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Objective:The predictive model of cardiac arrest in the emergency room was constructed and validated based on Logistic regression.Methods:This study was a retrospective cohort study. Patients admitted to the emergency room of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to July 2021 were included. The general information, vital signs, clinical symptoms, and laboratory examination results of the patients were collected, and the outcome was cardiac arrest within 24 hours. The patients were randomly divided into modeling and validation group at a ratio of 7:3. LASSO regression and multivariable logistic regression were used to select predictive factors and construct a prediction model for cardiac arrest in the emergency room. The value of the prediction model was evaluated using the area under the receiver operator characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).Results:A total of 784 emergency room patients were included in the study, 384 patients occurred cardiac arrest. The 10 variables were ultimately selected to construct a risk prediction model for cardiac arrest: Logit( P)= -4.503+2.159×modified early warning score (MEWS score)+2.095×chest pain+1.670×abdominal pain+ 2.021×hematemesis+2.015×cold extremities+5.521×endotracheal intubation+0.388×venous blood lactate-0.100×albumin+0.768×K ++0.001×D-dimer. The AUC of the model group was 0.984 (95% CI: 0.976-0.993) and that of the validation group was 0.972 (95% CI: 0.951-0.993). This prediction model demonstrates good calibration, discrimination, and clinical applicability. Conclusions:Based on the MEWS score, chest pain, abdominal pain, hematemesis, cold extremities, tracheal intubation, venous blood lactate, albumin, K +, and D-dimer, a predictive model for cardiac arrest in the in-hospital emergency room was constructed to predict the probability of cardiac arrest in emergency room patients and adjust the treatment strategy in time.
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Objective:To investigate the prognostic value of early serum lactate, albumin, and lactate/albumin ratio (L/A) on the 28-day prognosis of adult patients with sepsis.Methods:A retrospective cohort study was conducted among adult patients with sepsis admitted to the First Affiliated Hospital of Xinjiang Medical University from January to December in 2020. Gender, age, comorbidities, lactate within 24 hours of admission, albumin, L/A, interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP) and 28-day prognosis were recorded. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of lactate, albumin and L/A for 28-day mortality in patients with sepsis. Subgroup analysis of patients was performed according to the best cut-off value, Kaplan-Meier survival curves were drawn, and the 28-day cumulative survival of patients with sepsis was analyzed.Results:A total of 274 patients with sepsis were included, and 122 patients died at 28 days, with a 28-day mortality of 44.53%. Compared with the survival group, the age, the proportion of pulmonary infection, the proportion of shock, lactate, L/A and IL-6 in the death group were significantly increased, and albumin was significantly decreased [age (years): 65 (51, 79) vs. 57 (48, 73), pulmonary infection: 75.4% vs. 53.3%, shock: 37.7% vs. 15.1%, lactate (mmol/L): 4.76 (2.95, 9.23) vs. 2.21 (1.44, 3.19), L/A: 0.18 (0.10, 0.35) vs. 0.08 (0.05, 0.11), IL-6 (ng/L): 337.00 (97.73, 2 318.50) vs. 55.88 (25.26, 150.65), albumin (g/L): 27.68 (21.02, 33.03) vs. 29.62 (25.25, 34.23), all P < 0.05]. The area under the ROC curve (AUC) and 95% confidence interval (95% CI) of lactate, albumin, and L/A were 0.794 (95% CI was 0.741-0.840), 0.589 (95% CI was 0.528-0.647), 0.807 (95% CI was 0.755-0.852) for predicting 28-day mortality in sepsis patients. The optimal diagnostic cut-off value of lactate was 4.07 mmol/L, the sensitivity was 57.38%, the specificity was 92.76%. The optimal diagnostic cut-off value of albumin was 22.28 g/L, the sensitivity was 31.15%, the specificity was 92.76%. The optimal diagnostic cut-off of L/A was 0.16, the sensitivity was 54.92%, and the specificity was 95.39%. Subgroup analysis showed that the 28-day mortality of sepsis patients in the L/A > 0.16 group was significantly higher than that in the L/A ≤ 0.16 group [90.5% (67/74) vs. 27.5% (55/200), P < 0.001]. The 28-day mortality of sepsis patients in the albumin ≤ 22.28 g/L group was significantly higher than that in the albumin > 22.28 g/L group [77.6% (38/49) vs. 37.3% (84/225), P < 0.001]. The 28-day mortality in the group with lactate > 4.07 mmol/L was significantly higher than that in the group with lactate ≤ 4.07 mmol/L [86.4% (70/81) vs. 26.9% (52/193), P < 0.001]. The three were consistent with the analysis results of Kaplan-Meier survival curve. Conclusion:The early serum lactate, albumin, and L/A were all valuable in predicting the 28-day prognosis of patients with sepsis, and L/A was better than lactate and albumin.
