To explore the efficacy of“three-acupoint and five-needle”combined with abdominal pressure lifting on lung rehabilitation in patients with mechanical ventilation.
Methods
Thirtysix hospitalized patients with pulmonary invasive mechanical ventilation from July 2021 to February 2023 were randomly divided into two groups： control group and experimental group. The experimental group was treated with“three-acupoint and five-needle”combined with abdominal pressure lifting on the basis of routine treatment in the control group.The clinical efficacy，mechanical ventilation time and 28-day survival rate were compared between the two groups.The indexes of respiratory mechanics and airway clearance were compared between the two groups before getting off the ventilator. The indexes of inflammatory reaction at 1 day，2 days，3 days and 7 days after treatment were compared between the two groups.
Results
The time of mechanical ventilation in the experimental group was significantly lower than that in the control group （P＜0.05）.The 28-day mortality in the experimental group was lower than that in the control group，but there was no significant difference between the two groups （P＞0.05）. The tidal volume and peak expiratory flow before getting off the ventilator in the experimental group were significantly higher than those in the control group（P＜0.05）， and the cough strength score in the experimental group was higher than that in the control group，but there was no significant difference between the two groups （P＞0.05）. The levels of interleukin-6 （IL-6），interleukin-10（IL-10），C-reactive protein （CRP）and lactate decreased gradually in the control group and the experimental group at 1 day， 2 days， 3 days and 7 days after treatment （P＜0.05）. IL-6， IL-10， CRP and lactate in the experimental group were lower than those in the control group at each time point after treatment（P＜0.05）.
Conclusions
The method of“three-acupoint and five-needle”combined with abdominal pressure lifting can better promote the recovery of pulmonary ventilation function， shorten the time of mechanical ventilation and reduce the inflammatory reaction， but cannot reduce the 28-day survival rate of patients with mechanical ventilation.
To analyze the influencing factors of successful pre hospital recovery and to explore strategies for improving the success rate of OHCA recovery in the local area.
Methods
The clinical data from all out-of-hospital cardiac arrest （OHCA） patients who underwent cardiopulmonary resuscitation（CPR） were retrospectively collected during pre hospital visits at Yantian District People's Hospital in Shenzhen from January 1， 2015 to December 31， 2019. Analyses of demographic indicators， etiology，emergency response time， initial heart rate， presence or absence of witnesses， bystander CPR， use of automatic external defibrillators （AED） by bystanders， and pre hospital advanced life support status were carried out. The impact of various factors in key links of the out of hospital storage chain on resuscitation effectiveness was investigated and the corresponding response strategies were explored.
Results
This study included 63 patients with respiratory and cardiac arrest， with an emergency response time of （14.68 sses， bystander CPR， use of automatic external defibd expiratory volume （FEV1））， asthma control loud platform video anics and airway clearaaneous circulation （ROSC）］. Compared with the ineffective resuscitation group， the pre hospital ROSC successful group showed statistically significant differences in average age， location of OHCA， etiology， initial heart rhythm， emergency response time， eyewitness CPR，adrenaline use， and other aspects （P＜0.05）.
Conclusions
The emergency medical service system for OHCA in Yantian District is not perfect yet.It is necessary to further strengthen public awareness of first aid，enhance public training in first aid skills， and implement early CPR and defibrillation for patients with cardiac arrest.At the same time，AEDs should be scientifically configured to further improve the success rate of rescue for OHCA patients in the local area.
To analyze the impact of early mechanical ventilation on the mortality of adult in-hospital cardiac arrest （IHCA） retrospectively and to provide a theoretical basis for whether early mechanical ventilation should be implemented in IHCA patients.
Methods
This study included 1540 adult IHCA patients who received at least two minutes of external chest compressions at National Taiwan University Hospital from 2006 to 2014. Mortality of IHCA patients was the outcome indicator used， and the relationship between early mechanical ventilation and mortality was analyzed using univariate analysis and multivariate logistic regression models.
