P = 0.092). ROC curve analysis showed that the combined prediction model incorporating RFS and APACHEⅡ score had an area under the ROC curve (AUC) of 0.766 (95% CI was 0.668-0.864), with a sensitivity of 88.0% and a specificity of 62.0%, which was significantly superior to a single indicator (the AUC of RFS and APACHEⅡ score was 0.639 and 0.624, respectively). Conclusions:RFS significantly increases the risk of 30-day ICU readmission in critically ill patients. A combined model incorporating RFS and APACHEⅡ score demonstrates good predictive efficacy for 30-day ICU readmission in critically ill patients.

OBJECTIVE To explore the discrimination of processing degree of Zingiber officinale charcoal and the correlation between color and component content based on machine vision system， and provide reference for quality evaluation and processing degree control of Z. officinale charcoal. METHODS High-performance liquid chromatography method was used to determine the contents of 5 components in Z. officinale charcoal and its different processed products， such as 6-gingerol， 8-gingerol， 10-gingerol， 6-shogaol， gingerone. Machine vision system was used to obtain the image of the decoction pieces and extract the color features of the decoction pieces in RGB， L*a*b* and HSV color spaces. Machine learning methods， such as principal component analysis （PCA）， linear discriminant analysis （LDA）， partial least squares-discriminant analysis （PLS-DA） and support vector machine （SVM）， were used to establish qualitative identification model for Z. officinale charcoal processed products of different processing degree. The correlation between the color eigenvalues and the contents of measured 5 components were analyzed， and the color- component content prediction model was established.RESULTS With the deepening of processing， gingerone was produced after processing and the content firstly increased and then decreased， and the content of gingerone in standard carbon was the highest； the contents of 6-gingerol， 8-gingerol and 10-gingerol decreased gradually； the content of 6-shogaol increased firstly and then decreased. The prediction accuracy of qualitative discriminant model， which was established on the basis of objective quantization of image and color combined with LDA and SVM of supervised discriminant pattern recognition method， reached 100% in cross-validation training and 95.83% in the external validation. Content prediction model of 5 components was established on the basis of objective quantization of image and color combined with SVM， the RPD values were all greater than 2， the R2P and R2C values of gingerone were 0.633 9 and 0.683 3， and the values of other components were all greater than 0.75， indicating SVM had good prediction ability for the contents of 4 components except for gingerone. CONCLUSIONS The machine vision system is excellent for the discrimination of the processing degree of Z. officinale charcoal and the content prediction， which can provide a reference for the quality control of Z. officinale charcoal decoction pieces and the judgment of the processing degree.

Citri Reticulatae Pericarpium is a commonly used traditional Chinese medicine in China. By referring to herbal monographs and related research documents， and comparing all editions of Chinese Pharmacopoeia and local processing specifications， the processing history， modern processing specifications， study on chemical constituents and pharmacological effects before and after processing of Citri Reticulatae Pericarpium were summarized. It was found that the processing methods of Citri Reticulatae Pericarpium in the past dynasties were mainly cleansing， cutting and frying. The processing methods of Citri Reticulatae Pericarpium included in all editions of Chinese Pharmacopoeia were all cleansing and cutting. In modern local processing specifications， there were mainly processing methods such as frying， steaming and carbonizing. The components of Citri Reticulatae Pericarpium were mainly volatile oil and flavonoids. After processing， the total amount of volatile oil generally decreased， and the contents and compositions of volatile oil and flavonoids also changed. It may be the main reason for the difference of efficacy before and after processing. At present， the optimization of processing technology of Citri Reticulatae Pericarpium mainly focuses on steaming， processing with vinegar and baking. Pharmacological research on Citri Reticulatae Pericarpium mainly focuses on reducing blood lipid， relieving cough， relieving asthma and resolving phlegm， and inhibiting pulmonary fibrosis. The current research on the processing methods of Citri Reticulatae Pericarpium is not in-depth enough， the material basis of many processing methods has not been clarified， and the research on the efficacy before and after processing is not in-depth enough. Further research is needed to clarify the material basis and mechanism after the processing of Citri Reticulatae Pericarpium， so as to standardize the processing method and establish specific quality standards.

