Abstract:Objective To evaluate the efficacy and safety of adipose-derived mesenchymal stem cells(AD-MSCs)in the treatment of sepsis.Methods A comprehensive search of PubMed,Embase,Web of Science,Scopus,CNKI,Wanfang,and SinoMed was conducted to collect animal experiments on AD-MSCs for the treatment of sepsis.The search covered English databases from inception to December 18,2024,and Chinese databases from inception to April 8,2025.Results This study included 17 studies.The Meta-analysis of mortality showed that AD-MSCs reduced the risk of death in septic animals at 24 h(RR=0.59,P<0.000 1),48 h(RR=0.66,P=0.002 0),and72 h(RR=0.62,P<0.000 1).Further analyses indicated that administration within 1 hour was more effective than administration after>1 hour.Moreover,AD-MSCs reduced mortality in both CLP and nonCLP models,with a more pronounced benefit observed in nonCLP models.No significant differences in efficacy were found among different cell doses or animal species.In addition,AD-MSCs significantly decreased inflammatory cytokine levels,including serum TNF-α at 6 h and 72 h and serum IL-6 at 6 h,and reduced AST and ALT levels,while the effect on BUN was not statistically significant.Conclusions Current animal evidence suggests that AD-MSCs can effectively inhibit inflammatory response,reduce ALT,AST and BUN levels,and significantly reduce short-term mortality in animal models of sepsis.

Abstract:Objective To investigate the predictive value of endothelial activation and stress index(EASIX)for respiratory failure(RF)in the children with severe pneumonia.Methods 151 children with severe pneumonia admitted to our hospital from August 2023 to February 2025 were retrospectively selected and divided into RF group(n=52)and non-RF group(n=99)according to whether they were complicated with RF.The basic information,disease data,treatment status,blood biochemistry and blood routine of the first admission were collected,and EASIX was calculated according to the levels of lactate dehydrogenase(LDH),platelet count(PLT)and creatinine in peripheral blood of the first admission.Multivariate Logistic regression analysis was used to analyze the risk factors of RF in the children,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive performance of different indicators for RF.Results There were significant differences in chest infection,hemoglobin(Hb),procalcitonin(PCT),C-reactive protein(CRP),confusion,uremia,respiratory,BP,age 65 years(CURB-65),acute physiology and chronic health evaluationⅡ(APACHEⅡ)and EASIX between the RF group and the non-RF group(P<0.05).Multivariate Logistic regression analysis showed that CRP,CURB-65 score,APACHEⅡ score and EASIX were independent risk factors for RF in the children with severe pneumonia(P<0.05).The results of ROC curve analysis showed that the AUC of CRP,CURB-65 score,APACHEⅡ score and EASIX in predicting RF in the children with severe pneumonia were 0.749,0.714,0.661 and 0.812,respectively.The AUC predicted by EASIX was the highest,the optimal cut-off value was 0.81,the sensitivity was 89.23%,and the specificity was 66.15%.Compared with the low EASIX group,the hospitalization time of the high EASIX group was significantly longer and the incidence of poor prognosis was higher(P<0.05).Multivariate Logistic regression analysis showed that EASIX>0.81 was an independent risk factor for poor prognosis after adjusting for age,gender,CRP and APACHEⅡ score(P<0.001).Conclusions CRP,CURB-65 score,APACHEⅡ score and EASIX have important value in the prediction of respiratory failure in the children with severe pneumonia.In particular,EASIX shows good predictive accuracy and is closely related to the prognosis of children.Clinicians can comprehensively use these indicators to identify RF high-risk children at an early stage,and take effective intervention measures to improve the prognosis of children.

Abstract:Sepsis refers to life-threatening organ dysfunction caused by a dysregulated host response to infection.During sepsis,the heart is often the earliest and most frequently affected organ.Patients with sepsis are often accompanied by varying degrees of cardiac dysfunction,namely sepsis-induced myocardial dysfunction(SIMD).With the advances in echocardiography(including novel techniques such as speckle tracking),the description of SIMD not only includes the decrease in systolic function accompanied by a reversible reduction in the ejection fraction,but also includes hypernormal ejection fraction,left ventricular diastolic dysfunction,and right ventricular dysfunction.Similar to the heterogeneity of sepsis patients,SIMD also presents with heterogeneity.This review will discuss the different characteristics of echocardiographic changes and functional effects of SIMD,with the hope of providing new ideas for the treatment of SIMD.

