Objective:To evaluate the safety and efficacy of secondary transport on extracorporeal membrane oxygenation (ECMO) for critically ill children.Methods:This was a retrospective cohort study. Data from 222 pediatric patients who underwent ECMO transport from May 2019 to May 2024 at 5 ECMO centers and Chinese Database of Pediatric Extracorporeal Life Support Organization were collected. The cases were divided into primary and secondary transport groups by nature of transport. The clinical data, including demographics, ECMO indications, transport distance, pre-transport lab results, prognosis and complications were analyzed. Two independent samples t-test, Wilcoxon test, and χ2 test or Fisher′s exact probability method were used to compare the differences between 2 groups and evaluate the safety and efficacy of secondary transport. Results:Among the 222 children transported with ECMO, there were 135 males and 87 females, with an age of 3.0 (0.2, 7.0) years. There were 202 cases in the primary transport group and 20 cases in the secondary transport group. All secondary transport patients had failed attempts at weaning ECMO before transfer. The patients in the secondary transport group were older, had higher rates of surgical cannulation, circulatory support, and pre-ECMO lactate levels compared to the primary transport group (7.0 (2.8, 10.0) vs. 3.0 (0.2, 6.0) years old, 55.0% (11/20) vs. 3.6% (7/202), 80.0% (16/20) vs. 41.6% (84/202), (10±4) vs. (7±6) mmol/L, Z=3.41, χ 2=66.31, 10.99, t=2.24, all P<0.05). In the secondary transport group, the vasoactive-inotropic scores of patients on circulatory support and the oxygenation index for patients requiring respiratory support were higher than those in the primary transport group (83±33 vs. 82±68, 51.0±1.8 vs. 37.4±10.2, t=2.36, 2.63, respectively; both P<0.05). There were no statistically significant differences between the 2 groups in sex, transport distance, pre-ECMO creatinine, arterial blood gas BE values, and ECMO duration (all P>0.05). No life-threatening complications occurred during the transport in either group. Two patients in the secondary transport group underwent heart transplantation, and 1 patient underwent radiofrequency ablation. The overall survival rate between the 2 groups showed no statistically significant difference (45.0% (9/20) vs. 55.4% (112/202), χ2=1.15, P>0.05). Conclusions:Secondary ECMO transport for critically ill children don't increase mortality or life-threatening complications during transport. ECMO patients who cannot receive effective treatment locally can benefit from secondary transport to an advanced ECMO center provides further treatment opportunities.

Objective:To evaluate the safety and efficacy of secondary transport on extracorporeal membrane oxygenation (ECMO) for critically ill children.Methods:This was a retrospective cohort study. Data from 222 pediatric patients who underwent ECMO transport from May 2019 to May 2024 at 5 ECMO centers and Chinese Database of Pediatric Extracorporeal Life Support Organization were collected. The cases were divided into primary and secondary transport groups by nature of transport. The clinical data, including demographics, ECMO indications, transport distance, pre-transport lab results, prognosis and complications were analyzed. Two independent samples t-test, Wilcoxon test, and χ2 test or Fisher′s exact probability method were used to compare the differences between 2 groups and evaluate the safety and efficacy of secondary transport. Results:Among the 222 children transported with ECMO, there were 135 males and 87 females, with an age of 3.0 (0.2, 7.0) years. There were 202 cases in the primary transport group and 20 cases in the secondary transport group. All secondary transport patients had failed attempts at weaning ECMO before transfer. The patients in the secondary transport group were older, had higher rates of surgical cannulation, circulatory support, and pre-ECMO lactate levels compared to the primary transport group (7.0 (2.8, 10.0) vs. 3.0 (0.2, 6.0) years old, 55.0% (11/20) vs. 3.6% (7/202), 80.0% (16/20) vs. 41.6% (84/202), (10±4) vs. (7±6) mmol/L, Z=3.41, χ 2=66.31, 10.99, t=2.24, all P<0.05). In the secondary transport group, the vasoactive-inotropic scores of patients on circulatory support and the oxygenation index for patients requiring respiratory support were higher than those in the primary transport group (83±33 vs. 82±68, 51.0±1.8 vs. 37.4±10.2, t=2.36, 2.63, respectively; both P<0.05). There were no statistically significant differences between the 2 groups in sex, transport distance, pre-ECMO creatinine, arterial blood gas BE values, and ECMO duration (all P>0.05). No life-threatening complications occurred during the transport in either group. Two patients in the secondary transport group underwent heart transplantation, and 1 patient underwent radiofrequency ablation. The overall survival rate between the 2 groups showed no statistically significant difference (45.0% (9/20) vs. 55.4% (112/202), χ2=1.15, P>0.05). Conclusions:Secondary ECMO transport for critically ill children don't increase mortality or life-threatening complications during transport. ECMO patients who cannot receive effective treatment locally can benefit from secondary transport to an advanced ECMO center provides further treatment opportunities.

