Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

Objective:To analyze the influence of Internet + health coach technology (E-Coach) management mode on anticoagulant management and negative mood in patients with atrial fibrillation, and to provide intervention measures for improving anticoagulant management and alleviating negative mood in patients with atrial fibrillation.Methods:Using single-center randomized control study, 78 patients with atrial fibrillation from June 2022 to June 2023 in the Second Hospital, Jiaxing City by convenience sampling method was divided into intervention group (E-Coach management mode based on routine management) and control group (routine management) by random digits table method, 39 cases in each group. The intervention time was 6 months. The anticoagulant knowledge mastery situation, medication compliance, anxiety and depression scores were evaluated before and after the intervention in the two groups. The number of international normalized ratio (INR) full monitoring, days required for INR to reach the first standard (2.0-3.0), the rate of effective anticoagulation, the number of monitoring after INR≤3, bleeding and thrombosis were compared between the two groups.Results:One case was lost to follow-up in the intervention group, and three cases were lost to follow-up in the control group. The final trial intervention group consisted of 38 cases, while the control group consisted of 36 cases. There were 10 males and 26 females in the control group, aged (57.78 ± 10.50) years old, and 12 males and 26 females in the intervention group, aged (60.16 ± 9.86) years old. There were no significant differences in the anticoagulation knowledge mastery situation, medication compliance, anxiety and depression scores (all P>0.05). After the intervention, the scores of anticoagulation knowledge mastery and medication compliance were (13.68 ± 2.11), (7.39 ± 0.42) points in the intervention group, and (9.08 ± 1.93), (5.91 ± 0.85) points in the control group. There were significant differences between the two groups ( t=-9.77, -9.58, both P<0.01). The depression and anxiety scores were (48.74 ± 7.68), (50.61 ± 6.15) points in the intervention group, and (62.97 ± 9.66), (56.42 ± 7.13) points in the control group. There were significant difference between the two groups ( t=7.04, 3.76, both P<0.01). The number of INR full monitoring, days required for INR to reach the first standard, the rate of effective anticoagulation, and the number of monitoring after INR≤ 3 were (10.42 ± 2.04) times, (6.66 ± 1.70) times, 58.1%(25/38), 2.6%(1/38) in the intervention group, and (7.94 ± 1.76) times, (12.72 ± 2.45) times, 33.3%(12/36), 25.0%(9/36) in the control group. There were significant difference between the two groups ( t= -5.59, 12.45, χ2=4.84, 6.12, all P<0.05). Conclusions:E-Coach management mode effectively improves the anticoagulant management ability of patients with atrial fibrillation and reduces their negative emotions.

Objective:To analyze the influence of Internet + health coach technology (E-Coach) management mode on anticoagulant management and negative mood in patients with atrial fibrillation, and to provide intervention measures for improving anticoagulant management and alleviating negative mood in patients with atrial fibrillation.Methods:Using single-center randomized control study, 78 patients with atrial fibrillation from June 2022 to June 2023 in the Second Hospital, Jiaxing City by convenience sampling method was divided into intervention group (E-Coach management mode based on routine management) and control group (routine management) by random digits table method, 39 cases in each group. The intervention time was 6 months. The anticoagulant knowledge mastery situation, medication compliance, anxiety and depression scores were evaluated before and after the intervention in the two groups. The number of international normalized ratio (INR) full monitoring, days required for INR to reach the first standard (2.0-3.0), the rate of effective anticoagulation, the number of monitoring after INR≤3, bleeding and thrombosis were compared between the two groups.Results:One case was lost to follow-up in the intervention group, and three cases were lost to follow-up in the control group. The final trial intervention group consisted of 38 cases, while the control group consisted of 36 cases. There were 10 males and 26 females in the control group, aged (57.78 ± 10.50) years old, and 12 males and 26 females in the intervention group, aged (60.16 ± 9.86) years old. There were no significant differences in the anticoagulation knowledge mastery situation, medication compliance, anxiety and depression scores (all P>0.05). After the intervention, the scores of anticoagulation knowledge mastery and medication compliance were (13.68 ± 2.11), (7.39 ± 0.42) points in the intervention group, and (9.08 ± 1.93), (5.91 ± 0.85) points in the control group. There were significant differences between the two groups ( t=-9.77, -9.58, both P<0.01). The depression and anxiety scores were (48.74 ± 7.68), (50.61 ± 6.15) points in the intervention group, and (62.97 ± 9.66), (56.42 ± 7.13) points in the control group. There were significant difference between the two groups ( t=7.04, 3.76, both P<0.01). The number of INR full monitoring, days required for INR to reach the first standard, the rate of effective anticoagulation, and the number of monitoring after INR≤ 3 were (10.42 ± 2.04) times, (6.66 ± 1.70) times, 58.1%(25/38), 2.6%(1/38) in the intervention group, and (7.94 ± 1.76) times, (12.72 ± 2.45) times, 33.3%(12/36), 25.0%(9/36) in the control group. There were significant difference between the two groups ( t= -5.59, 12.45, χ2=4.84, 6.12, all P<0.05). Conclusions:E-Coach management mode effectively improves the anticoagulant management ability of patients with atrial fibrillation and reduces their negative emotions.