Abstract:Objective To observe the efficacy of dapagliflozin combined with sacubitril-valsartan(Entresto)in treating left heart failure-associated pulmonary arterial hypertension(LHF-PAH)and conduct an economic analysis.Methods A total of 100 LHF-PAH patients admitted to Handan First Hospital from June 2021 to October 2023 were included and randomly assigned to two groups:a single group(n=50,heart failure symptomatic treatment+Entresto)and a combined group(n=50,single group regimen plus dapagliflozin).The cardiac function indicators[left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)],plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP),6-minute walking test(6MWT)distance,mean pulmonary artery pressure(MPAP),occurrence of major adverse cardiac events(MACE),efficacy and cost-effectiveness ratio(C/E)were compared between the two groups.Results After 6-month treatment,LVESD and LVEDD in both groups were smaller than those before treatment,and the combined group was smaller than the single group(P<0.05);LVEF and 6MWT in both groups were higher than those before treatment(P<0.05),and the combined group was higher than the single group(P<0.05);The plasma NT-proBNP level and MPAP in both groups was lower than those before treatment(P<0.05),and the combined group was lower than the single group(P<0.05).There was no difference in the incidence of MACE between the combined group(4.17%)and the single group(14.89%)(P>0.05).The total effective rate of the combined group was 95.83%,which was higher than 76.60%in the single group(P<0.05).The C/E of the combined group was 45.66 RMB yuan,which was lower than 46.07 RMB yuan of the single group.Conclusions The combination of dapagliflozin and Entresto has a better effect on LHF-PAH,can effectively improve heart function,obviously reduce MPAP,can obviously enhance exercise endurance and is cost-effective.

Abstract:Objective To investigate whether plasma exosomal histone H3 could be used to predict the occurrence of heat stroke(HS)complicated by disseminated intravascular coagulation(DIC).Methods Peripheral blood was collected from 50 HS patients(21 with DIC and 29 without DIC)that were admitted to the intensive care unit on Days 1 and 4 and from 30 healthy volunteers.Plasma exosomes were isolated by ultra-high-speed differential centrifugation,and the levels of histone H3 were measured.The correlation between plasma exosomal histone H3 level and the coagulation parameters and occurence of DIC was analyzed.Results Plasma exosome histone H3 levels were significantly higher in the HS complicated by DIC group[(501.9±203.1)pg/100 μg on Day 1 and(639.1±271.5)pg/100 μg on Day 4]than in the HS uncomplicated by DIC group[(186.2±35.5)pg/100 μg on Day 1,P<0.001 and(148.1±29.4)pg/100 μg on Day 4,P<0.001]and healthy controls[(137.8±40.0)pg/100 μg on Day 1,P<0.001 and(140.6±34.6)pg/100 μg on Day 4,P<0.001].There was no significant difference in plasma exosome histone H3 levels on Days 1 and 4(P>0.05)between patients with uncomplicated HS and healthy controls.Plasma exosome histone protein H3 was significantly higher in the HS complicated by DIC group on Day 4 than on Day 1(P<0.01),but there was no significant change in the uncomplicated HS group(P>0.05).Plasma exosomal histone H3 levels were significantly correlated with coagulation markers and ISTH scores(P<0.001).The area under the receiver operating characteristic(ROC)curve for plasma exosomal histone H3 levels predicting the occurrence of DIC was 1.000[95%confidence interval(CI)1.000-1.000,P<0.001].The sensitivity and specificity for predicting the occurrence of DIC were both 100%at a threshold of 291.5 pg/100 μg.Conclusions Plasma exosomal histone H3 may be a reliable biomarker for HS complicated by DIC.

