Abstract:Objective To identify the influencing factors of health-related quality of life(HRQOL)in patients with sepsis-related liver injury,construct and verify a nomogram model for risk prediction.Methods A total of 616 patients with sepsis-related liver injury in the hospital from January 2018 to April 2022 were selected,and their HRQOL was evaluated using the Short Form 36 Health Survey(SF-36)at 24 months after discharge.According to the SF-36 scores,the patients were divided into the high HRQOL group(SF-36 score＞median value)and the low HRQOL group(SF-36 score ≤ median value).The differences in baseline data between the two groups were statistically analyzed,the influencing factors of patients' HRQOL were explored,and a nomogram was used to construct a risk model for HRQOL in patients with sepsis-related liver injury.Results Among the 616 patients,2 voluntarily withdrew midway,and a total of 614 patients completed the follow-up survey.Using the random number table method,614 patients were divided into a training set(n=430)and a validation set(n=184)at a ratio of 7∶3:the training set was used to screen the influencing factors of HRQOL and construct the nomogram model,while the validation set was used to evaluate the model performance.The SF-36 scores of 614 patients ranged from 42 to 90 points,with a median score of 68 points;in the training set of 430 cases,there were 216 cases in the low HRQOL group and 214 cases in the high HRQOL group;in the validation set of 184 cases,there were 94 cases in the low HRQOL group and 90 cases in the high HRQOL group.Multivariate Logistic regression in the training set showed that age ≥ 60 years,high APACHE Ⅱ score at diagnosis,≥ 2 types of sepsis-induced physiological dysfunction,and low social support were independent risk factors of low HRQOL(P＜0.05).The constructed nomogram risk model showed that the concordance index(C-index)of 0.976,indicating good discrimination;the area under the ROC curve was 0.915(95％CI0.888-0.942),with a sensitivity of 0.837 and a specificity of 0.841;the calibration curve drawn showed that the calibration curve was in good agreement with the ideal curve,indicating good model accuracy.The area under the ROC curve of the validation set was 0.904(95％CI 0.864-0.945),with a sensitivity of 0.926 and a specificity of 0.748;the calibration curve was in good agreement,and decision curve analysis demonstrated net benefit＞0 within the threshold probability rang of 0.02-1.00.Conclusions Age≥60 years,high APACHE Ⅱ score at diagnosis,≥ 2 types of physiological dysfunction after sepsis,and low social support level are risk factors for low HRQOL in patients with sepsis-related liver injury;the nomogram model constructed based on the training set and verified by the validation set has good discrimination,calibration,and clinical practicability,and can provide a reliable tool for clinical evaluation of patients' HRQOL.

Abstract:Objective Ventilator-associated pneumonia(VAP)is a common and serious complication in neurocritical care.This study systematically evaluates the current research status and trends in this field through bibliometric methods.Methods Using the Web of Science Core Collection database as the literature data source,we searched for literature published from 1992 to 2025 on ventilator-associated pneumonia in neurocritical care.VOSviewer and CiteSpace are used to visualize the included literature in terms of publication volume and citation frequency,collaboration and co-citation,keyword clustering and bursting.Results A total of 406 articles were included.The annual number of publications has increased steadily,with a significant acceleration since 2010.The United States led in terms of publication volume(160 articles),citation frequency(5 033 times),and total link strength(TLS=677),followed closely by Italy and Germany.University of Basel(TLS=101),Heldenberg University(TLS=89)and Mayo Clinic(TLS=41)are the core research institutions in this field.Marsch Stephan(TLS=191)and Sutter Raoul(TLS=191)were identified as highly influential scholars.Critical Care Medicine(TLS=48 571),Stroke(TLS=33 378),Neurocritical Care(TLS=33 062)were the core journals in this field.Keyword clustering analysis showed that research hotspots in this field focus on neurocritical care,acute respiratory failure,brain related diseases/conditions,and artificial intelligence.Keyword bursting analysis suggested that previous research has mainly focused on the disease field represented by brain injury,and the current research paradigm has shifted from exploring specific diseases to systematically analyzing the predictors and risk factors of VAP in neurocritical care.It is worth noting that since 2016,ventilator-associated pneumonia has become a continuous research frontier in this field.Conclusions In the field of neurocritical care,the research on ventilator-associated pneumonia shows an upward trend,and the international multi-center cooperation network is also constantly expanding.The deep integration of artificial intelligence technology and the collaborative promotion of interdisciplinary research are expected to provide crucial support for the establishment of early accurate diagnosis system and optimization of prevention and control strategies for ventilator-associated pneumonia.

