To study the serum levels of homocysteine (Hcy), cystatin C (Cys-C), uric acid (UA) and lipoprotein a in patients with acute myocardial infarction and to explore the correlation of their changes with the degree of myocardial injury.

A retrospective study was conducted on 150 patients with AMI admitted to Shuyang Hospital from January 2022 to December 2023, designated as the AMI group. Additionally, 120 healthy individuals who underwent physical examinations at Shuyang Hospital during the same period were selected as the control group. The levels of serum Hcy, Cys-C, UA, and lipoprotein a were measured and analyzed, and the relationship between changes in these indicators and the degree of myocardial injury was investigated.

The levels of serum Hcy, Cys-C, UA, and lipoprotein a in the case group were significantly higher than those in the control group, and the difference was statistically significant (P<0.05). The levels of serum Hcy, Cys-C, UA, and lipoprotein a in patients with severe myocardial injury were significantly higher than those in patients with mild myocardial injury, and the differences were statistically significant (P<0.05). The correlation analysis results showed that serum Hcy, Cys-C, UA, and lipoprotein a in AMI patients were positively correlated with the degree of myocardial injury (r=0.513, 0.448, 0.399, 0.519, P<0.05).

As the degree of myocardial injury increases, the level of serum Hcy, Cys-C, UA, and lipoprotein a is significantly elevated, which may synergistically participate in the occurrence and development of acute myocardial infarction.

To investigate the correlation between the totaled health risks in vascular events (THRIVE) score, neutrophil-lymphocyte ratio (NLR), serum anticardiolipin antibodies (ACA), and glial fibrillary acidic protein (GFAP) levels and the prognosis of intravenous thrombolysis in acute cerebral infarction (ACI).

A total of 117 patients with ACI thrombolysis seen in our hospital from February 2022 to February 2024 were selected as the study subjects, among them, there were 65 males and 52 females. The age ranged from 30 to 80 years, with an average of (63.07±4.24) years. The prognosis of the patients was evaluated using the modified Rankin scale (mRS) score six months after discharge from the hospital, with a poor prognosis group (n=40) and a good prognosis group (n=77). The THRIVE score, NLR value, serum ACA, and GFAP levels were compared between the two groups, and the correlation between THRIVE score, NLR value, serum ACA, and GFAP levels and the prognosis of intravenous thrombolysis for ACI was analyzed using Spearman's rank correlation score method.

THRIVE scores, NLR values, serum ACA, and GFAP levels were significantly higher in the poor prognosis group than in the good prognosis group (P<0.05); Spearman's correlation analysis showed that the THRIVE score, NLR value, serum ACA and GFAP levels were positively correlated with the prognosis of ACI intravenous thrombolysis (P<0.05).

THRIVE score, NLR, ACA and GFAP levels are closely related to the prognosis of intravenous thrombolysis in ACI, and monitoring these indicators can help to assess the prognosis and treatment outcome of patients.

To explore the chain mediating role of social support and psychological resilience in perceived stress and sleep quality in acute stroke patients.

A cross-sectional study design was adopted to conduct a questionnaire survey on 527 patients with acute stroke at Changzhou Second People's Hospital from August 2023 to January 2025. The demographic characteristics questionnaire, a 10-item perceived stress questionnaire, a social support scale, a psychological resilience scale, and a Pittsburgh sleep quality index scale were used for evaluation. Pearson correlation analysis and SPSS-PROCESS macro plugin were carried out for chain mediation analysis.

Patient stress (18.86±6.32 points) was negatively associated with social support (36.22±7.62 points) and resilience (57.92±14.46 points) (r=-0.272, r=-0.296, P <0.001) and positively associated with sleep quality (7.19±3.27 points) (r=0.372, P<0.001). Social support was positively correlated with psychological resilience (r=0.508, P<0.001) and negatively correlated with sleep quality (r=-0.293, P<0.001). Psychological resilience was negatively correlated with sleep quality (r=-0.337, P<0.001). Mediation analysis showed that perceived stress positively predicted sleep quality (β=0.25, P<0.001); social support (β=-0.10, P<0.001) and psychological resilience (β=-0.19, P<0.001) negatively predicted sleep quality and played some intermediary effects; the mediation effect of both was 8.24% and 9.41% respectively; the direct effect of perceived stress on sleep quality was 0.130, accounting for 76.47% of the total effect; perceived stress mediated sleep quality through social support and psychological resilience, accounting for 7.06% of the total effect.

The sleep quality of patients with acute stroke is directly affected by perceived stress and indirectly influenced through the mediating pathways of social support and psychological resilience. Clinical attention should be paid to psychosocial intervention, which can improve patients' sleep quality and overall prognosis by enhancing social support networks and cultivating psychological resilience.

