Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.

Objective:To investigate the distribution characteristics of body height, body weight and body mass index (BMI) in children aged 3-17 years in China.Methods:Data were obtained from the National Nutrition and Health Systematic Survey in 0-18 years old children in China. The study selected 70 853 children aged 3-17 years from 28 urban and rural survey sites in 14 provinces (autonomous regions and municipalities) in 7 regions of China with multi-stage stratified cluster random sampling. M ( Q1, Q3) was used to describe the region, age and gender specific body height, body weight and BMI in the children aged 3-17 years. Wilcoxon rank sum test was used to compare the body height, body weight, and BMI between boys and girls in same age group. Kruskal-Wallis H rank sum test was used to compare the body height, body weight and BMI among boys in different age groups and among girls in different age groups, as well as among boys in same age group and among girls in same age group from different regions, and DSCF method was used for further pairwise comparisons. Results:In this study, the median body height and body weight were 172.0 cm and 62.9 kg in 17-year-old boys and 160.0 cm and 53.7 kg in 17-year-old girls. The median for children's body height, body weight, and BMI in most age groups were higher in northeastern and northern China than in southern China, and the differences could be observed until age 17 years. The differences in body weight and BMI in children in northeastern and northern China were greater in Q3 than in Q1 compared with southern China. Conclusions:The body height of children aged 3-17 years continues to increase in China. Northeastern and northern China have more children with higher bodyweight, showing an obvious body weight increase trend, to which close attention needs to be paid.

Objective To investigate the influence of type 2 diabetes mellitus(T2DM)on cognitive function and the effective connectivity with in the default mode network(DMN)in the brain.Methods A total of 93 hospitalized patients diagnosed with T2DM were enrolled in this study as T2DM group from The First Affiliated Hospital of Guangzhou University of Chinese Medicine during September 2021 to December 2022.Simultaneously,108 healthy individuals were recruited from the community as normal control(NC)group.The cognitive functions were evaluated in the two groups.A random dynamic causal modeling approach was employed to analyze the effective connectivity within DMN in both groups.Additionally,Pearson correlation analysis was performed to examine the association between differential connectivity,clinical indicators,and cognitive scores in both groups.Results In comparison to the NC group,T2DM individuals exhibited statistically significant reductions in scores in the auditory verbal learning test(AVLT)for immediate recall and the digit symbol substitution test(DSST)(P＜0.05).Additionally,they displayed a notable decrease in effective connectivity from the left lateral parietal cortex(LLPC)to the posterior cingulate cortex(PCC),as well as from the LLPC to the right lateral parietal cortex(RLPC)within the DMN(P＜0.05).Pearson correlation analysis unveiled a negative association between HbA1c levels and the strength of effective connectivity from LLPC to PCC.Conversely,a positive correlation was observed between AVLT(immediate)scores and the strength of effective connectivity from LLPC to PCC and LLPC to RLPC.Additionally,DSST scores displayed a positive correlation with the strength of effective connectivity from LLPC to PCC(P＜0.05).Conclusion Patients with T2DM display compromised effective connectivity from LLPC to PCC and LLPC to RLPC within the DMN network,and this alteration may associated with cognitive impairment.