Abstract:Objective To observe the effects of cross electro-nap acupuncture on ventilator-dependent patients with stroke-related pneumonia complicated with mechanical ventilation.Methods Ninety patients were randomly divided into three groups(30 cases each)by random number table.All patients received conventional acupuncture,symptomatic treatment and basic nursing as the baseline intervention;additionally,the three groups were given different acupuncture regimens for 28 days.Within each group,diaphragmatic respiratory variability(TFdi),arterial oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2),pneumonia severity index(PSI)score,Glasgow coma score(GCS),and off-ventilator success rate were compared before and after treatment.Additionally,post-treatment results of the three groups were compared with each other to explore the optimal regimen for ventilator-dependent patients with stroke-related pneumonia.Results Within each group,TFdi,PaO2,PaCO2,PSI,GCS and other indicators improved significantly after treatment(P＜0.05).One-way ANOVA of inter-group post-treatment results showed that the indicators(TFdi,PaO2,PaCO2,PSI,GCS)improvement followed the order:cross electro-nap acupuncture group＞electrical acupuncture group＞conventional acupuncture group.The off-ventilator success rate was 86.67％in the cross electro-nap group,66.67％in the electrical acupuncture group,and 50.00％in the conventional acupuncture group.Combined with post-treatment indicators and weaning success rate,the therapeutic effect of the cross electro-nap group was superior to that of the other two groups.Conclusions Cross electro-nap acupuncture can improve TFdi,PaO2,PaCO2,PSI,GCS and other indicators in ventilator-dependent patients with stroke-related pneumonia,and increase the off-ventilator success rate.

Abstract:Sepsis-induced cardiomyopathy(SIC)is a common cardiovascular complication among septic patients,which significantly increases mortality.As a key rate-limiting enzyme in glycolysis,pyruvate kinase M2(PKM2)not only regulates cellular energy metabolism but also participates in multiple pathophysiological processes including inflammation,mitochondrial quality control(MQC),and dysregulated calcium homeostasis.Based on existing research,this review summarizes the biological characteristics of PKM2 and its research advances in SIC,thereby providing novel therapeutic perspectives for sepsis-induced cardiomyopathy.

Abstract:Objective To investigate the effect and mechanism of sulforaphane(SFN)in reducing cerebral injury and neurological dysfunction after cardiopulmonary resuscitation(CPR).Methods A porcine model of cardiac arrest(CA)and CPR in pigs(CA 10 min+CPR 6 min)was established.Animals were randomly divided into three groups:Sham group(n=6),CPR group(n=9),and CPR+SFN group(n=9).In the CPR+SFN group,we administered 2 mg/kg SFN dissolved in 20 mL saline through the femoral vein at 5 minutes after successful modeling.The administration was completed within 10 minutes.Serum levels of brain injury markers(NSE and S100β)were measured at 1 hour,2 hours,4 hours,and 24 hours after resuscitation.At 24 hours post-resuscitation,pathological brain damage,levels of proinflammatory factors,and expression of proteins related to the nuclear factor erythroid 2-related factor-2(Nrf2),heme oxygenase 1(HO-1),and nuclear factor-κB(NF-κB)pathways were assessed.Results ①Baseline indexes such as body weight,HR,MAP,CBF,ETCO2,pH and lactic acid before modeling(all P＞0.05).②During resuscitation,the parameters of CPR cycle,adrenalin dosage and defibrillation times were comparable between the CPR group and the CPR+SFN group(all P＞0.05).The resuscitation success rates were 6/9 and 7/9,respectively(P＞0.05).③Compared with the CPR group,the CPR+SFN group showed increased MAP at 2 h,3 h and 4 h,with a significant difference at 3 h(P＜0.05).④Serum NSE and S100β levels in the CPR+SFN group at 2 h,4 h and 24 h were lower than those in the CPR group(P＜0.05).⑤The pathological changes of brain tissue in the CPR+SFN group were milder than those in the CPR group.⑥The Iba1 positive expression ratio,TNF-α and IL-6 contents in CPR+SFN group were significantly lower than those in CPR group(all P＜0.05).⑦Compared with the CPR group,the protein expression levels of Nrf2 and HO-1 in the CPR+SFN group were further significantly increased,while the protein expression level of NF-κB was significantly decreased in CPR+SFN group(all P＜0.05).Conclusions SFN alleviates post-resuscitation brain injury in a porcine model,and the mechanism may be associated with the attenuation of inflammatory injury via modulation of the Nrf2/HO-1/NF-κB pathway.