Abstract:Objective To construct a prediction model for the 28-day prognosis of sepsis patients by using machine learning algorithms and to explore the predictive value of serum secretory leukocyte peptidase inhibitor(SLPI)and S100 calcium-binding protein P(S100P).Methods This study adopted a prospective observational research method,enrolling sepsis patients admitted to the emergency department of Cangzhou Central Hospital from March 2024 to March 2025 as the research subjects.They were divided into the sepsis without shock group(58 cases)and the sepsis with shock group(95 cases)based on the severity of the condition.According to the 28-day prognosis after admission,they were further divided into the death group(44 cases)and the survival group(109 cases).Forty healthy individuals who underwent physical examinations during the same period were included as the control group.The levels of SLPI and S100P in the serum of sepsis patients were detected on the day of admission by using enzyme-linked immunosorbent assay(ELISA).Multivariate Logistic regression was used to analyze the risk factors for 28-day mortality in sepsis patients,and Spearman correlation analysis was conducted.The R software was used to construct a decision tree model based on the risk factors affecting 28-day mortality in sepsis patients,and the predictive performance of the model was evaluated by using the receiver operating characteristic(ROC)curve and the area under curve(AUC).Results The levels of SLPI[492.40(424.45,556.9)pg/mL,vs.389.85(332.3,446.72)pg/mL]and S100P[60.5(52.05,77.3)ng/mL,vs.(42.62,55.27)ng/mL]in the serum of sepsis with shock patients were significantly lower than those in the sepsis without shock patients(P<0.001).The levels of SLPI[422.1(345.7,496.2)pg/mL,vs.547.6(456.22,607.85)pg/mL]and S100P[50.5(44.5,55.6)ng/mL,vs.78.5(69.45,87.65)ng/mL]in the serum of the survival group were significantly lower than those in the death group(P<0.001).There were statistically significant differences in the SOFA score,APACHEⅡ score,blood lactate(Lac),albumin(ALB),and procalcitonin(PCT)in sepsis patients between the survival group and the death group(P<0.001).The results of multivariate Logistic regression analysis identified that SLPI[OR=1.01,95%CI(1.00,1.02)],S100P[OR=1.23,95%CI(1.14,1.37)],SOFA score[OR=1.41,95%CI(1.15,1.83)],APACHEⅡ score[OR=1.16,95%CI(1.03,1.34)],and Lac[OR=1.15,95%CI(1.03,1.32)]were risk factors for 28-day mortality in sepsis patients(P<0.05).Spearman correlation analysis showed that S100P and SLPI were significantly positively correlated with APACHEⅡscore,SOFA score and Lac(r=0.768、0.676、0.699,r=0.691、0.803、0.702,P<0.001).A decision tree was constructed based on the risk factors affecting 28-day mortality in sepsis patients,and the three variables most associated with to patient mortality(S100P,SOFA score and SLPI)were identified ultimately.The accuracy rate of the decision tree model was 89.54%,the sensitivity was 84.09%,the specificity was 91.74%,and the area under ROC curve was 0.935[95%CI(0.877,0.968)].The AUC of APACHEⅡ score and SOFA score alone for predicting 28-day mortality in sepsis patients was 0.748[95%CI(0.712,0.773)]and 0.798[95%CI(0.765,0.827)],respectively.The decision tree model showed significantly better predictive performance than APACHEⅡscore and SOFA score alone.Conclusions The levels of serum SLPI and S100P in sepsis patients are significantly elevated.The decision tree model constructed based on SLPI and S100P can more accurately assess the adverse prognosis of sepsis patients.

Abstract:Sepsis is one of the important causes of death for critically ill patients,and sepsis-induced acute lung injury(ALI)is a common complication.The traditional view posits that pyroptosis,apoptosis,and necroptosis act independently.However,the PANoptosis proposed in 2019 integrates these three major cell death pathways and is uniformly regulated by the PANoptosome complex.Recent studies have shown that PANoptosis drives the collapse of the alveolar-capillary barrier,inflammatory storm and coagulation disorders in sepsis-induced ALI.This article aims to summarize the concept and mechanism of PANoptosis and its role in sepsis-induced ALI,with the expectation of providing potential therapeutic intervention measures for improving the prognosis of sepsis patients.