ObjectiveTo explore the improvement effect of Flos Puerariae， Hoveniae Semen， and their compatibility on acute alcoholic gastric mucosal injury， and lay a foundation for further development of Flos Puerariae， Hoveniae Semen， and their compatibility in the prevention and treatment of alcohol-induced multiple organ injury. MethodThe acute alcohol-induced gastric mucosal injury model of mice was established by multiple intragastric administration of 56% Hongxing Erguotou liquor （15 mL·kg^-1）. A total of 120 male ICR mice were randomly divided into 8 groups， namely， the blank group， model group， omeprazole group （0.026 g·kg^-1）， Flos Puerariae-Hoveniae Semen （compatibility） high， medium， and low-dose groups （29.2，14.6， 7.3 g·kg^-1）， Flos Puerariae group （19.5 g·kg^-1）， and Hoveniae Semen group （19.5 g·kg^-1）， with 15 mice in each group. After one week of adaptive feeding， the animals were pre-administrated with the corresponding drug at the rate of 10 mL·kg^-1 for 3 d. From the 4^th day， after 1 h of administration， Erguotou liquid was administrated at the rate of 15 mL·kg^-1 and the blank group was administrated with the same volume of deionized water to record the drunkenness and sober up time. The administration was lasted for 3 d. One hour after the last administration， the eyeballs were removed and the mice were sacrificed. The concentration of ethanol in serum was determined by gas chromatograph， and the activity of ethanol dehydrogenase （ADH） in gastric mucosa was determined by ultraviolet-vis spectrophotometer. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in gastric mucosa. Serum inflammatory factors were determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA expression of nuclear transcription factor-κB （NF-κB） p65 and NF-κB inhibitory protein α （IκBα） were detected by real-time polymerase chain reaction （Real-time PCR）. ResultAs compared with the normal group， the content of interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in serum of mice in the model group was increased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues was increased （P<0.01）， and the mRNA expression of IκBα was decreased （P<0.01）. As compared with the model group， the drunkenness time of the omeprazole group， high and medium-dose compatibility groups， and Flos Puerariae group was prolonged （P<0.05）， the sober up time of the high and medium-dose compatibility groups was shortened （P<0.05）， the ethanol concentration in the serum of the high-dose compatibility group was decreased （P<0.05）， the ADH activity in the gastric mucosa of the omeprazole group and high and medium-dose compatibility groups was increased （P<0.05）， the macroscopic injury score of the high， medium， and low-dose compatibility groups and Flos Puerariae group was decreased （P<0.05）， the score of pathological injury in the omeprazole group， high， medium， and low-dose compatibility groups， and Flos Puerariae group was decreased （P<0.01）， the expression of IL-6 in serum of all drug groups was decreased （P<0.05）， the expression of IL-1β in serum of the omeprazole group， high， medium， and low-dose Flos Puerariae groups， and Hoveniae Semen group was decreased （P<0.05）， the expression of TNF-α in serum of high and medium-dose groups was decreased （P<0.05）， the mRNA expression of NF-κB p65 in gastric mucosa tissues of all drug groups was decreased （P<0.05）， and the mRNA expression of IκBα in gastric mucosa tissues of the omeprazole group and high， medium， and low-dose compatibility groups was increased （P<0.05）. As compared with the high-dose compatibility group， the drunkenness time in the low-dose compatibility group and Hoveniae Semen group was shortened （P<0.01）， the sober up time in the Flos Puerariae and Hoveniae Semen groups was prolonged （P<0.01）， the concentration of ethanol in the serum of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group increased （P<0.05）， the macroscopic injury score of the medium and low-dose compatibility groups and Hoveniae Semen group was increased （P<0.05）， the pathological injury score of the medium and low-dose compatibility groups， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， the content of IL-1β in serum of low-dose compatibility group， Flos Puerariae group， and Hoveniae Semen group was increased （P<0.01）， and the mRNA expression of IκBα in gastric mucosa of the Flos Puerariae group and Hoveniae Semen group was decreased （P<0.05）. As compared with the medium-dose compatibility group， the drunkenness time in the Hoveniae Semen group was shortened （P<0.05）， the sober up time in the Flos Puerariae group was prolonged （P<0.05）， the pathological injury score in the Flos Puerariae group and Hoveniae Semen group was increased （P<0.01）， and the content of IL-1β in serum of the low-dose compatibility group， the Flos Puerariae group， and Hoveniae Semen group was increased （P<0.05）. As compared with the low-dose compatibility group， the pathological injury score of the Hoveniae Semen group was increased （P<0.05）. ConclusionFlos Puerariae， Hoveniae Semen， and their compatibility play a role in preventing and treating acute alcoholic gastric mucosal injury in mice， which may be related to the inhibition of the expression of NF-κB signal pathway in gastric mucosa， and the high-dose compatibility group has the optimal effect.

Objective:To explore the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder (PTSD) in patients with acute myocardial infarction(AMI) after discharge, and to clarify main intervention direction of PTSD in patients with AMI.Methods:Patients with AMI who were discharged from Tangshan Gongren Hospital between 1 month and 1 year were selected from November 2019 to November 2020.The cardiac discomfort symptoms scale, fear of progress questionnaire(FoP-Q-SF) and post-traumatic stress disorder self-rating scale(PTSD-SS) were used to investigate cardiac discomfort symptoms, fear of disease progress level and post-traumatic stress disorder status.Spearman rank correlation analysis was used to analyze the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder by SPSS 24.0 software. The mediating effect of fear of disease progress was analyzed by AMOS 24.0 software.Results:The PTSD score was (32.78±12.38) of patients with AMI discharged from hospital for 1 month to 1 year and the incidence of PTSD was 12.3%.Spearman correlation test showed cardiac discomfort symptoms and fear of disease progress were positively correlated with PTSD( r=0.530, 0.723, both P<0.01) and cardiac discomfort symptoms was positively correlated with fear of disease progress( r=0.518, P<0.01). Mediating effect test showed that fear of disease progress was a complete mediator between cardiac discomfort symptoms and PTSD. Conclusion:Cardiac discomfort symptoms can affect PTSD through a complete mediator of fear of disease progress.

Novel coronavirus pneumonia (COVID-19) is currently raging worldwide, and the prevention and control situation is very grim. Gratifying achievements of organ donation have been made in China since its implementation. Due to the characteristics of potential donors, such as complicated personnel structure, sudden onset and critical illness, it is necessary for multi-department to contact with the donors and their families during the work link of donor evaluation, family communication, donor transportation, organ function maintenance and organ procurement, which raises higher requirement for the screening and management of potential donors under COVID-19 epidemic. During the outbreak, Beijing Youan Hospital, Capital Medical University has completed 9 cases of organ donation, formulated the relevant screening process, established the prevention and control requirements, and gained certain experience and effects, which benefits the orderly and smooth development of organ donation under the COVID-19 epidemic.