Abstract:Objective To investigate the changes and clinical significance of ECG fragmented QRS complex(fQRS)and soluble growth stimulation expressed gene 2 protein(sST2)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 178 patients with acute STEMI admitted to the hospital from January 2023 to October 2024 were enrolled as the observation group,and another 186 patients with myocarditis admitted to the hospital during the same period were selected as the conventional group.After enrollment,the levels of fQRS and sST2 in the electrocardiogram of the two groups were detected.General data of the two groups(age,sex,body mass index,hypertension,smoking,and underlying diseases)were collected.Logistic regression was used to analyze the influencing factors of acute STEMI,and the receiver operating characteristic(ROC)curves were plotted.The area under the curve(AUC)was used to evaluate the prognostic value of electrocardiogram fQRS and sST2 levels and their combination for acute STEMI.Results The levels of fQRS and sST2 in ECG in observation group were higher than those in conventional group(P＜0.05).The age and neutroplil-to-lymphocyte ratio(NLR)levels in the observation group were higher than those in the conventional group(P＜0.05),and the age,NLR,modified shock index(MSI),neutrophil-to-HDL cholesterol ratio(NHR),time from onset to admission and GRACE score at admission were higher in the observation group.Multivariate Logistic analysis showed that NLR,MSI,fQRS,and sST2 levels were risk factors for acute ST-elevation myocardial infarction(P＜0.05).ROC curve results showed that the AUC values of ECG fQRS and sST2 and their combination in predicting acute ST-segment elevation myocardial infarction were 0.722,0.725 and 0.797,respectively(P＜0.05).Conclusions Both ECG fQRS and serum sST2 can be used to predict the occurrence of acute STEMI,and their combination has higher diagnostic value.

Abstract:Objective To develop a nomogram for predicting the risk of early peritoneal effusion in acute pancreatitis(AP)patients.Methods We retrospectively analyzed clinical data of AP patients admitted to the first affilated hospital of Xiamen university from January 2018 to November 2024,documenting the occurrence of ascites within 48 hours of admission.Patients were divided into groups based on early ascites occurrence.Candidate predictors including demographics,clinical indices and laboratory markers were collected.Multivariate Logistic regression was used to identify independent risk factors of early ascites,which were incorporated into a nomogram,and the model's discrimination was evaluated by concordance index and area under the receiver operating characteristic curve(AUC),and calibration was assessed with calibration plots.Results Ascites occurred in 59 of 415 patients(14.2％).Multivariate analysis demonstrated that elevated C-reactive protein(CRP)(OR=1.007 6,95％CI 1.003 5-1.011 6)and reduced serum calcium(Ca2+)(OR=0.017 6,95％CI 0.002 8-0.114 5)were independent risk factors for early ascites.The nomogram achieved an AUC of 0.832(95％CI 0.782-0.884)with good calibration(Hosmer-Lemeshow P=0.709).Decision curve analysis(DCA)and clinical impact curve(CIC)indicated practical clinical value of the model.Conclusions The CRP-and Ca2+-based nomogram reliably predicts the risk of early peritoneal effusion in AP patients,which may facilitate early identification of high-risk patients and prompt intervention to improve outcomes.

Abstract:Objective To develop a predictive model for prolonged intensive care unit(ICU)stay(pLOS-ICU)in patients after liver transplantation using machine learning techniques.Methods Adult patients who underwent liver transplantation and were admitted to the ICU at the first affiliated hospital of Xinjiang medical university from April 2013 to April 2024 were retrospectively included.Predictive models were established based on ten machine learning.Model performance was evaluated by comparing the area under the receiver operating characteristic curve(AUC)and clinical decision curves.Model interpretability was assessed using Shapley additive explanations(SHAP).Results A total of 230 patients were included and divided into a traning set(n=162)and an internal validation set(n=68).In the training set,from 20 candidate variables encompassing preoperative demographics,underlying diseases,intraoperative data,early postoperative laboratory results,and supportive therapies,seven variables were selected for model construction:the proportion of neutrophils at 8 hours postoperatively,hemoglobin level at 8 hours postoperatively,albumin at 8 hours postoperatively,unconjugated bilirubin at 8 hours postoperatively,alanine aminotransferase(ALT)level at 24 hours postoperatively,whether dopamine was used postoperatively,and whether parenteral nutrition support was used postoperatively.Among all models,the Logistic model performed best(training set AUC=0.797,internal validation set AUC=0.819).SHAP values were used to evaluate feature importance and explain the predictions.Conclusion Early postoperative liver function indicators,inflammatory status,circulatory and nutritional support,and preexisting comorbidities are key predictors of prolonged ICU stay after liver transplantation.SHAP analysis facilitates enables individualized risk assessment and early intervention.