With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

Objective To construct an artificial airway stability scheme for in-hospital transport of patients with severe neurological diseases,and to explore the application effect.Methods A total of 210 patients from June 2022 to September 2023 admitted to Jiaxing Second Hospital Neurosurgery Intensive Care Unit(NICU)completed in-hospital transport to examination area of artificial airway nerve severe were selected as the research object,104 patients from June 2022 to January 2023 as control group,received regular transport care,106 patients from February to September 2023 in intervention group received nosocomial transport artificial airway stability scheme.The incidence of airway-related adverse events,transit time and family satisfaction were compared between two groups.Results The incidence of airway-related adverse events in intervention group was lower than that in control group.The transit time in intervention group(19.08±3.17)min was faster than that in control group(25.50±4.84)min.The family satisfaction of intervention group was higher than that of control group,the difference was statistically significant(P＜0.05).Conclusion The implementation of NICU in-hospital transport artificial airway stability program can effectively reduce the incidence of airway-related adverse events and transit time,improve family satisfaction.

Liver fibrosis is primarily driven by the activation of hepatic stellate cells(HSCs),a process associated with ferroptosis.Ginsenoside Rb1(GRb1),a major active component extracted from Panax ginseng,inhibits HSC activation.However,the potential role of GRb1 in mediating HSC ferroptosis remains un-clear.This study examined the effect of GRb1 on liver fibrosis both in vivo and in vitro,using CCl4-induced liver fibrosis mouse model and primary HSCs,LX-2 cells.The findings revealed that GRb1 effectively inactivated HSCs in vitro,reducing alpha-smooth muscle actin(a-SMA)and type Ⅰ collagen(Col1A1)levels.Moreover,GRb1 significantly alleviated CCl4-induced liver fibrosis in vivo.From a mechanistic standpoint,the ferroptosis pathway appeared to be central to the antifibrotic effects of GRb1.Specifically,GRb1 promoted HSC ferroptosis both in vivo and in vitro,characterized by increased glutathione depletion,malondialdehyde production,iron overload,and accumulation of reactive oxygen species(ROS).Intriguingly,GRb1 increased Beclin 1(BECN1)levels and decreased the System Xc-key subunit SLC7A11.Further experiments showed that BECN1 silencing inhibited GRb1-induced effects on HSC ferroptosis and mitigated the reduction of SLC7A11 caused by GRb1.Moreover,BECN1 could directly interact with SLC7A11,initiating HSC ferroptosis.In conclusion,the suppression of BECN1 counteracted the effects of GRb1 on HSC inactivation both in vivo and in vitro.Overall,this study highlights the novel role of GRb1 in inducing HSC ferroptosis and promoting HSC inactivation,at least partly through its modulation of BECN1 and SLC7A11.

Objective To investigate the effect of"zero channel"emergency mode on the treatment of patients with severe traumatic brain injury.Methods A total of 147 patients with severe traumatic brain injury admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as study objects.Sixty-two patients hospitalized in traditional emergency mode from January to December 2020 were included in control group,and 85 patients hospitalized in"zero channel"emergency mode from January to December 2021 were included in observation group.The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,duration of operation,clinical prognosis and complication rate were compared between two groups.Results The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,and duration of operation in observation group were significantly shorter than those in control group(P<0.05).The proportion of good recovery in observation group was significantly higher than that in control group(68.20%vs.38.70%,χ2=12.671,P<0.001).The complication rate of observation group was significantly lower than that of control group(21.18%vs.80.65%,χ2=51.000,P<0.001).Conclusion"Zero channel"emergency mode can effectively shorten the treatment time of patients with severe traumatic brain injury,improve the success rate of rescue,reduce the incidence of complications,worthy of clinical use and promotion.

Objective:To design a continuous renal replacement therapy (CRRT) waste liquid bag disposal vehicle and explore its effectiveness.Methods:In February 2024, convenience sampling was used to select 100 waste liquid bags generated during CRRT in the ICU of Zhejiang Provincial Hospital of Chinese Medicine as research subjects. The waste liquid bags were divided into an observational group ( n=50) and a control group ( n=50) using a random number table method. The control group was treated using usual method, while the observational group was treated using a CRRT waste liquid bag disposal vehicle. The emptying time of a single bag of waste liquid, the number of splashes per unit area, and operator satisfaction were compared between two groups. Results:The emptying time of a single waste liquid bag in the observational group was lower than that in the control group [ (38.34±1.98) vs. (315.46±11.23) s, P<0.01]. The number of splashes per unit area of 5 cm × 5 cm in the observational group was less than that in the control group [ (0.28±0.09) vs. (8.62±0.64), P<0.01]. The operator satisfaction score of the observational group was higher than that of the control group [ (4.88±0.05) vs. (1.44±0.10) points, P<0.01] . Conclusions:The CRRT waste liquid bag disposal vehicle can reduce the emptying time of waste liquid bags and the pollution to the surrounding environment during the discharge process, improve operator satisfaction, and is worthy of promotion in clinical practice.