[Analysis of factors affecting the return of spontaneous circulation in elderly patients with out-of-hospital cardiac arrest].

OBJECTIVE: To investigate the factors that influence the return of spontaneous circulation (ROSC) in elderly patients suffering from out-of-hospital cardiac arrest (OHCA). METHODS: A retrospective study was used to collect the clinical data of OHCA patients admitted to the emergency center of Zhengzhou People's Hospital from July 2016 to July 2019 based on the pre-hospital emergency database of Utstein model. Patients' gender, age, cardiac arrest (CA) etiology, presence or absence of bystander cardiopulmonary resuscitation (CPR), emergency response time, initial cardiac rhythm, ventilation method, use of epinephrine, defibrillation and ROSC were included. The patients were divided into elderly and young groups according to whether age ≥ 60 years old, and the differences in various indicators between the two groups were compared. Univariate Logistic regression analysis was used to analyze the relationship between emergency response time and ROSC in elderly patients and multivariate Logistic regression analysis was used to identify factors influencing ROSC in elderly patients. RESULTS: A total of 3 429 adult OHCA patients were enrolled in this study, including 2 105 elderly patients (61.39%), and 1 324 young and middle-aged patients (38.61%). Compared to the young group, the proportion of females, non-cardiac causes and asystole as the initial rhythm was higher in the elderly group, the emergency response time was shorter, the rate of defibrillation and tracheal intubation, and the success rate of ROSC were lower (all P < 0.05). Among them, the proportion of cardiac arrest as the initial rhythm in elderly male patients was significantly higher than that of young male patients (P < 0.05); the proportion of non-cardiac causes in elderly female patients was significantly higher than that of young female patients, and the proportion of defibrillation was significantly lower than that of young female patients (all P < 0.05). Multivariate Logistic regression analysis showed that cardiac arrest as the initial rhythm was strongly associated with ROSC in elderly male patients [odds ratio (OR) = 0.126, 95% confidence interval (95%CI) was 0.045-0.352, P < 0.05]. Univariate Logistic regression analysis of the relationship between emergency response time and ROSC in elderly patients showed that although there was no significant difference in the ROSC success rate among elderly patients with various emergency response times, an emergency response time within 10 minutes was beneficial for ROSC in elderly patients. CONCLUSIONS: The success rate of ROSC is very low in elderly OHCA patients aged ≥60 years. Although the CPR-related indicators of elderly patients are significantly different from those of young patients, there are gender differences. The association between the elderly male patients and cardiac arrest as the initial rhythm is stronger, while OHCA caused by non-cardiac diseases is more common and defibrillable rhythm is less common in elderly female patients. It may be more beneficial for elderly patients to shorten the emergency response time and increase bystander CPR.

Platforms of graphene/MXene heterostructure for electrochemical monitoring of rutin in drug and Tartary buckwheat tea.

The use of two-dimensional heterostructure composite as electrode modification material has become a new strategy to improve the electrocatalytic activity and electroactive sites of electrochemical sensor. Herein, a soluble heterostructure, namely rGO-PSS@MXene, was designed and synthesized by integrating poly (sodium p-styrenesulfonate)-functionalized reduced graphene oxide into MXene nanosheets via ultrasonic method. The interactive heterostructure can effectively alleviate the self-stacking of MXene and rGO, endowing them with superior electron transfer capacity and large specific surface area, thereby producing prominent synergistic electrocatalytic effect towards rutin. In addition, the excellent enrichment effect of rGO-PSS@MXene for rutin also plays an important role through the electrostatic and π-π stacking interactions. The electrochemical characteristics of rutin on the sensor were examined in detail and a sensitive sensing method was proposed. Under optimized conditions, the method showed satisfactory linear relationship for rutin in the concentration range of 0.005-10.0 µM, with limit of detection of 1.8 nM (S/N = 3). The quantitative validation results in herbal medicine and commercial Tartary buckwheat tea were highly consistent with the labeled quantity and the results of HPLC determination, respectively, suggesting the sensor possessed excellent selectivity and accuracy. This proposed strategy for rutin determination is expected to expand the application of MXene heterostructure in electrochemical sensors, and is envisioned as a promising candidate for quality monitoring of drugs and foods.