To investigate the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in patients with severe acute heart failure.

The clinical data of 120 patients with severe acute heart failure admitted to our hospital from April 2023 to December 2024 were retrospectively analyzed. There were 80 males and 40 females, the age ranged from 53 to 75 years, with an average of (66.32±6.03) years. They were divided into observation group and control group by the different treatment methods, with 60 cases in each group. The control group was treated with rhBNP on the basis of conventional treatment, and the observation group was combined with levosimendan; Both of them were treated for 2 weeks. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), N-terminal brain natriuretic peptide precursor (NT-proBNP), myocardial troponin I (cTnI), myocardial creatine kinase isoenzyme MB (CK-MB), and soluble suppression of tumorigenicity 2 (sST2), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), Minnesota heart failure quality of life (MLHFQ) score, 6-minute walking test (6MWT) at before and after treatment 2 weeks and adverse reactions were compared between the two groups.

After treatment for 2 weeks, the LVEF in observation group was significantly higher than that in control group, LVEDD and LVESE were significantly lower (P<0.05); after treatment for 2 weeks, the levels of NT-proBNP, cTnI, CK-MB, sST2, TNF-α, IL-6 and MLHFQ in observation group were significantly lower than those of the control group, and the 6MWT was significantly longer (P<0.05). But there was no statistical significance in the total incidence of adverse reactions between the two groups (P>0.05).

rhBNP combined with leveo-simendan can promote the recovery of cardiac function and improve the quality of life in patients with severe acute heart failure, which is safe and controllable, and has clinical promotion value.

To explore the influence of perioperative fluid management strategies based on the concept of injury control (DC) on the complications and prognosis of patients with multiple rib fractures accompanied by acute hemoppneumothorax.

A retrospective analysis was conducted on the clinical data of 80 patients with multiple rib fractures accompanied by acute hemopneumothorax admitted to our hospital from February 2023 to February 2025, including 52 males and 28 females. The age ranged from 24 to 75 years, with an average of (49.41±5.73) years. According to different nursing methods, they were divided into the DC group (n=43) and the control group (n=37). The control group was given traditional care, while the DC group was given care based on the DC concept on the basis of the control group. The 24-hour positive balance volume, central venous pressure (CVP), stroke volume variation (SVV), oxygenation index (PaO2/FiO2), complications and prognosis of the two groups of patients during the perioperative period were compared.

The levels of 24-hour positive equilibrium, CVP and SVV in the DC group were all lower than those in the control group, while the level of PaO₂/FiO₂ was higher than that in the control group (all P<0.05). The total incidence of complications during the nursing period in the DC group was 6.98%, which was lower than that in the control group (24.32%) (P<0.05). The mechanical ventilation time, ICU stay time and injury recovery time of patients in the DC group were all shorter than those in the control group (all P values <0.05). There was no statistically significant comparison of the 28-day mortality rate between the two groups (P>0.05).

Fluid management under the guidance of the DC concept can optimize the volume status of patients with multiple rib fractures accompanied by acute hemoppneumothorax, reduce the risk of complications, and improve the prognosis.

To analyze the anesthesia-related risk factors of postoperative cognitive dysfunction (POCD) after hip fracture surgery in the elderly and to explore the corresponding emergency intervention strategies.

A total of 180 elderly patients with hip fractures who were admitted to the Affiliated Hospital of Xuzhou Medical University from May 2022 to February 2025 were selected as the research subjects of this study. The incidence of POCD within 7 days after surgery in all patients was recorded, and the anesthesia-related risk factors for POCD in surgery for hip fractures in the elderly were analyzed.

Among 180 elderly patients with hip fractures, 38 cases developed POCD, with an incidence rate of 21.11%. There were statistically significant differences in the operation time, anesthesia time, anesthesia method, intraoperative dosage of propofol and remifentanil, whether dexmedetomidine was used during the operation, and the lowest intraoperative local cerebral oxygen saturation (rSO₂) between the POCD group and the non-POCD group (P<0.05). Univariate Logistic regression analysis showed that the operation time, anesthesia time, anesthesia method, intraoperative dosage of propofol and remifentanil, whether dexmedetomidine was used during the operation, and the lowest intraoperative rSO₂ were all anesthesia-related risk factors for POCD in elderly patients with hip fractures (P<0.05).

There are many anesthesia-related risk factors for POCD in surgery for hip fractures in the elderly; clinically, the incidence of POCD can be actively reduced through intervention strategies such as close monitoring of anesthesia depth, reasonable selection of anesthesia methods and anesthetic drugs, and combined rSO₂ monitoring.

To explore the value of detecting intestinal type fatty acid binding protein (I-FABP), D-lactate, and inflammatory factors in patients with sepsis-related acute gastrointestinal injury.