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Objective To explore the clinical efficacy of "Zhishen-Tiaosui" acupuncture treatment for the stroke patients with unilateral spatial neglect. Methods A total of 66 patients who met the inclusion criteria were randomized into two groups, 33 in each group. The control group was treated with conventional body acupuncture, and the treatment group was treated with Zhishen-Tiaosui acupuncture treatment. Both groups were treated for 20 days and followed up for 8 weeks. The Fugl-Meyer Assessment (FMA) was used to assess limb motor function, and the Catherine Bergego Scale (CBS) was used to assess the daily living ability and the extent of unilateral spatial neglect. The Modified Barthel Index (MBI) assesses the ability of daily living and evaluates clinical outcomes. Results After treatment, FMA (39.21 ± 8.96 vs. 26.34 ± 8.06, t=6.135), MBI (49.62 ± 10.19 vs. 40.18 ± 9.52, t=5.919) in the treatment group were significantly higher than those in the control group (P<0.01), CBS (9.55 ± 4.68 vs. 18.20 ± 6.97, t=3.889) were significantly lower than those in the control group (P<0.01). Treatment group brain regions in the left frontal back, the left inferior frontal gyrus, left occipital in back to back to back to before the left temporal and temporal, left and right side of the anterior cingulate, back in the right frontal, cingulate gyrus of the left side, left precuneus activation intensity were significantly higher than the control group (t=4.615, 3.052, 3.644, 3.575, 3.152, 2.816, 2.579, 3.511, P<0.01). The total effective rate was 78.8% (26/33) in the treatment group and 54.5% (18/33) in the control group. The difference between the two groups was statistically significant (χ2=5.657, P=0.017). Conclusions The Zhishen-Tiaosui can improve the blood circulation of the brain in the unilateral space of the stroke, enhance the cognitive function and exercise capacity, and improve the daily living ability.
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Objective To compare the clinical efficacies of vasiculation moxibustion with pastes prepared in different ways and at different acupoint groups in treating allergic rhinitis due to deficient cold of lung qi. Method Eighty subjects were randomized into 4 groups, 20 in each group. Raw Bai Jie Zi (Semen Brassicae) was used in the vesiculation paste for group 1 and 2;stir-baked Bai Jie Zi (Semen Brassicae) was used for group 3 and 4. In group 1 and group 3, bilateral Feishu (BL 13), Fengmen (BL12), and Gaohuang (BL 43) were selected; in group 2 and group 4, bilateral Dazhu (BL11), Geshu (BL17), and Shenshu (BL23) were selected. The symptom and sign scores were compared before and after intervention. Result There were significant differences in comparing the symptoms and signs among the four groups (P＜0.05), and paired comparisons showed that the therapeutic efficacies of group 1 and group 3 were significantly higher than that of group 2 and group 4 (P＜0.05), while the differences in the therapeutic efficacy between group 1 and group 3, group 2 and group 4 were statistically insignificant (P>0.05). Conclusion Vesiculation moxibustion at the point group of Fengmen (BL12), Feishu (BL13), and Gaohuang (BL43) can markedly improve the symptoms and signs of allergic rhinitis due to deficient cold of lung qi;raw and stir-baked Bai Jie Zi (Semen Brassicae) can work equally in vesiculation paste for allergic rhinitis.
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Objective To explore the role of team-based learning(TBL)in the teaching of pe-riodontics for undergraduates. Methods Totally 38 2008 grade undergraduates majored in stomatology were divided into six groups according to previous test scores. Individual test,group test and group re-sponder were conducted successively . Average test scores before and intra class were calculated and questionnaires survey was conducted after the course. Results There was no significant correlation be-tween average test scores intra class and basic knowledge and preview effect(r=0.028,P>0.05). Ques-tionnaire survey demonstrated that learning motivation,learning interests,knowledge mastering and com-munication ability of students were significantly improved. Conclusion TBL teaching promotes the class-room atmosphere and improves team collaboration and learning enthusiasm. Students show high accep-tance for this new teaching modes,so it can be tried in the teaching of stomatology.
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Thirty-one cases of limb pain after wind-stroke were treated by direct moxibustion with small moxa cones. Results showed that 12 cases got remarkable effects, 15 cases effect and 4 cases ineffectiveness, with a total effective rate of 87.1%.