The modified early warning score (MEWS), as a rapid assessment and early warning scoring tool, has been widely used in patients in China, which can help nurses to identify potentially critical patients early, but not in all clinical fields. Through the retrieval of the relevant literature of the clinical application of the MEWS in Wanfang Medical Database from 2011 to 2018, the SWOT analysis was used in this paper [strength (S), weakness (W), opportunities (O) and threats (T)] methods, to systematically analyze the advantages, problems existence, implementation opportunities and challenges in the clinical application of the MEWS in our country. The purpose of this study was to obtain the best cut-off value of MEWS in different diseases and to formulate standard early-warning intervention measures for MEWS, which may provide reference for clinical workers to carry out relevant research.

The common Japanese Kampo medicine issued by MHLW was sorted and analyzed, record total ingredients, average dosage, total dosage of general prescription, maximal and minimal dosage of general prescription of Japanese Kampo was originated from the classic prescription. The ingredients of each prescription medicine was relatively less, and mostly composed of 4 to 9 ingredients. The average dosage was less, around 15-25 g and the average dosage of single drug was 3.16 g. The dose of Japanese Kampo medicine was relatively less, and it was only about 1/4 of the drug used in Chinese mainland. The reasons were related to many factors like historical evolution of Chinese prescription, the habit of taking medicine, people’s constitution of different nations and so on.

Objective To compare the Modified Early Warning Score(MEWS),blood glucose value score and the two scores combined with the ability to predict the prognosis of patients with acute complication of diabetes mellitus,and to explore the most suitable assessment tools. Methods 419 patients with acute complica-tions were collected in diabetic mellitus. To put the admission time as the inital observation point,MEWS score, blood glucose value score and MEWS combined with blood glucose value were assessed and compared between the time point of admission and discharge by ROC curve.Results Using death as a prediction index,MEWS score of subjects operating characteristic area under the curve of AUCROC was 0.875 and the optimal cut-off value of was over 4 in the sensitivity of 78.43%,specificity of 85.60%,the positive predictive valueof 43.01% and the negative predictive value of 96.63% independently. The average score of blood glucose area under ROC curve AUCROC was 0.681 and the optimal cut-off value was 2 in the sensitivity of 50.98%,the specificity of 85.33% the positive predictive value of 73.4% and negative predictive value of 67.5% respectively. Two scores combined with area under ROC curve AUCROCwas 0.982,and the optimal cut-off value was over 7 in the sensitivity of 94.12%,the specificity of 95.65%,the positive predictive value of 75% and the negative predictive value of 99.15% individually. Conclusion For predicting the prognosis of patients with acute complications of diabetes,the combined scores are better than the pure MEWS score and blood glucose value.It is worth of clinical application.

Objective To investigate the effects of different penetration enhancers on percutaneous absorption of Xiaoyan Runma mucilage in vitro, and to improve the curative efficacy of this mucilages through selection of the effective penetration enhancers. Methods Xiaoyan Runma mucilage was prepared with different penetration enhancers. An intelligent permeability instrument was used for in vitro percutaneous absorption test of rats , with isolated mice abdomen skin serving as in vitro transdermal barrier and saline isotonic solution as receptor fluid. Then the contents of lidocaine hydrochloride in receptors were determined by HPLC.The accumulative transit dose (Q) and percutaneous permeability (J) within 12 h were calculated and compared with those of mucilage without any enhancer. Results With Q value serving as an index, different enhancers had different promote permeation effects on Xiaoyan Runma mucilage, and the effects in descending order were as follows:4% azone [(222.75±3.4) μg?(cm2)-1]>2% azone[(207.42±5.1) μg?(cm2)-1]>3% menthol [(183.38±4.9) μg?(cm2)-1]>5%menthol [(160.82±5.4) μg?(cm2)-1]>2% azone+3% menthol [(151.25±5.5) μg?(cm2)-1]>2% azone+5% isopropyl myristate [(127.26±7.1) μg?(cm2)-1]>2% oleic acid [(125.16±6.5) μg?(cm2)-1]>no enhancer [(109.82±8.2)μg?(cm2)-1].4% azone was the best penetration enhancer for the mucilage delivery in vitro, with Q and J value as [(222.75± 3.4)μg?( cm2 )-1 ] and 19. 896 μg?( cm2 )-1?h-1 , respectively, which was 2. 08 times those of mucilages without any enhancer. Conclusion Being as a transdermal absorption enhancer of Xiaoyan Runma mucilage, 4% azone has the best effect. This study can provide the optimal formulation for transdermal delivery system of Xiaoyan Runma mucilage.