As a traditional Chinese medicinal material， Citri Sarcodactylis Fructus is often used as medicine after steaming to reduce its pungency and give full play to its medicinal effects. By consulting the relevant literature， this paper intends to sort out the related researches on the processing history， modern processing standard records， flavor and meridian tropism， efficacy， processing and taking methods， processing technology， chemical composition， pharmacological effects and quality analysis of Citri Sarcodactylis Fructus. It is found that the processing methods of Citri Sarcodactylis Fructus in the past dynasties are mainly roasting， distilled into dew， aging， frying， salting and steaming， of which steaming is the most common. In modern times， steaming is mainly used in Guangdong and Sichuan. The descriptions of flavor and meridian tropism and efficacy of Citri Sarcodactylis Fructus in the past dynasties are basically consistent with the modern descriptions. Its taste is pungent， bitter and acidic， and it is warm in nature. It belongs to the liver， spleen， stomach and lung meridians. Citri Sarcodactylis Fructus contains volatile oil， flavonoids and their glycosides， coumarins and limonins and other compounds. In recent years， high performance liquid chromatography （HPLC）， gas chromatography-mass spectrometry （GC-MS） and ultra performance liquid chromatography-mass spectrometry （UPLC-MS） and other methods are commonly used for the chemical composition analysis. Citri Sarcodactylis Fructus has the activities of relieving cough， reducing phlegm， relieving asthma， anti-inflammation， anti-bacteria and anti-oxidation， etc. After processing， its volatile and non-volatile components， and pharmacological effects all have a certain change. However， the current research on processing of Citri Sarcodactylis Fructus is not in-depth enough. It is necessary to further analyze the material basis of steaming to reduce dryness， explore its dryness medicinal substances and dryness-effect quantitative correlation， so as to clarify its processing mechanism， and provide basis for the subsequent processing research， resource development and comprehensive application of Citri Sarcodactylis Fructus in the future.

O BJECTIVE To optimize stir-frying with saltwater technology of Citrus reticulata . METHODS Taking the contents of limonin ，nomilin and obacunone ，color difference value and free radical scavenging rate of 1，1-diphenyl-2-trinitrophenyl hydrazine （DPPH） as the indexes ，the entropy weight method was used for comprehensive evaluation. The stir-frying with saltwater technology of C. reticulata was optimized by central composite design-response surface method by using water-salt ratio ，stewing time，frying temperature and frying time as factors. RESULTS The optimal stir-frying with saltwater technology of C. reticulata included water-salt ratio of 8 ∶ 1（mL/g），stewing time of 22 min，frying time of 9 min and frying temperature of 158 ℃. After three times of validation tests ，the average comprehensive score of the optimized technology was 92.35（RSD＝2.19％），and its relative error with the predicted value （93.25）was 1.10％. CONCLUSIONS The optimal stir-frying with saltwater technology is stable and feasible.

Objective:To explore the detection rate, missed diagnosis rate, and clinical significance of incidental extra-hip findings (IEHFs) in hip joint MRI.Methods:The data of 1 734 cases who underwent MRI examination of hip joint from September 2014 to September 2018 at the First Central Hospital of Baoding City were retrospectively analyzed. According to the revised CT colonography reporting and data system (C-RADS), the IEHFs were divided into 4 types using structural imaging reading method. E1 type was anatomical variation; E2 type was sign without clinical significance; E3 type was sign with little clinical significance; E4 type was sign with important clinical significance. The types and distributions of IEHFs were analyzed, and the results of structural imaging reading were compared with those of the initial MRI reports. The missed diagnosis rate was calculated in this group.Results:Among the 1 734 patients, 1 651 of IEHFs were found in 1 064 patients. There were 1 080 E2 type IEHFs (65.4%, 1 080/1 651), with cervical cysts (26.0%, 281/1 080) accounting for the largest number. There were 354 IEHFs of E3 type (21.4%, 354/1 651), with most cases were prostatic hyperplasia (47.2%, 167/354). There were 217 IEHFs of E4 type (13.1%, 217/1 651), most of which were the enlarged lymph nodes in the inguinal region (30.9%, 67/217). E2 and E3 IEHFs accounted for a great proportion in male patients. The proportion of E2 IEHFs was the largest in female patients. There was significant difference in IEHFs composition between male and female patients (χ2=294.080, P<0.001). The IEHFs of patients under 60 years old were mainly E2 type, while those of over 60 years old patients were mainly E3 type. There was significant difference in IEHFs composition among different age groups (χ2=206.702, P<0.001). The overall missed diagnosis rate of IEHFs was 85.2% (1 406/1 651). The missed diagnosis rate of E2 was the highest (91.1%, 984/1 080), and that of E4 was the lowest (63.1%, 137/217). Conclusion:The incidence of IEHFs in patients undergoing hip joint MRI are prevalent. The structural imaging reading method can increase the detection of IEHFs. Therefore, it is suggested that revised C-RADS be used to grade IEHFs to reduce the rate of missed diagnosis.