Abstract:Adult acute poisoning is a common emergency in the emergency department,and hemoperfusion is one of the key resuscitative treatment methods.However,there is a lack of unified consensus on the selection of hemoperfusion cartridges for hemoperfusion therapy in China.This consensus emphasizes that the selection of hemoperfusion cartridges should be based on the pharmacokinetic or toxicokinetic characteristics of drugs/toxins,combined with the properties of hemoperfusion cartridges,as well as factors such as the severity of poisoning,complications,and local medical conditions.Additionally,it puts forward suggestions on the timing of treatment initiation and single treatment duration.This consensus aims to provide a reference for clinicians in the rational selection of hemoperfusion cartridges for the treatment of adult acute poisoning,further standardize the hemoperfusion treatment process for adult acute poisoning,and thereby improve the success rate of treatment.

Abstract:The European Resuscitation Council(ERC)published ERC guidelines 2025 first aid.The core of the guidelines focused on preventing cardiac arrest and reducing the incidence of emergencies.Finally,24 themes were included,which were divided into 7 general principles,8 medical emergencies,5 trauma emergencies and 4 environmental emergencies.The key updates include:defining the three principles of safety-calling-training for first aid providers,customized first aid courses,integration of structured ABCDE evaluation framework,recommendation of naloxone for nasal use when opioids are overdosed,replacement of conventional cervical collars with manual fixation of cervical spine,priority of drowning non-contact rescue,etc.This interpretation aims to systematically sort out the core content and evidence basis of the guidelines,provide practical guidance for clinical medical staff,first aid trainers and the public,promote the fair landing of the first aid system in different resource scenarios,and finally strengthen the first ring value of first aid in the survival chain.

Abstract:Cardiac arrest is a major cause of death worldwide.Effective cardiopulmonary resuscitation and rapid defibrillation remains key effective intervention for out-of-hospital cardiac arrest.Performing cardiopulmonary resuscitation within four minutes after collapse is critical for survival.Staying updated with the latest cardiopulmonary resuscitation guidelines is essential.In 2025,the European Resuscitation Council released the 2025 European Resuscitation Council Guidelines for Resuscitation.The main updates in the Epidemiology section include the following:Updated core epidemiological data on cardiac arrest;Incorporation of ten quality-improvement initiatives proposed by the International Liaison Committee on Resuscitation;Recommendations for standardized assessment tools for long-term follow-up,including first consideration of psychological health in survivors' families;Establishment of new standards mandating systematic autopsy and molecular genetic analysis for sudden unexplained deaths in individuals under 50;A new chapter addressing the challenges of resource-limited and remote settings.This article offers an interpretation of the new guideline for reference.

Abstract:In October 2025,the European Resuscitation Council(ERC)released the 2025 ERC Guidelines for Cardiopulmonary Resuscitation,which introduced updates and revisions in the section on post-resuscitation care.Key areas of update include cardiac arrest etiology screening,coronary reperfusion strategies,management of post-resuscitation seizures and myoclonus,the concept of temperature management and target temperature selection,multimodal neuroprognostication workflows,and structured rehabilitation and follow-up protocols.These revisions are all based on the latest evidence.This article provides an interpretation of this section of the guidelines for reference.

Abstract:In October 2025,the European Resuscitation Council(ERC)released the European Resuscitation Council Guidelines 2025.The section on newborn resuscitation and support of transition of infants at birth provides a systematic support approach for neonates,covering preparation before delivery,training of healthcare staff,thermal management,umbilical cord handling,assessment and intervention of vital signs,establishment of emergency vascular access,management in resource-limited and out-of-hospital settings,communication skills with parents,and principles for temporarily discontinuing or terminating resuscitation.This article offers an interpretation of the updated guideline content for reference.

Abstract:In October 2025,the European Resuscitation Council published the European Resuscitation Council Guidelines 2025.The education for resuscitation section addressed education in various settings where people may teach and learn resuscitation,including every level from basic to advanced life support.New topics added in the 2025 guidelines included education tailored for specific groups of life-saving rescuers,educational methods to teach high-quality resuscitation competencies,feedback and debriefing in life support courses,education in low-resource settings and remote areas.Major changes include updates to technology-enhanced learning for resuscitation,simulation-based resuscitation education and faculty development.This article provided an interpretation of the guidelines for reference purposes.