Abstract:Objective To explore the clinical application value of elastic power(EP)in lung-protective ventilation for prone position mechanical ventilation patients with moderate-to-severe acute respiratory distress syndrome(ARDS)and the prognostic evaluation for 28-day status.Methods A prospective,observational cohort study was performed on the patients diagnosed with moderate-to-severe ARDS in the Intensive Care Unit of the First Affiliated Hospital of Jinzhou Medical University from January 2021 to December 2023.The patients were divided into survival group and death group according to the 28-day prognosis.Prone position ventilation treatment was implemented based on the changes of their conditions,and baseline data and respiratory indexes were collected.EP,mechanical power(MP),respiratory rate(RR),tidal volume(VT)and best positive end expiratory pressure(PEEP)were compared between the two groups at 16 h and 48 h after prone position ventilation.COX multivariate regression was used to evaluate the 28-day mortality risk of moderate-to-severe ARDS patients undergoing prone position ventilation;the assessment value of elastic power/compliance(EP/Cst)normalized by compliance in 28-day mortality was analyzed by the receiver operating characteristic(ROC)curve and Kaplan-Meier survival curve.Results 102 patients with moderate-to-severe ARDS treated with prone position ventilation were divided into the survival group(n=68)and the death group(n=34).There were no significant differences in age,gender,body mass index(BMI),underlying disease,oxygenation index(PaO2/FiO2,P/F)between two groups(all P＞0.05).Compared with the survival group,APACHE Ⅱ score and SOFA score in the death group were significantly increased[APACHE Ⅱ(score):21.37±3.22 vs.23.53±3.52,SOFA(score):10.78±2.52 vs.12.03±2.42,all P＜0.05].EP,MP,EP/Cst,MP/Cst,RR and best PEEP were all lower in the survival group than in the death group at 16 h and 48 h after prone ventilation treatment,and VT was higher than that in the death group[EP16 h(cmH2O):16.70±2.76 vs.18.18±3.34,EP48h(cmH2O):15.97±2.69 vs.20.06±2.86;MP16 h(cmH2 O):19.16±2.57 vs.20.38±3.25,MP48h(cmH2O):17.90±4.14 vs.21.11±4.37;EP/Cst16h(J/min × cmH2O/mL × 10-3):484.25±85.16 vs.529.18±76.38,EP/Cst48 h(J/min × cmH2O/mL × 10-3):480.41±82.85 vs.533.29±67.29;MP/Cst16h(J/min × cmH2O/mL × 10-3):513.53±85.09 vs.551.24±53.00,MP/Cst48h(J/min × cmH2O/mL × 10-3):499.81±43.29 vs.552.24±47.83;VT16h(mL):323.41±37.99 vs.309.71±16.36,VT48h(mL):338.57±34.86 vs.300.91±28.49;RR16 h(times/min):19.87±4.63 vs.23.50±4.35,RR48 h(times/min):18.44±4.41 vs.24.14±5.18;Best PEEP16h(cmH2O):13.38±2.67 vs.15.00±2.88,Best PEEP48 h(cmH2 O):11.51±2.35 vs.17.15±2.83,all P＜0.05].COX multivariate regression results showed that EP/Cst16 h,MP/Cst16 h and RR16 h were independent risk factors for prone mechanical ventilation in ARDS patients.ROC curve analysis showed that the area under curve of EP/Cst16h was 0.829,and the best cutoff value was 524.50;The area under curve of MP/Cst16h was 0.715,and the best cutoff value was 514.50;The combined area under the curve of EP/Cst16h and MP/Cst16h was 0.832,the best cutoff value was 492.50,all P＜0.001.Kaplan-Meier survival curve analysis of EP/Cst between the two groups showed that the 28-day cumulative survival rate of the high EP/Cst group was significantly lower than that of EP/Cst group(Log Rank=6.499,P=0.011).Conclusions EP and EP/Cst have good clinical value for lung-protective ventilation in prone mechanical ventilation patients with moderate-to-severe ARDS,and EP/Cst can be used to evaluate the 28-day prognosis.

Abstract:Sepsis can cause multiple organ failure by excessive interaction between immunity and coagulation,Sepsis-induced coagulopathy(SIC)is one of the important factors leading to poor prognosis.With the continuous development of artificial intelligence,the application of machine learning has become more and more common in the medical field.Machine learning refers to the automatic learning of underlying laws from training set data,and these laws are used for classification,prediction,and decision-making of new data.The application of machine learning in SIC can help physicians detect the disease earlier and take effective interventions to reduce the disease severity and improve the patient's prognosis.This review summarizes the pathogenesis of SIC,the research progress of machine learning algorithm in the diagnosis,treatment and prognosis evaluation of SIC,and discusses its advantages and disadvantages as well as future research directions and improvement measures in order to provide directions for future research and clinical treatment.

