摘要
Objective:To screen the independent influencing factors of restoration of spontaneous circulation (ROSC) in patients after cardiopulmonary resuscitation (CPR) and establish a predictive model, and explore its clinical value.Methods:A retrospective case control study was conducted. The clinical data of cardiac arrest patients admitted to the emergency department of Tangdu Hospital of Air Force Military Medical University and received CPR from January to July 2023 were analyzed, including general information, blood biochemical indicators, main cause of cardiac arrest, whether it was defibrillation rhythm, duration from admission to CPR, and whether ROSC was achieved. The clinical data between the patients whether achieved ROSC or not were compared. The binary multivariate Logistic regression analysis was used to screen the independent influencing factors of ROSC in in-hospital CPR patients. According to the above influencing factors, the ROSC prediction model was established, and the receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of the model for ROSC.Results:A total of 235 patients who received CPR in the emergency department were enrolled, including 153 cases (65.11%) of in-hospital CPR and 82 cases (34.89%) of out-of-hospital CPR. The ROSC ratio was 30.21% (71/235). Among all patients, the majority were aged 61-80 years [40.43% (95/235)], and cardiogenic disease was the main cause of cardiac arrest [32.77% (77/235)]. Among 153 patients with in-hospital CPR, 89 were non-ROSC and 64 were ROSC with ROSC rate of 41.83%. Compared with the non-ROSC group, the patients in the ROSC group had lower blood lactic acid (Lac), N-terminal pro-brain natriuretic peptide (NT-proBNP), Lac/albumin (Alb) ratio (LAR), and ratio of non-defibrillation rhythm [Lac (mmol/L): 5.50 (2.33, 9.65) vs. 7.10 (3.50, 13.35), NT-proBNP (μg/L): 0.87 (0.20, 8.68) vs. 3.00 (0.58, 20.17), LAR: 0.14 (0.07, 0.29) vs. 0.19 (0.10, 0.43), non-defibrillation rhythm ratio: 68.75% (44/64) vs. 93.26% (83/89)], higher actual base excess (ABE) and Alb [ABE (mmol/L): -3.95 (-12.75, 0.23) vs. -7.50 (-13.50, -3.35), Alb (g/L): 38.13±7.03 vs. 34.09±7.81], and shorter duration from admission to CPR [hours: 3.25 (1.00, 14.00) vs. 8.00 (2.00, 27.50)], the differences were statistically significant (all P < 0.05). Binary multivariate Logistic regression analysis showed that LAR [odds ratio ( OR) = 0.037, 95% confidence interval (95% CI) was 0.005-0.287], non-defibrillation rhythm ( OR = 0.145, 95% CI was 0.049-0.426), and duration from admission to CPR ( OR = 0.984, 95% CI was 0.972-0.997) were independent influencing factors for ROSC in hospitalized CPR patients (all P < 0.05). Based on the above influencing factors, a ROSC prediction model was constructed through regression analysis results. The ROC curve analysis showed that the area under the ROC curve (AUC) for predicting ROSC in in-hospital CPR patients was 0.757 (95% CI was 0.680-0.834), Yoden index was 0.429, sensitivity was 76.6%, and specificity was 66.3%. Conclusions:LAR, non-defibrillation rhythm and duration from admission to CPR were independent influencing factors for ROSC in patients with in-hospital CPR. The ROSC prediction model established based on the above influencing factors has a good predictive value for ROSC of CPR patients in hospital, and can guide clinicians to evaluate the prognosis of patients through relevant indicators as early as possible.
摘要
Objective To observe the effect of Natural mountain spring on oxidative damage of aging mice . Methods Thirty male aging mice were randomly divided into experimental group ( drink Natural mountain spring ) and control group ( drink tap water ) according to the level of MDA .The serum in the two groups was taken for T-SOD activity and MDA content analysis after two months .Results The MDA content in experimental group decreased markedly than that in control group .Conclusion Natural mountain spring could alleviate oxidative damage by free radicals to extent .
摘要
Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.
摘要
Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.
