Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis.

BACKGROUND: This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China. METHODS: Relevant studies, published between January 1, 2010 and September 5, 2022, were retrieved from databases, including EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, China National Knowledge Infrastructure, and Wanfang databases. We included clinical studies in which all patients were diagnosed with CA and underwent out-of-hospital CPR, and the outcome variables were at least one of the following: return of spontaneous circulation (ROSC), survival to admission, survival to hospital discharge, 1-month survival, achieved good neurological outcomes, and 1-year survival. Two investigators independently extracted the study data and assessed its quality using a modified Newcastle-Ottawa Scale tool. The data were pooled using random-effects models. RESULTS: Of the 3620 identified studies, 49 (63,378 patients) were included in the meta-analysis. The pooled ROSC rate was 9.0% (95% confidence interval [CI] 7.5-10.5%, I2 = 97%), the pooled survival to admission rate was 5.0% (95% CI 2.7-8.0%, I2 = 98%), and the pooled survival to discharge rate was 1.8% (95% CI 1.2-2.5%, I2 = 95%). Additionally, the ROSC rate of patients with bystander CPR was significantly higher than that of those without bystander CPR, and the pooled odds ratio (OR) was 7.92 (95% CI 4.32-14.53, I2 = 85%). The ROSC rate of participants who started CPR within 5 min was significantly higher than that of those who started CPR after 5 min, and the pooled OR was 5.92 (95% CI 1.92-18.26, I2 = 85%). The ROSC rate of participants with defibrillation was significantly higher than that of those without defibrillation, and the pooled OR was 8.52 (95% CI 3.72-19.52, I2 = 77%). CONCLUSION: The survival outcomes of out-of-hospital CPR in China are far below the world average. Therefore, the policy of providing automated external defibrillators (AEDs) in public places and strengthening CPR training for healthcare providers and public personnel should be encouraged and disseminated nationwide. Trial registration This study was registered in PROSPERO (CRD42022326165) on 29 April 2022.

Unplanned extubation among critically ill adults: A systematic review and meta-analysis.

BACKGROUND: Unplanned extubation has been widely recognized as a life-threatening adverse event in intensive care unit patients. AIM: To systematically quantify the global prevalence of unplanned extubation among critically ill adults and reintubation rate after unplanned extubation. METHODS: Systematic review and meta-analysis. We identified original peer-reviewed studies through electronic searches of EMBASE, PubMed, ISI Web of Science, and CINAHL databases involving ventilated adult intensive care unit patients. Primary endpoints were prevalence of overall unplanned extubation rate rate, type of unplanned extubation (self-extubation or accidental extubation) and reintubation rate within 48 hours. Two reviewers independently selected studies and extracted data on the outcomes. Random effect meta-analysis of proportions was used to estimate the pooled prevalence rates. RESULTS: Of 1613 retrieved citations, 38 studies from 18 countries published between 1990 and 2020 were included. The overall methodological quality was low (mean score on Newcastle-Ottawa scale, 2.6/5). The pooled prevalence of unplanned extubation was 6.69% (95% CI, 5.29%-8.24%; 34 studies involving 121,129 subjects) with an incidence density of 1.06 events per 100 ventilator-days (95% CI, 0.7-1.3; 16 studies involving 375,967 ventilation days). The majority of unplanned extubations (84.2%) were self-extubations (95% CI, 79.8%-88.3%; 23 studies involving 2274 unplanned extubations). In addition, 50.2% of subjects with unplanned extubations required reintubation within 48 hours (95% CI, 43.6%-56.9%; 10 studies involving 1564 unplanned extubations). CONCLUSION: Despite significant heterogeneity between studies, these data showed that 6.7% of intubated adult subjects in the intensive care unit experience unplanned extubation, most of which are self-extubations. Further well-designed studies are required to better understand unplanned extubation among intubated intensive care unitpatient, using standardized methods of data collection and reporting.

Sensitive electrochemical immunoassay for chlorpyrifos by using flake-like Fe3O4 modified carbon nanotubes as the enhanced multienzyme label.