Results
Among the 1540 adult IHCA patients， 329 （21.36%）received early mechanical ventilation， while 1211 （78.64%） did not. The respective mortality rates were 89.67% （95% CI： 86.38～92.96） and 84.39% （95% CI： 82.35～86.44）. The multivariate logistic regression model showed that the risk of death for IHCA patients receiving early mechanical ventilation was increased by 58% （OR： 1.580， 95% CI： 1.03～2.43， P=0.04） compared to those who did not receive mechanical ventilation.
Conclusion
Early mechanical ventilation is an independent risk factor of mortality in IHCA patients，and it may increase the death rate in these patients.
To analyze the genotype resistance characteristics of HIV/AIDS patients who had failed virology in Guangzhou， and to explore the factors affecting the occurrence of drug resistance.
Methods
The clinical data of HIV/AIDS patients who failed virology and had a complete drug resistance report after antiretroviral therapy （ART） were retrospectively analyzed in an infection clinic in Guangzhou from March 2021 to March 2023 and the binary logistics regression method was used to analyze the incidence of drug resistance.
Results
A total of 394 patients with virological failure were included， of which 152 developed resistance， resulting in a resistance rate of 38.6%. Among these， 106 cases （26.9%），115 cases （29.2%）， 10 cases （2.5%）， and 3 cases （0.8%） exhibited resistance to nucleoside reverse transcriptase inhibitors （NRTIs）， non - nucleoside reverse transcriptase inhibitors （NNRTIs）， protease inhibitors （PIs）， and integrase inhibitors （INSTIs）， respectively. Additionally， 100 cases （65.8%） showed moderate to high resistance to lamivudine （3TC） and emtricitabine （FTC）. Furthermore， 108 cases （71.1%）and 94 cases （61.8%） showed moderate to high resistance to nevirapine （NVP） and efavirenz （EFV），respectively. Multi-factor logistic analysis showed that the baseline CD4+ T lymphocyte count was ≤200/μL，recent CD4+ T lymphocyte count was ≤200/μL， 201～399/μL，and HIV load was ≥1000 copies/ml during drug resistance detection， which were resistant risk factors for the occurrence of drug resistance.
Conclusion
HIV/AIDS patients with virological failure after ART in Guangzhou are complex in drug resistance， and the drug resistance sites are diverse. Low CD4+T lymphocyte count and high HIV load are risk factors for drug resistance.
To investigate the changes in serum zinc and associated inflammatory factors in human immunodeficiency virus/tuberculosis （HIV/TB） co-infected individuals following the development of immune reconstitution inflammatory syndrome （IRIS） during antiretroviral therapy （ART）， as well as to assess their clinical implications.
Methods
A total of 83 patients with co-infection of HIV/TB were involved in this study with follow-up. According to the occurrence of TB/IRIS during ART， the patients were divided into IRIS group （34 cases） and no-IRIS group （49 cases）. In addition， healthy individuals without HIV/TB （40 cases） were also enrolled as control. Serum levels of zinc and related inflammatory factors were analyzed and compared between different groups.
Results
The serum zinc concentration in the IRIS group of HIV/TB co-infected patients was lower than that in the control group of HIV-infected patients and also lower than that in the no-IRIS group of HIV/TB co-infected patients.
Conclusion
Zinc deficiency may be a potential factor in the occurrence of tuberculosis-related immune reconstitution inflammatory syndrome.
To observe the application effect of cloud platform video nursing in children with severe asthma， and to analyze its influence on coping style.
Methods
A total of 146 children with severe asthma admitted to our hospital from October 2021 to October 2023 were prospectively selected as research objects，and were divided into 73 observation group （receiving cloud platform video nursing）and 73 control group （receiving routine nursing） by simple digital random table method. Pulmonary function （FVC），maximum expiratory flow （PEF）， 1s forced expiratory volume （FEV1））， asthma control test （C-ACT）， coping style （CODI）， disease perception and medical fear （BIPQ）， medical fear questionnaire （CMFS） and quality of life were compared between the two groups.