摘要
OBJECTIVE:To establish a method for separation and determination of ethanol,dichloromethane and N,N-dimethylformamide in pidotimod tablets.METHODS:The residual organic solvents were quantitatively determined by GC on DB-624 capillary column with FID detector,using nitrogen as the carries gas.Temperature programming was carried out in which the column temperature was initially maintained at 40 ℃ for 5 minutes,then increased at a rate of 50 ℃ per minute to 200 ℃,and maintained at 200 ℃ for at least 10 minutes.The temperature at injection mouth was maintained at 160 ℃;the detector temperature was maintained at 280 ℃.The split ratio was 5∶1.RESULTS:3 residual organic solvents were completely separated and their determination was free of inference from hidden foreign substances.The linear ranges of the ethanol,dichloromethane and N,N-dimethylformamide were 10.036～802.88 (r=0.999 9),26.44～105.76 (r=0.999 6),and 1.76～140.8 (r=0.999 5) ?g?mL-1,respectively,and their average recovery rates were 102.4%,99.0%,and 99.2%,respectively,with RSD at 1.99%,3.34%,and 0.55%,respectively.CONCLUSION:The method is sensitive,accurate and rapid,and it is suitable for determination of residual organic solvents in pidotimod tablets.
摘要
Objective To study the imaging features and adequate interventional therapy of the diffuse type hepatic cellular carcinoma(HCC).Methods Fourteen patients with the diffuse type HCC underwent hepatic angiography and the adequate interventional therapy by TAI or TAE according to imaging appearances,blood supply and function of liver.Results ①Imaging appearances:the most common appearances of fourteen patients with the diffuse type HCC on DSA and CT included:tumor blood vessel was extensive and increased,tumor stain was extensive in left and right liver leaf(such as grain,small spot ,nodule shadows or low density area),liver enlarged obviously with liver cirrhosis,portal vein tumor thrombus,arteriopotal shunt and widespreadly scattered iodized oil,et al.②Therapeutic effect:the mean survival time of fourteen patients was 3 months,the longest survival period was 10 months and the shortest one was olny 15 days.Conclusion ①The specific appearances of the diffuse type HCC are diffuse small spot-like,frosted glass-like,double orbit-like and big liver-like.②The interventional therapeutic effect and prognosis of the diffuse type HCC are the worst than that of other type primary hepatic carcinoma.Selecting adequate interventional therapeutical plan can obviously prolong survival time of the patient.
摘要
Objective To study angiography features and clinical significance of "multiple tumor feeding embolization".Methods Twelve patients with pelvic tumor were reviewed retrospectively.The lesions included fibrosarcoma(n=1),chondrosarcoma(n=2),osteosarcoma(n=2) and metastatic tumor(n=7).Results Angiography features were:(1)multiple origin and branch of tumor-feeding vessels.(2)large vascular mass with dense tumor stain.(3)larger size of tumor stain comparing with that of bone destraction.After treatment,symptom relief and tumor shrink were obviously using"the multiple tumor-feeding embolization".Conclusion Angiography features of pelvic tumor are great value in guiding the clinical therapy.
摘要
Objective To explore DSA findings curative measures and effects of bronchial arterial embolization(BAE)of bronchiectasis with massive hemoptysis. Methods 35 patients with massive hemoptysis due to bronchiectasis were performed selective bronchial arterial DSA and BAE referring to image data of chest plain film and CT. Embolic materials were polyvinyl alcohol(PVA)and/or gelatinum sponge particles. Curative effects were followed-up for 3 months to 3 years. Results ①DSA revealed bronchial artery as being the only abnormal vessel accounted for 74.3%,bronchial artry combined with nonbronchial systemic artery as 22.9% and only non-bronchial artery involved 2.9%. Abnormal vessel number was 1 -5(mean 1.8) per case. Direct and indirect bleeding sign was displayed as 25.7% and 100% respectively. ②Curative and embolization effects were shown as 61 target vessels of 34 patients being embolized and total effective rate reaching 85.3%; of which 16 cases were adopted super-selective technique,1 case was failure of stopping bleeding for two times within 3 days,4 cases recurred within 3 months and 2 cases recurred over 3 months; with recurrent rate of 20.6%,but no serious complications such as spinal cord injury. Conclusions DSA examination and selective BAE of bronchiectasis with massive hemoptysis could provide high positive angiographic features and reliable curative effect.