Objective: To explore the risk factors and prognosis of pulmonary infection in patients with acute cerebral infarction. Methods: From May 2015 to October 2017, the clinical data of 236 patients with acute cerebral infarction in the First People's Hospital of Jinzhong were studied.The patients were divided into infection group (36 cases) and uninfected group (200 cases) according to whether or not the infection occurs.The clinical data and prognosis were compared between the two groups for half a year. Results: The age, disturbance of consciousness, difficulty swallowing, invasive operation, large area cerebral infarction between the infected group and uninfected group had statistically significant differences (t=11.093, χ²=83.388, 69.925, 43.274, 151.345, all P<0.05). Logistic regression analysis showed that the results of age, consciousness disorder, dysphagia, invasive operation and massive cerebral infarction all had statistically significant differences(all P<0.05). In the infected group, the length of hospitalization[(23.24±5.61)d] and the cost of hospitalization[(15 239.24±3 522.60) CNY]were significantly higher than those in the uninfected group[(15.65±2.35)d, (9687.24±2215.78) CNY](t=13.671, 12.486, all P<0.05). After treatment for 6 months, the neural function defect scale of the infection group[(24.26±2.12)points] was significantly higher than that of the uninfected group[(16.24±2.23)points], and the daily life activities ability score of the infection group[(70.12±2.81)points] was significantly lower than that of the uninfected group[(79.24±3.25) points], the differences were statistically significant between the two groups(t=20.009, 15.800, all P<0.05). Conclusion There are many risk factors of pulmonary infection in patients with acute cerebral infarction, such as advanced age, invasive operation, disturbance of consciousness, dysphagia, large area cerebral infarction and so on.The prognosis of patients with acute cerebral infarction complicated with pulmonary infection is poor.

Objective To analyze the efficacy and safety of amiodarone in the treatment of patients with tachyarrhythmia in emergency department.Methods The clinical data of 112 patients with emergency tachyarrhythmia admitted to the Emergency Department of the First People's Hospital of Jinzhong from March 2017 to March 2018 were analyzed.According to the different treatment plans applied,the patients were divided into two groups,with 56 patients in each group.The control group was given routine emergency treatment,and the observation group was treated with routine emergency treatment and amiodarone.The efficacy,blood pressure,heart rate and safety in the two groups were compared.Results The total effective rate in the observation group was 91.07％,which was higher than that in the control group(69.64％) (x2 =8.145,P ＜ 0.05).The diastolic blood pressure,systolic blood pressure and heart rate in the observation group were (77.40:±:6.21) mmHg,(124.24 ± 6.15) mmHg and (130.18 ± 6.14) beats/min,respectively,which were lower than those in the control group[(93.47 ± 7.40)mmHg,(140.60 ± 7.48)mmHg and (150.35 ± 12.32) bests/main] (x2 =8.145,t =12.448,12.642,10.966,all P ＜ 0.05).The total incidence rate of adverse reactions in the observation group was 3.57％,which was lower than 19.64％ in the control group (x2 =7.049,P ＜0.05).Conclusion For patients with tachyarrhythimia in the emergency department,the application of amiodarone has significant curative effects and high safety,which can help stabilize their blood pressure,heart rate and improve their conditions,and yet incurs less adverse reactions.Therefore,it is of significant value to be popularized in clinical applications.

Objective    To explore the diagnostic value of circulating tumor cells (CTC) measured by magnetic nanoparticle method in lung cancer. Methods    (1) We measured binding capability of A549 or NCI-H1965 cell lines with recognition peptide and capture efficiency by adding tumor cells into the whole blood of healthy human. (2) We measured CTC of 34 patients suspected with lung cancer, and the counting results of CTC were compared with the following pathological results. Results    (1) The binding capability was 80.0%±6.0% for A549 and 70.1%±4.8% for H1957, while the capture efficiency was 57.3%±7.0% for A549 and 37.3%±6.1% for H1975. (2) CTCs were identified in 71.9% of patients with lung cancer. The specificity was 83.3%, and area under receiver operating characteristic (ROC) curve was 0.792 (P=0.003). Conclusion    CTC measured by magnetic nanoparticle method has promising application in the diagnosis of lung cancer.