Results
Pulmonary function indexes FVC，PEF，FEV1，CODI acceptance， fantasy， self-comfort scores， quality of life scores， asthma symptoms， treatment-related problems and worries-related problems were higher than those before intervention （P＜0.05） in both groups after intervention.After intervention，the pulmonary function indexes FVC，PEF，FEV1，CODI acceptance，fantasy，self-comfort score and quality of life score of the observation group were higher than those of the control group（P＜0.05）. The C-ACT scores of the children in both groups were higher at 6 months， 3 months and before intervention sequentially（P＜0.05），and the C-ACT scores of the children in the observation group were higher at 3 months and 6 months than those in the control group（P＜0.05）.After intervention，CODI distance，escape，negative emotional response and BIPQ and CMFS scores in both groups were lower than before intervention（P＜0.05）. After intervention， CODI， avoidance， negative emotional reaction， BIPQ and CMFS scores in observation group were lower than those in control group （P＜0.05）.
Conclusions
The application of cloud platform video nursing in severe asthma can improve the lung function and asthma control effect of children，improve coping style，disease perception and medical fear，and improve the quality of life of children.
To explore the application value of PDCA-style ［plan （P）， execution （Do， D），check （C） and action （A）］ circular teaching method in the training of severe ultrasound-guided hemodynamic evaluation for internal medicine residents.
Methods
In this study， a prospective randomized controlled study method was used.From July 2017 to August 2024，90 third-year residents in Xinyang Central Hospital were selected and randomly divided into group A （experimental group） and group B （control group）， with 45 residents in each group. Both groups received routine education after entering the department， among which the group A was trained in severe ultrasound-guided hemodynamic evaluation by PDCA circulation method；the group B was trained according to the training objectives and requirements of the Department of Critical Care Medicine in the Standardized Training Contents and Standards for Internal Medicine Residents. After the training period， questionnaire survey， written test and clinical ability assessment were conducted for the two groups of internal medicine residents， and the research results were statistically analyzed.
Results
Group A was superior to group B in theoretical achievement， and the difference was statistically significant（P＜0.05）. Group A was superior to group B in the diagnosis and differential diagnosis of diseases and the evaluation of clinical decision-making ability， with statistically significant difference （P＜0.05）. There was no significant difference between the two groups in skill operation， receiving patients and writing medical records（P＞0.05）.
Conclusion
Training residents majoring in internal medicine to apply PDCA cycle method in the rotation of critical medicine department can master the basic theory and skills of critical illness faster and better， which is more conducive to improving the clinical decision-making ability of residents majoring in internal medicine.
To establish an information management platform and to observe its application effect in regional emergency echelon construction of critical care specialty.
Methods
First of all， a platform construction team was set up with their different roles. The platform design idea was determined： the overall architecture mainly included one main platform， that was the critical care specialty network platform system，and three sub-platforms：cloud teaching platform，critical care data center platform，and big data display platform. 63 intensive care specialist nurses were selected for management of this platform； using the remote assistance information teaching sub-platform， nursing training was carried out through the combination of online and offline lectures and ward rounds. Online intensive care specialist training and assessment were carried out with the sub-platform of specialty teaching. A database of critical diseases was established by jointing nearby hospitals to provide data resources for regularly scientific research and training. The completion of the help project， the specialist nursing capacity and the satisfaction of nurses before and after the application of the platform were compared.
Results
After the application of the platform， the completion rates of nursing consultation， technical guidance， nursing rounds， nursing lectures，teaching rounds，nurse training，nurse assessment and nurse refresher were higher than those before the application of the platform （P＜0.05）. After the application of the platform， the nursing staff's scores and total scores in the four dimensions of theoretical knowledge learning， practical operation guidance， nursing team establishment and scientific research guidance were higher than those before the application of the platform （P＜0.05）. The satisfaction of nurses after implementation was significantly higher than that before implementation （P＜0.05）.
Conclusion
The application platform can promote the improvement of specialized nursing ability of intensive care nurses， improve the job satisfaction of nurses， and contribute to the continuous improvement of nursing quality.