Objective: To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20. Methods: A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results: (1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P<0.05). The Lac value in cesarean section group was the lowest[(1.79±1.25) mmol/L], while that in midwifery group was the highest[(4.45±1.58) mmol/L]. pH value was the lowest (7.25±0.07) in the midwifery group and the highest (7.31±0.06) in the cesarean section group.The value of BE was the lowest in the midwifery group[-(5.66±2.52) mmol/L], and the highest in the cesarean section group[-(2.99±2.28) mmol/L], with statistically significant differences among the three groups (P<0.05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress, premature rupture of membranes, and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns.Methods of delivery, intrauterine distress, premature rupture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns.(3) A total of 199 cases with pH value <7.2 were diagnosed as asphyxia, and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn.When Lac was >3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH <7.2, the cut points of Lac and BE are >3.97 mmol/L and ≤-6 mmol/L, respectively.

OBJECTIVETo summarize the 2491 acupuncture inpatient consultations in Qilu Hospital of Shandong University during 2014, and analyze the application of acupuncture in comprehensive hospital, hoping to provide direction and methods for clinical practice and scientific research of acupuncture.

METHODSThe consultation record and hospitalization information during 2014 in Department of Acupuncture-Moxibustion and Tuina, Qilu Hospital of Shandong University, were collected and summarized through Inpatient Information Management System. The distribution of consultation discipline and disease were analyzed.

RESULTSAmong all the consultations, 15 second-class disciplines were involved, and the number of neurology and surgery was 1399, accounting for 59.00% of all consultation. 111 types of diseases were found in consultation, mainly postoperative complications, cerebrovascular disease and arthropathy. The primary disease of consultations involved all the systems, mainly nervous system disease, musculoskeletal system disease, connective tissue diseases and genitourinary system diseases, accounting for 73.89% of all consultations. .

CONCLUSIONAcupuncture is closely related with clinical disciplines of neurology and surgery. The cooperation between acupuncture and pediatrics and oncology should be strengthened. Acupuncture has an advantage over treating postoperative complications and neuromuscular diseases.

OBJECTIVE:To elucidate the efficacy and mechanism of Hugan tablets in hepatoprotective effects from perspective of metabolic pathways. METHODS:36 male rats were randomly divided into normal group (0.5%sodium carboxymethyl cellu-lose),model group(0.5%sodium carboxymethyl cellulose)and Hugan tablets group(1.7 g/kg),12 in each group,intragastrically administrated once a day,for 9 d. After 1 h of last administration,rats in model group and Hugan tablets group were intraperitone-ally injected 50%CCl4 peanut oil solution 1 mL/kg to induce liver injury. After 24 h of modeling,malondialdehyde(MDA),super-oxide dismutase(SOD),glutathione peroxidase(GSH-Px)levels in liver tissue of rats were detected. Nuclear magnetic resonance spectroscopy(1H-NMR)metabolomics technique was adopted to establish the serum and liver metabolite profiles of rats,and the ef-fects of Hugan tablets on changes of metabolic profile and potential biomarkers in serum and liver of rats with CCl4-induced acute liver injury were analyzed. RESULTS:Compared with normal group,MDA level in liver tissue of rats in model group was signifi-cantly increased(P<0.05),SOD and GSH-Px levels were significantly reduced(P<0.05). Both body physiology and material me-tabolism of rats were obviously changed,and levels of 11 metabolic potential biomarkers in serum and 14 metabolic potential bio-markers in liver were significantly increased/decreased (P<0.05). Compared with model group,MDA level in liver tissue in Hugan tablets group was significantly reduced(P<0.05),SOD and GSH-Px levels were significantly increased(P<0.05). Serum and liver metabolism tended to be normal,6 metabolic potential biomarkers(isoleucine,leucine,3-hydroxybutyrate,acetone,ace-toacetate,choline) in serum and 8 metabolic potential biomarkers (3-hydroxybutyrate,alanine,glutamate,pyruvate,succinate, choline,lactate,glucose)in liver got significant callback(P<0.05). CONCLUSIONS:The hepatoprotective mechanism of Hugan tablets may be associated with antioxidative stress and regula-tion of lipid metabolism,glucose metabolism and amino acid metabolism.