Abstract:Objective To analyze the influencing factors of reocclusion in the patients of acute ischemic stroke with large vessel occlusion(AIS-LVO)after mechanical thrombectomy,and to construct a predictive model to guide clinical decision-making.Methods This study was a retrospective analysis,the clinical data of 312 AIS-LVO patients underwent mechanical thrombectomy treatment in Yuncheng Central Hospital affiliated to Shanxi Medical University from January 2021 to December 2024 were collected.According to the occurrence of reocclusion within 72 h after surgery,the patients were divided into non-occlusion group(n=287)and reocclusion group(n=25).The relevant data of the two groups were compared,and the influencing factors of postoperative reocclusion in the patients were analyzed by Logistic regression model.Based on this,a nomogram prediction model was constructed,and the prediction efficiency of the model was evaluated for internal validation through calibration curve and decision curve.Results The National Institutes of Health Stroke Scale(NIHSS)score and homocysteine(Hcy)levels in the reocclusion group were higher than those in the non-occlusion group before surgery.The proportion of target vessel stenosis,multiple thrombectomy during surgery,postoperative thrombus escape,and no use of tirofiban during the perioperative period in the reocclusion group were higher than those in the non-occlusion group.The preoperative platelet-derived growth factor(PDGF)level was lower than that in the non-occlusion group(P＜0.05).Logistic regression analysis showed that preoperative NIHSS score,PDGF level,intraoperative thrombectomy frequency,and postoperative thrombus escape were all influencing factors for the occurrence of postoperative reocclusion in AIS-LVO patients undergoing mechanical thrombectomy(P＜0.05).Nomogram prediction model.The results showed that the consistency index(C-index)of the model in predicting the risk of reocclusion after mechanical thrombectomy in AIS-LVO patients was 0.933,indicating good discrimination of prediction model.A calibration curve was drawn,and the results showed that it approached the ideal curve with good consistency.Decision curve showed that within the risk threshold range of 0.00-0.80,the clinical net benefit rate of the model was always greater than 0,indicating good clinical practicality of the model.Conclusions The risk of reocclusion in the patients undergoing AIS-LVO mechanical thrombectomy is related to preoperative NIHSS score,PDGF level,intraoperative thrombectomy frequency,and postoperative thrombus escape.The predictive model constructed based on this has ideal discrimination,consistency,and predictive efficacy for the risk of reocclusion in the patients.

Abstract:High mobility group box 1(HMGB1)is a conserved non-histone nuclear protein that not only participates in intracellular processes such as DNA replication,recombination and repair,but also involves in inflammatory response extracellularly as a damage-associated molecular pattern(DAMP).Acute lung injury(ALI)is an acute diffuse pulmonary inflammatory response caused by various factors such as infection and trauma.Its main characteristics include the disruption of the alveolar-capillary barrier,non-cardiogenic pulmonary edema,and hypoxemia.With the continuous deepening of research in recent years,it has been discovered that HMGB1 plays an important role in ALI and regulates its occurrence and development.Therefore,this article summarizes the research on the mechanism of HMGB1 in ALI,and reviews how HMGB1 alleviates inflammatory responses,improves pulmonary edema and tissue damage by regulating autophagy,immune cell functions,and ferroptosis during the process of ALI.The aim is to explore the mechanism of HMGB1 intervention in ALI,in order to provide new ideas for protecting lung function and improving lung injury.