A retrospective analysis of medical records of 80 sepsis patients admitted to Yan'an People's Hospital from January 2021 to December 2024 was conducted, including 42 males and 38 females. The age ranged from 32 to 70 years, with an average of (53.52±4.10) years. According to the relevant acute gastrointestinal injury situation, the patients were divided into sepsis-related acute gastrointestinal injury group (n=25), sepsis-related non acute gastrointestinal injury group (n=55). According to the final results of acute gastrointestinal injury, they were divided into grade I-II group (n=16) and grade III-IV group (n=9). All patients were tested for serum I-FABP, D-lactate, and inflammatory factors, and the changes in serum I-FABP, D-lactate, and inflammatory factors were analyzed. The receiver operating characteristic (ROC) curve was used to analyze their early diagnostic value.

The levels of serum I-FABP, D-lactate, C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) in sepsis related acute gastrointestinal injury group were significantly higher than those in sepsis-related non gastrointestinal injury group (P<0.05); The levels of serum I-FABP, D-lactate, CRP, IL-6, and PCT in patients with grade III-IV were significantly higher than those in patients with grade I-II (P<0.05); ROC curve analysis showed that serum I-FABP, D-lactate, and inflammatory factors all had certain diagnostic value for acute gastrointestinal injury related to sepsis patients, and the combined detection AUC was 0.857, sensitivity was 91.34%, and specificity was 94.65%, indicating high diagnostic value.

The combined detection of serum I-FABP, D-lactate and inflammatory factors can improve the diagnostic efficiency of sepsis related acute gastrointestinal injury and can early reflect gastrointestinal tissue damage in patients.

To explore the efficacy and influencing factors of emergency surgery for adult incarcerated inguinal hernia.

A total of 150 patients with incarcerated inguinal hernia treated at Yulin Traditional Chinese Medicine Hospital from January 2022 to June 2024 were selected as the study subjects, including 109 males and 41 females; the age ranged from 35 to 76 years, with an average of (49.37±6.04) years. According to the postoperative prognosis, patients were divided into a poor prognosis group (n=27) and a good prognosis group (n=123). Clinical data of the two groups were collected, and a multivariate logistic regression model was used to analyze the risk factors for poor prognosis after emergency surgery for adult incarcerated inguinal hernia.

There were statistically significant differences (P<0.05) in age, body mass index (BMI), smoking history, surgical procedure, duration of surgery, and postoperative hospital stay between the two groups of patients; There was no statistically significant difference in gender, medical history, inguinal hernia type, duration of entrapment, intraoperative complications, and postoperative complication levels between the two groups (P>0.05). The results of multivariate unconditional logistic analysis showed that age BMI, smoking history, intraoperative operation style, operation duration, postoperative hospital stay, intraoperative peritoneal damage, postoperative urinary retention, postoperative pelvic infection, and postoperative hematoma/seroma were all independent risk factors for poor prognosis of adult incarcerated inguinal hernia after emergency surgery (P<0.05).

The efficacy of emergency surgery for adult incarcerated inguinal hernia is still acceptable, but there are many factors that affect poor postoperative prognosis. Timely treatment should be targeted at risk factors to delay the progression of the disease.

To explore the evaluation of the application effect of disposable non-injurious sputum suction tube in emergency and critically-ill patients in sputum suction and airway mucosal protection.

From June 2024 to December 2024, critically-ill patients hospitalized in the emergency department of Mentougou Hospital affiliated to Beijing Tongren Hospital, were selected as study subjects. The patients were randomly assigned to a control group and an experimental group. The patients in the control group were suctioned with an ordinary sputum suction tube, and the patients in the experimental group were suctioned by an innovatively designed disposable non-damaging sputum suction tube, which was a one-time non-damage sputum suction tube, that is, the head end of the sputum suction tube was designed in the shape of an elephant trunk, and several arc protrusions were added around the opening of the suction tip and the side hole. After sputum aspiration treatment, the sputum suction effect per unit time and the condition of airway mucosal injury were compared between the two groups.

The increase in peripheral capillary oxygen saturation (SpO2) per unit time and the amount of sputum suction per unit time in the experimental group were significantly higher than those in the control group after sputum aspiration treatment, and the difference was statistically significant (P<0.05). The number of bloody sputum and injured cells was significantly lower than that of the control group (P<0.05), but there was no significant difference in the improvement of sputum sound (P>0.05).

The one-time non-injurious sputum suction tube has a good sputum suction effect, which can effectively prevent airway mucosal injury in patients, and has strong application value in clinical practice.

To analyze the risk factors of acute kidney injury (AKI) in critically-ill elderly patients and the effectiveness of continuous renal replacement therapy (CRRT) intervention.