A highly sensitive electrochemical immunoassay of chlorpyrifos (CPF) was developed by using a biocompatible quinone-rich polydopamine nanospheres modified glass carbon electrode as the sensor platform and multi-horseradish peroxidase-flake like Fe3O4 coated carbon nanotube nanocomposites as the signal label. Due to the quinone-rich polydopamine nanospheres, the platform exhibited excellent fixing capacity by simple coating of sticky polydopamine nanospheres and subsequent oxidization. By coprecipitation of Fe(3+) and Fe(2+) on polydopamine modified carbon nanotubes (CNTs) with the aid of ethylene glycol (EG), the flake-like Fe3O4 coated CNTs (CNTs@f-Fe3O4) were synthesized and chosen as the carrier of multi-enzyme label due to the high loading of secondary antibody (Ab2) and horseradish peroxidase (HRP) and also the peroxidase-mimic activity of Fe3O4. Under the optimum conditions, the immunosensor can detect CPF over a wide range with a detection limit of 6.3 pg/mL. Besides, the high specificity, reproducibility and stability of the proposed immunosensor were also proved. The preliminary application in real sample showed good recoveries, indicating it holds promise for fast analysis of CPF in aquatic environment.

Electrochemical immunosensor based on hydrophilic polydopamine-coated prussian blue-mesoporous carbon for the rapid screening of 3-bromobiphenyl.

A sensitive electrochemical immunosensor for 3-bromobiphenyl (3-BBP) detection was constructed by employing a new polydopamine coated prussian blue-mesoporous carbon (PDOP/PB/CMK-3) nanocomposite as the substrate platform and multi-horseradish peroxidase-double helix carbon nanotubes-secondary antibody (multi-HRP-DHCNTs-Ab2) as the signal label. PB/CMK-3 was firstly successfully in-situ synthesized with the aid of the CMK-3 reduction, which was characterized by transmission electron microscope (TEM), infrared spectroscopy (IR), X-ray diffraction (XRD) and N2 adsorption-desorption analysis. By using PDOP/PB/CMK-3 as the substrate, it can effectively enhance the specific surface for antigen loading due to the three-dimensional structure of the nanocomposites, while large amount of PB that fixed inside or outside the pore of CMK-3 successfully improved the electrochemical response and the PDOP film can provide a biocompatible environment to maintain the activity of antigen availability. Under the optimized conditions, the proposed immunosensor shows a good current response to 3-BBP in a linear range from 5 pM to 2 nM with a detection limit of 2.25 pM. In addition, the specificity, reproducibility and stability of the immunosensor were also proved to be acceptable, indicating its potential application in environmental monitoring.

Electrochemical immunoassay of benzo[a]pyrene based on dual amplification strategy of electron-accelerated Fe3O4/polyaniline platform and multi-enzyme-functionalized carbon sphere label.

An electrochemical immunosensor, basing on a dual amplification strategy by employing a biocompatible Fe(3)O(4)/polyaniline/Nafion (Fe(3)O(4)/PANI/Nafion) layer as sensor platform and multi-enzyme-antibody functionalized highly-carbonized spheres (multi-HRP-HCS-Ab(2)) as label, was constructed for sensitive detection of benzo[a]pyrene (BaP). The stable film, Fe(3)O(4)/PANI/Nafion, can not only immobilize biomolecules, but also catalyze the reduction of hydrogen peroxide, indicating an accelerated electron transfer pathway of the platform. The experimental conditions, including the concentration of Nafion, concentration of Fe(3)O(4)/polyaniline (Fe(3)O(4)/PANI), pH of the detection solution and concentrations of biomolecules, were studied in detail. Basing on a competitive immunoassay, the current change was proportional to the logarithm of BaP concentration in the range of 8 pM and 2 nM with the detection limit of 4 pM. The proposed immunosensor exhibited acceptable reproducibility and stability. This new type of dual amplification strategy may provide potential applications for the detection of environmental pollutants.

Migration of implants: a problem with injectable polyacrylamide gel in aesthetic plastic surgery.

Polyacrylamide gel (PAAG) has been used as a soft tissue filler material for cosmetic purposes in Europe and China since 1997. The various complications of PAAG have been reported. A total of 15 patients who received PAAG injections at other institutions were treated for gel migration in the authors' hospitals. During treatment, the authors found that the injected PAAG had not formed capsules within the muscle and was encapsulated only by thin fibrous tissue in skin and mammary glands. Consequently, the filler material migrated easily because of muscular activity or the influence of gravity, especially when the capsule was broken by incorrect massage or incidental force. It is suggested that PAAG should not be injected into muscular tissue or subcutaneous areas with active movement, such as joints and muscles involved in facial expression with thin skin. After years of gel implantation, the thinned capsule may result in an increasing incidence of this complication. Management and some clinical findings in relation to the complication also are discussed.