Abstract:Objective To explore the therapeutic mechanism of Xianfang Huoming decoction in sepsis based on ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)combined with bioinformatics and network pharmacology.Methods The active ingredients of Xianfang Huoming decoction were analyzed by using UPLC-Q-TOF-MS/MS.The active ingredients obtained by the analysis and those retrieved through literature search were imported into traditional Chinese medicine systems pharmacology(TCMSP)databases to screen the effective active ingredients and potential targets of Xianfang Huoming decoction.The differentially expressed genes of sepsis were analyzed by GEO database.The GeneCards and OMIM databases were used to screen the targets of sepsis.The Venny tool was used to screen the drug-disease mapping targets,and the String database was used to construct the protein-protein interaction(PPI)network of overlapping targets,which was then imported into the Cytoscape software to establish the drug-ingredient-target-disease network diagram,and to screen out the core targets and key components.Metascape database was used to analyze the KEGG pathway and GO functional enrichment,and the signaling pathways with higher relevance were screened based on the P value.The molecular docking and molecular dynamics simulations of the key active ingredients and core targets were carried out by AutoDock,Pymol,Gromacs and other software to further elucidate the stability of the binding of the key ingredients to the targets at the molecular level.Results 39 compounds were analyzed by UPLC-Q-TOF-MS/MS,and the obtained compounds were imported into the TCMSP database and further screened under the conditions of"OB≥30％,DL≥0.18"to obtain 24 active ingredients.We obtained 177 potential targets of Xianfang Huoming decoction for the treatment of sepsis.PPI network analysis screened the top 5 core targets based on the degree value,which were interleukin(IL)-6,tumor necrosis factor(TNF),signal transducer and activator of transcription 3(STAT3),tumor suppressor factor P53(TP53),and protein kinase B(AKT)type 1.GO and KEGG enrichment analyses showed that Xianfang Huoming decoction involved multiple signaling pathways in sepsis therapy,mainly including mitogen-activated protein kinase(MAPK),PI3K-Akt.Through molecular docking and molecular dynamics simulation,it was found that quercetin,luteolin,β-sitosterol and naringenin,the top 4 core components of Xianfang Huoming decoction,had good binding ability with TP53,AKT1,STAT3,IL-6 and TNF.Conclusions Xianfang Huoming decoction has a"multi-component,multi-target,multi-pathway"effect.Quercetin,luteolin,β-sitosterol and naringenin may be the main active components of Xianfang Huoming decoction,and TP53,AKT1,STAT3,IL-6 and TNF may be the potential therapeutic targets of Xianfang Huoming decoction in the treatment of sepsis.Xianfang Huoming decoction may exert therapeutic effects through signaling pathways such as MAPK,PI3K-Akt.

Abstract:Objective To analyze the research progress and the evolutionary route of hotspots in emergency medical supplies reserves both domestically and internationally.Methods This study examined a total of 640 domestic and international papers sourced from the Web of Science Core Collection and CNKI,spanning the period from 2004 to 2024.Employing a multifaceted approach including the context of publication,disciplinary distribution,authors,research institutions,highly cited papers,keyword theme tracking,and cluster analysis,a visual analysis was conducted by using the CiteSpace bibliometric software.Results The volume of domestic publications witnessed a notable surge following significant unforeseen events,notably the 2008 Wenchuan Earthquake,and achieved a substantial spike particularly after the COVID-19 pandemic,subsequently stabilizing in recent times.Conversely,international literature publication has demonstrated a steady,albeit fluctuating,upward trajectory,with a marked increase in output similarly observed after the COVID-19 outbreak.Domestically,research endeavors primarily revolved around disciplines such as law,economics,and public administration.In contrast,international research primarily focused on disciplines like"Engineering"and"Operations Research Management Science".In terms of highly cited papers,domestic research focuses on key issues and solutions for emergency medical supplies reserves,including the location of emergency logistics centers and optimization models for concurrent allocation and scheduling of emergency supplies.In contrast,international studies predominantly center on model algorithms for emergency medical supplies allocation,emphasizing interdisciplinary research applications.Domestic research hotspots have progressively shifted from the establishment of emergency management systems and strategies to deeper explorations in emergency rescue,health emergency response,and emergency logistics and material allocation.On the international front,research had evolved from foundational studies in mathematical modeling and optimal location selection to broader domains encompassing disaster management and emergency response,emergency medical services and supply chain optimization,scheduling and optimization algorithm applications,as well as innovative applications of emerging technologies such as deep learning in the realm of emergency medical material reserves.Conclusions There exists a convergence in the inception timing and development trends of research on emergency medical material reserves both domestically and internationally,closely tied to the global outbreaks and pandemics of major infectious diseases.The research communities and institutions involved,both domestically and internationally,remain relatively dispersed,awaiting the formation of a broad academic consensus and cohesive research teams.Domestic research primarily focuses on system construction and mode innovation,whereas international research delves deeply into mathematical and computer science disciplines,emphasizing model optimization and strategy design.The overall trend in research is a deepening shift from macro-level theories to concrete practices and from single discipline to interdisciplinary integrations.

