Cardiac arrest is characterized by the sudden cessation of cardiac activity,accompanied by the abrupt loss of respiration and consciousness,leading to ischemia-hypoxia in vital organs and subsequently resulting in irreversible damage.Even among patients who achieve return of spontaneous circulation(ROSC),only approximately 1%attain favorable neurological functional outcomes.The primary driver of this poor prognosis is cerebral ischemia reperfusion injury(CIRI)following cardiopulmonary resuscitation(CPR).Pharmacological intervention has become a key strategy to improve neurological recovery in these patients.Currently,a wide range of agents targeting CIRI are diverse,with diverse mechanisms of action.Commonly used clinical drugs and their mechanisms include:①Anti-inflammatory agents:Minocycline mitigates inflammation by modulating microglial polarization,while aspirin improves cerebral microcirculation via anti-platelet aggregation;②Antioxidative stress agents:Mitoquinone mesylate(MitoQ)selectively targets,mitochondria to scavenge reactive oxygen species(ROS),while Edaravone dexborneol rapidly inhibits oxidative damage through broad-spectrum free radical scavenging;③Mitochondrial dysfunction-targeted agents:Methylene blue restores energy metabolism by stabilizing mitochondrial membrane potential and inhibiting mitochondrial permeability transition pore(MPTP)opening;④Multi-targeted traditional Chinese medicine(TCM)therapy:Angong Niuhuang Wan and Danshen Chuanxiongqin alleviate brain injury by inhibiting inflammasomes,suppressing astrocyte activation,and modulating relevant signaling pathways,demonstrating the synergistic advantage of a"multi-component-multi-target"mechanism.This review systematically summarizes the mechanisms of action and research progress of these agents,aiming to provide a theoretical basis for clinical drug selection in post-CA management.

Cardiac arrest is characterized by the sudden cessation of cardiac activity,accompanied by the abrupt loss of respiration and consciousness,leading to ischemia-hypoxia in vital organs and subsequently resulting in irreversible damage.Even among patients who achieve return of spontaneous circulation(ROSC),only approximately 1%attain favorable neurological functional outcomes.The primary driver of this poor prognosis is cerebral ischemia reperfusion injury(CIRI)following cardiopulmonary resuscitation(CPR).Pharmacological intervention has become a key strategy to improve neurological recovery in these patients.Currently,a wide range of agents targeting CIRI are diverse,with diverse mechanisms of action.Commonly used clinical drugs and their mechanisms include:①Anti-inflammatory agents:Minocycline mitigates inflammation by modulating microglial polarization,while aspirin improves cerebral microcirculation via anti-platelet aggregation;②Antioxidative stress agents:Mitoquinone mesylate(MitoQ)selectively targets,mitochondria to scavenge reactive oxygen species(ROS),while Edaravone dexborneol rapidly inhibits oxidative damage through broad-spectrum free radical scavenging;③Mitochondrial dysfunction-targeted agents:Methylene blue restores energy metabolism by stabilizing mitochondrial membrane potential and inhibiting mitochondrial permeability transition pore(MPTP)opening;④Multi-targeted traditional Chinese medicine(TCM)therapy:Angong Niuhuang Wan and Danshen Chuanxiongqin alleviate brain injury by inhibiting inflammasomes,suppressing astrocyte activation,and modulating relevant signaling pathways,demonstrating the synergistic advantage of a"multi-component-multi-target"mechanism.This review systematically summarizes the mechanisms of action and research progress of these agents,aiming to provide a theoretical basis for clinical drug selection in post-CA management.

BACKGROUND: Lung cancer incidence in Macao increases gradually, smoking is one of the important high risk factors. The purpose of this study is to observe the detection rate of lung cancer and nodules in long-term smoking Macao individuals. METHODS: We recruited eligible Macao residents by publicity, all subjects were arranged to receive low-dose computed tomography screening. Image features of lung nodules were analyzed by radiologist. For suspicious lung cancer, multiple disciplinary team (MDT) was arranged. RESULTS: A total of 291 were adopted, 10 lung cancers were detected, the detection rate of lung cancer was 3.44% (95%CI: 2.78%-4.01%), all were males. There were 5 adenocarcinoma patients, each 2 squamous-cell carcinoma and small cell lung carcinoma patients; 1 adenosquamous cancer patient. Among 10 lung cancers, 40% had stage 1 disease. The detection rate of lung nodules was 72.9% (95%CI: 67.8%-78.0%); The number of suspicious lung nodules were 44, and the detection rate was 15.1% (95%CI: 11.0%-19.2%). There was no significant differences in the lung cancer detection rate between the single and multiple lung nodule groups (P>0.05). There were 168 subjects in the <6 mm solid lung nodule (SN) and <5 mm no-solid lung nodule (NSN) group and no lung cancer was found, 44 subjects in the ≥6 mm SN and ≥5 mm NSN group. All 9 lung cancer patients were detected in this group. The detection rate of lung cancer was higher than that of the <6 mm SN and <5 mm NSN group (P<0.05). CONCLUSIONS There are high detection rate of lung cancer and lung nodule in the long-term smoking individuals. The lung cancer rate increases when the lung nodule size is larger than 6 mm in SN and 5 mm in NSN. Adenocarcinoma is the major type in the smokers' lung cancers. We suggest long-term smokers should join in the future lung cancer screening trial in Macao. Female lung cancer screening should be established different standard.