Abstract:A scientific,efficient and accessible emergency medical service(EMS)system is one of the key measures to reduce the delay in treating patients with cardiac arrest(CA)and improve their prognosis.The European Resuscitation Council Guidelines:Systems Saving Lives serves as an authoritative guideline in the field of cardiopulmonary resuscitation(CPR)worldwide,providing significant support for the standardization of CPR techniques and the optimization of CA treatment processes globally.The newly released Guidelines further expands on theoretical concepts,strengthens policy guidance,public education,social activities,patient management,technological innovation and flexible strategy formulation in enhancing the quality of CA treatment compared to the previous version.This study aims to systematically analyze the key updates in the 2025 Guidelines and provide reference for the optimization of China's emergency medical system.

Abstract:In October 2025,the European Resuscitation Council published the European Resuscitation Council Guidelines 2025.The Ethics in Resuscitation section covered advance care planning,termination of resuscitation,organ donation,bystander,family involvement,suicide,education,research ethics.Major changes in the 2025 guidelines included dynamic advance care planning with patient-centered education,bystander cardiopulmonary resuscitation bias reduction through cultural/gender training and mental health support,team-based termination of resuscitation decisions for locally validated out-of-hospital cardiac arrest with mandatory debriefing,organ donation policy evaluation ensuring termination of resuscitation and transparent procedures,integration of ethical conflict analysis in resuscitation education,individualized approaches for suicide-related arrests with immediate cardiopulmonary resuscitation initiation,standardized termination of resuscitation application for out-of-hospital cardiac arrest in resource-limited settings,expanded deferred consent with autonomy safeguards and public education.This article provides an interpretation of the guidelines for reference purposes.

Abstract:In October 2025,the European Resuscitation Council published the European Resuscitation Council Guidelines 2025.These Paediatric Life Support section of these guidelines provides recommendations on the prevention of cardiac arrest,basic life support,advanced life support,resuscitation in special circumstances,post-resuscitation care,prognostication,and post-discharge care for infants,children and adolescents(aged 0-18 years).This article provides an interpretation of the guidelines for reference purposes.

Abstract:Based on the latest advancements in resuscitation science from the International Liaison Committee on Resuscitation(ILCOR)2025,the 2025 Guidelines of the European Resuscitation Council(ERC)integrate 96 systematic reviews,43 scoping reviews,and 112 evidence updates to establish an evidence-based framework for resuscitation practice covering all populations and scenarios.This interpretation focuses on the core updated points of the guidelines.Starting with the background of development and methodological characteristics,it systematically analyzes the key updates in core areas including survival chain optimization,basic life support,advanced life support,resuscitation for special populations and scenarios,resuscitation education,and ethical norms.Propose application recommendations based on challenges in clinical practice,providing precise reference for guideline transformation to healthcare professionals in domestic emergency and resuscitation fields,and contributing to enhancing the homogenization level of resuscitation care in China.

Abstract:In October 2025,the European Resuscitation Council(ERC)released the 2025 ERC Guidelines for Cardiopulmonary Resuscitation.The section on resuscitation in special circumstances encompasses specific treatments for cardiac arrest due to special causes,occurring in special settings,and affecting special populations.Major updates in the 2025 edition include discouraging routine emergency/early coronary angiography in patients without ST-segment elevation on electrocardiogram,revised recommendations for cardiac arrest associated with hyperkalemia,hypothermia,occurrence in the catheterization laboratory,and patients with asthma or chronic obstructive pulmonary disease(COPD)as well as pregnant patients,and the addition of new recommendations for cardiac arrest occurring in the operating room,related to local anesthetics,and in patients with pectus excavatum.

Abstract:In October 2025,the European Resuscitation Council published the European Resuscitation Council Guidelines 2025.The Adult Basic Life Support section covered recognizing cardiac arrest,alerting the emergency services,role of the dispatcher,high-quality chest compressions,rescue breaths,using an automated external defibrillator,and safety precautions.Major changes in the 2025 guidelines included updating the process of alerting the emergency services and the description of abnormal breathing.New topics had been added regarding the role of the dispatcher,head-up cardiopulmonary resuscitation,psychological support for rescuers,and cardiopulmonary resuscitation for obese patients.Topics removed from guidelines included basic life support in response to COVID and management of foreign body airway obstruction.This article provided an interpretation of the guidelines for reference purposes.