Abstract:It provides a detailed analysis of localized and systemic infections resulting from injuries caused by various animal species,including cats,dogs,rodents,arthropods,and marine animals.The review also summarizes the main pathogens involved and their clinical manifestations.The results indicate that infections following animal injuries are primarily caused by bacteria,viruses,and parasites,with significant variations in infection patterns and transmission routes across animal types:bites from cats and dogs predominantly lead to bacterial infections;rodent injuries facilitate the transmission of viruses and parasites;arthropod bites spread multiple pathogens;and marine animal injuries are often complicated by toxins and opportunistic bacterial infections.The study emphasizes that animal-induced injuries represent a major global public health challenge,particularly in developing countries and rural areas.Future efforts should strengthen mechanistic research and enhance global cooperation in prevention and control.

Abstract:Sepsis is a severe systemic inflammatory response syndrome(SIRS)triggered by infection.Early identification and accurate prognostic assessment are crucial for improving patient outcomes.Cell-free DNA(cfDNA),as an emerging biomarker,has garnered significant research attention in the field of sepsis in recent years.Studies indicate its involvement in the pathogenesis and progression of the disease and suggest its potential value in prognostic assessment.This article systematically reviews the generation mechanisms of cfDNA(including release pathways mediated by apoptosis,necrosis,and immune responses),its clinical applications(such as early identification,severity assessment,and mortality prediction),and its complementary role with conventional scoring systems and biomarkers.By analyzing the relationship of cfDNA levels with the degree of organ failure,treatment response,and long-term prognosis in septic patients,this review aims to provide valuable insights for clinical practice.

Abstract:Objective To construct a nomogram prediction model for early surgical repair of multiple ligament injuries in knee dislocation.Methods The data of 258 patients with early surgery for multiple ligament injury of knee dislocation admitted to the Affiliated Xiaoshan Hospital of Hangzhou Normal University from April 2021 to April 2024 were reviewed,and were randomly divided into the training set(208 cases)and the validation set(50 cases)according to 8∶2.All the patients were given anterior and posterior cruciate ligament reconstruction by arthroscop and collateral ligament repair treatment at the early stage.The repair effect was examined after surgery,and the patients with obvious and effective effects were included in the effective repair group,and the patients with no repair effect were included in the ineffective repair group.The article analyzed the influence of disease severity and Lysholm score on the early surgical repair effect of multi-ligament injury of knee dislocation,established the prediction model of early surgical repair effect of multi-ligament injury of knee dislocation,verified the model and evaluated the efficacy.Results 46 cases(22.12％)of the training set were ineffective,and 14 cases(28.00％)of the validation set were ineffective.Logistic regression analysis showed that the degree of disease,Lysholm score and International Knee Documentation Committee(IKDC)score were risk factors for early surgical repair of multi-ligament knee dislocation injury.With the above influencing factors as predictive variables,a nomogram prediction model was established,and the C-index was 0.812(95％CI 0.778-0.834).The correction curve for predicting the early surgical repair effect of multiple ligament injuries of knee dislocation was close to the ideal curve(P＞0.05).ROC curve results of the training set showed that the sensitivity,specificity and AUC of the nomogram model to predict the early surgical repair effect of multiple ligament injuries of knee dislocations were 77.98％,82.03％and 0.853(95％CI 0.771-0.923).ROC curve results of validation set showed that the sensitivity,specificity and AUC of the nomogram model to predict the early surgical repair effect of multiple ligament injuries of knee dislocation were 72.01％,89.03％and 0.884(95％CI 0.810-0.955).Conclusions The degree of disease,Lysholm score and IKDC score are the factors that affect the early surgical repair effect of multi-ligament injury of knee dislocation.The nomogram model constructed based on above-mentioned indexes has a good predictive effect on the early surgical repair of multiple ligament injuries in knee dislocation.

