Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.

Objective:To investigate the therapeutic impact of combining vitamin D supplementation with dietary adjustments on elderly male patients with diabetes and osteosarcopenia.Methods:From January 2021 to May 2023, a total of 108 male patients diagnosed with diabetes and osteosarcopenia were admitted to Beijing hospital for research purposes.The patients were randomly assigned to either a control group( n=54)or a trial group( n=54).The control group received conventional dietary adjustments, while the trial group received vitamin D supplementation in addition to dietary adjustments.Various parameters including 25-(OH)-VitD 3 levels, blood glucose levels, appendicular skeletal muscle mass index(ASMI), bone mineral density, and bone metabolism indexes were measured before and after the treatment in both groups. Results:Compared to the pre-treatment period, the levels of 25-(OH)-VitD 3, grip strength, 6 m step speed, and ASMI increased in both groups, while fasting blood glucose and 2 h postprandial blood glucose decreased significantly(all P<0.05).Additionally, the experimental group showed higher levels of 25-(OH)-VitD 3, grip strength, 6 m step speed, and ASMI compared to the control group post-treatment, with lower levels of fasting blood glucose and 2 h postprandial blood glucose(all P<0.05).Compared with the pre-treatment period (bone density values in the lumbar spine: 0.41±0.09, the hip: 0.42±0.12 in the control group; bone density values in the lumbar spine: 0.43±0.07, the hip: 0.44±0.09 in the experimental group), the bone density values of the lumbar spine and the hip were higher in both groups after treatment(bone density values in the lumbar spine: 0.76±0.12, the hip: 0.78±0.12 in the control group; bone density values in the lumbar spine: 0.95±0.22, the hip: 0.97±0.28 in the experimental group). The bone density values of the lumbar spine and the hip in the experimental group were higher than those of the control group after treatment(all P<0.05).Furthermore, serum concentrations of parathyroid hormone(PTH)and osteoclast differentiation factor(RANKL)were significantly lower, while serum osteocalcin(OCN)was significantly higher in both groups post-treatment(all P<0.05).In the experimental group, serum PTH and RANKL concentrations were significantly lower and serum OCN was significantly higher compared to the control group post-treatment(all P<0.05). Conclusions:The results show that incorporating vitamin D into dietary changes can effectively regulate blood glucose levels, decrease bone loss, enhance bone density, and improve muscle quality in this patient population.

Objective:To investigate the neurobiochemical metabolites of caudate nucleus and thalamus in patients with obsessive-compulsive disorder and their relationship with obsessive-compulsive symptoms.Methods:From April 2019 to January 2022 in Beijing Anding Hospital, totally 25 untreated patients with obsessive-compulsive disorder were recruited, and 20 healthy controls matched with gender, age and educational background were recruited for the study.The maps of neurobiochemical metabolites of patients and normal controls were collected by hydrogen proton magnetic resonance spectroscopy.With bilateral caudate nucleus and thalamus as brain regions of interest.The relative concentrations of N-acetylaspartic acid (NAA), glutamic acid (Glu) and γ-aminobutyric acid (GABA) were fitted by LCModel software.At the same time, the clinical symptoms of patients were evaluated with Yale-Brown obsessive-compulsive scale (Y-BOCS) and Hamilton anxiety scale (HAMA). SPSS 20.0 software was used for statistical analysis.Independent double sample t-test was used to compare the differences of different nerve biochemical metabolite concentrations between patients with obsessive-compulsive disorders and healthy controls.Pearson correlation analysis was used to explore the correlation between biochemical metabolite concentrations and clinical symptoms. Results:The Glu concentration in the left thalamus of patients with obsessive-compulsive disorder (3.97±0.41) was higher than that of the control group (3.66±0.55)( t=-2.11, P<0.05), while the NAA concentration was (4.87±0.47)lower than that of the control group (5.15±0.44)( t=2.05, P<0.05). The GABA concentrations in the right caudate nucleus (0.50±0.18) and thalamus (0.80±0.19) were lower than those in the control group ((0.63±0.23), (0.96±0.24))( t=2.08, 2.36, both P<0.05). Pearson correlation analysis showed that the Glu concentration in the left caudate nucleus of patients with obsessive-compulsive disorder was positively correlated with the total score of Y-BOCS( r=0.46, P<0.05). Spearman correlation analysis showed that Glu concentration in the right caudate nucleus was positively correlated with the total score of HAMA in patients with obsessive-compulsive disorder ( r=0.46, P<0.05). Conclusion:NAA, Glu and GABA metabolism in caudate nucleus and thalamus are abnormal in patients with obsessive-compulsive disorder, and Glu concentration is positively correlated with the severity of obsessive-compulsive and anxiety symptoms.

Objective To observe the expression of PD-L1 in breast cancer tissue and to investigate its correlation with cellu-lar immunity.Methods One hundred and fourteen paraffin-embedded specimens of breast cancer were collected from the Qian′an Municipal People′s Hospital.The expression of PD-L1 in breast tumor tissue was detected by immunohitochemical technique,then the relationship between PD-L1 expression and tumor clinicopathological characteristics was analyzed;the levels of peripheral blood CD3+,CD3+CD4+,CD3+CD8+,CD3-CD19+,CD3-CD16+CD56+cells and CD4+/CD8+in the patients with PD-L1 negative and PD-L1 positive of the two groups were detected by the flow cytometry.Results Among 114 cases of breast cancer specimen,35 ca-ses(30.7%)were PD-L1 expression positive with the expression rate of 30.7%.The PD-L1 expression was correlated with the tumor size,histological grade and Ki-67 high expression(P<0.05);the cellular immunity status in the patients with PD-L1 negative expression was better than that in the patients with PD-L1 positive expression(P<0.05).Conclusion The PD-L1 expression is closely correlated with the poorer clinicopathological characteristics of breast cancer,its mechanism may be correlated with the dis-ruption of cellular immunity in the patients with PD-L1 positive expression.

Objective To explore the methods and mesures for the pre-analytical quality control of test specimen and to improve the accuracy and reliability of test results.Methods According to the relevant requirements of IS015189,various measures for the specimen circulation process and collection technology two aspects were taken to control the full links of clinical specimen collection and transport,and the incidence of unqualified specimen before and after the improvements were analyzed.Results After the imple-mentation of the improvement measures,the incidence of unqualified specimens was decreased significantly.Conclusion Implemen-tation of the whole aspect of pre-analytical quality control can effectively improve the quality of specimen in order to improve the test quality.

Objective To discuss the diagnosis and treatment of splenic harmatoma(SH). Methods The clincial data of three cases of SH treated in our hospital from January 1997 to December 2007 were collected,and the other 17 cases which were published from January 1997 to December 2007 in the Chinese biological and medical lit-erature database were reviewed. The clinical manifestation,pathological findings,diagnosis and treatment of these 20 patients were analyzed. Results The main symptoms were abdominal pain or discomfort and abdominal mass in 13 cases(13/20). All 20 patients underwent surgical treatment with good recovery without severe complications and re-currence. Conclusions The definite diagnosis of SH depends on postoperative pathological findings. Complete surgi-cal resection is the best treatment for SH with favourable prognosis.