Abstract:Objective To explore the influencing factors of nosocomial infection in emergency intensive care unit(EICU)patients and to establish a prediction model of nosocomial infection.Methods The retrospective study was conducted to analyze the patients admitted to the EICU of the Second Affiliated Hospital of Guangzhou Medical University from January 2018 to December 2021,including 78 patients with nosocomial infection.218 patients without nosocomial infection were matched in the proportion of 1∶3.The independent risk factors of nosocomial infection in EICU patients were analyzed by multivariate Logistic regression,and the prediction model of nosocomial infection in EICU patients was constructed.Results Multivariate Logistic regression analysis showed that age(P=0.011,OR=1.026,95％CI 1.006-1.047),endotracheal intubation(P＜0.001,OR=5.739,95％CI 2.771-11.887),the combined use of antibiotics(P＜0.001,OR=3.127,95％CI 1.649-5.930)were independent risk factors for nosocomial infection in EICU patients.The final prediction model was P=0.026 × A+1.747 × B+1.140 × C-4.730(A was age;when there was endotracheal intubation,B was assigned as 1,otherwise it was 0;When antibiotics were combined,the value of C was 1,otherwise it was 0).When the predictive model value was＞0,the risk of nosocomial infection increased.The AUC of the model was 0.787,the sensitivity was 0.910,the specificity was 0.586,the optimal cutoff value was 0.19,and the prediction accuracy was 74.80％.Conclusions Age,the combined use of antibiotics and endotracheal intubation are independent risk factors for nosocomial infection in EICU of our hospital.The prediction model of EICU nosocomial infection constructed based on above-mentioned indexes has good prediction effect.

Abstract:Objective To explore the clinical value of echocardiography parameters in predicting new-onset atrial fibrillation in sepsis.Methods A total of 377 patients with sepsis in Emergency Medicine Center of Beijing Chaoyang Hospital from December 2019 to August 2024 were included.According to the patients with or without atrial fibrillation within 72 h after being admitted to hospital,they were divided into two groups:93 cases in the new-onset atrial fibrillation group and 284 cases in no new-onset atrial fibrillation group.The clinical data,laboratory biochemical indicators and echocardiography parameters were compared between the two groups.Univariate and multivariate Logistic regression analyses were used to identify the influencing factors of new-onset atrial fibrillation in sepsis,and the prediction model was constructed and evaluated.Results Age[odds ratio(OR)=1.049,P＜0.001],mechanical ventilation(OR=2.714,P＜0.001),use of vasoactive agents(OR=2.303,P=0.006),and left atrial anteroposterior diameter(OR=1.046,P=0.042)were independent predictive factors of new-onset atrial fibrillation in sepsis.The area under curve(AUC)of the prediction model established by the four factors was 0.725(P＜0.001),the sensitivity of the model was 61.3％,and the specificity was 80.6％,the Hosmer-Lemeshow goodness of fit test showed a good effect(P=0.208).Conclusions Age,mechanical ventilation,use of vasoactive agents,and left atrial anteroposterior diameter are independent risk factors of new-onset atrial fibrillation in sepsis,the model established by the four factors can predict the risk of new-onset atrial fibrillation in sepsis effectively.

Abstract:Maritime casualty evacuation has its unique application characteristics and environmental requirements,mainly reflected in the wide coverage of maritime combat area,slow movement at sea,harsh and complex natural environment conditions at sea,etc.These characteristics put forward higher requirements for unmanned aerial vehicles(UAV)engaged in maritime combat missions.In this paper,the development status of maritime UAV,the characteristics of maritime casualty evacuation and the advantages of UAV in maritime casualty evacuation were analyzed,and the important role and existing problems of maritime UAV in casualty evacuation were deeply discussed.It is hoped to provide theoretical support for the future development of maritime UAV and the research of maritime wounded evacuation.

Abstract:With the rapid development of 5G technology,its application in the field of emergency rescue has gradually attracted attention.The high speed,low latency and wide connection features of 5G technology provide new opportunities for the optimization of the emergency rescue system.This article reviews the research progress of the modernization construction of the emergency rescue system in the context of 5G in recent years,covering the aspects such as the application background of 5G,policy support and promotion under the background of 5G,talent team building,information platform expansion,optimization of rescue processes,improvement of equipment performance,precise allocation of resources,comprehensive information sharing,coordinated linkage mechanism,and education and training on popular science of public first aid knowledge in China.It also elaborates on the existing problems and challenges in the construction of the emergency rescue system under the background of 5G,and looks forward to the future development,with the aim of providing references for the construction and development of the emergency rescue system in China.