A total of 110 elderly critically-ill patients admitted to the First People's Hospital of Hangzhou from January 2019 to January 2024 were selected as the research subjects, including 85 males and 25 females. The age ranged from 78 to 95 years, with an average of (88.89±4.18) years. According to the occurrence of AKI, they were divided into 53 cases in AKI group and 57 cases in non-AKI group. Clinical data of the two groups of patients were collected, including gender, age, body mass index (BMI), underlying diseases, cardiopulmonary resuscitation, pH value at admission, sequential organ failure assessment (SOFA) score at admission, acute physiology and chronic health evaluation II (APACHE II) score, blood glucose at admission, albumin at admission, hemoglobin (HGB) at admission, and mannitol. The use of non-steroidal anti-inflammatory drugs, aminoglycosides, norvancomycin, teicoplanin, furosemide, and hydroxyethyl starch was analyzed using a multivariate Logistic regression model to investigate the risk factors of AKI in elderly critically-ill patients and the clinical effect of CRRT interventional therapy. The predictive value of each independent risk factor for AKI was analyzed through the receiver operating characteristic curve (ROC).

There was a statistically significant difference (P<0.05) in SOFA score, APACHE II score, admission blood glucose, admission albumin, and admission HGB between the two groups of patients. There was no statistically significant difference of gender, age and BMI between the two groups, in the use of combined underlying diseases, cardiopulmonary resuscitation, pH value at admission, HGB at admission, mannitol, nonsteroidal anti-inflammatory drugs, aminoglycosides, vancomycin, teicoplanin, furosemide, and hydroxyethyl starch (P>0.05). The results of multivariate unconditional logistic analysis showed that SOFA score, APACHE II score, admission blood glucose, admission albumin, admission HGB, and the occurrence of shock were all independent risk factors for AKI in elderly critically-ill patients (P<0.05). ROC analysis showed that the area under the curve of the combined prediction of these independent risk factors for AKI was 0.819 (95% CI: 0.741-0.914); After CRRT intervention treatment in 53 patients with concurrent AKI, 17 patients showed significant improvement, 22 were effective, and 14 were ineffective.

The main factors contributing to AKI in elderly critically-ill patients are SOFA score, APACHE II score, blood glucose at admission, albumin at admission, and HGB at admission. CRRT intervention therapy has a certain clinical effect.

To summarize and collect the operational status of Public Health Emergency Operation Centers (PHEOC) across various regions globally and to compare the construction and functional differences of PHEOCs in different countries or regions, aiming to provide reference for enhancing health emergency capability and PHEOC construction in China.

A thematic search strategy was established to retrieve publicly available literature and grey literature on PHEOCs worldwide from 2003 to June 30, 2025. Key elements such as the establishment or activation time and operational models of PHEOCs across different countries or regions were extracted and compared.

A total of 22 countries or regions with available PHEOC construction information were identified. Comparative analysis was conducted across six WHO regions. Global PHEOC development exhibits distinct regional characteristics. In the African and Eastern Mediterranean regions, under the guidance of WHO and with external funding support, rapid progress has been made, though many centers still face challenges in digital infrastructure and sustaining routine operations. The Americas and Europe started earlier and emphasize information integration and institutionalized emergency mechanisms; some countries have already achieved highly integrated PHEOC functions. In China, PHEOCs have played a vital role in managing major public health emergencies such as COVID-19. However, issues remain in standardization, resource coordination, and regional collaboration.

Global PHEOC development has entered a new phase characterized by simultaneous systematization and standardization, yet disparities in capacity and progress across regions persist. Moving forward, international cooperation and technological exchange should be strengthened to promote the development of standardized frameworks, performance evaluation mechanisms, and intelligent information systems. Countries should build efficient, coordinated, and intelligent PHEOC systems tailored to their specific national contexts.

To elucidate the regulatory mechanism of Dahuang Fuzi decoction (DHFZT) on hypoxia/reoxygenation (H/R)-injured intestinal epithelial cells through the solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling axis.

Twenty male Sprague-Dawley rats were randomized into DHFZT drug-containing serum (n=10) and control serum (n=10) groups. Drug-containing serum was prepared following 3-day oral gavage. Caco-2 cells were subjected to 12-hour hypoxia (1% O₂) and 2-hour reoxygenation (21% O₂) to establish the H/R model. Cell viability was quantified using CCK-8 assay. Six experimental groups were designed: Control (normal culture), H/R model, H/R+ferroptosis inhibitor Lip-1 (1μM,24h), and H/R+DHFZT serum (5%, 10%, 20%, 24h). Mitochondrial ultrastructure was analyzed by transmission electron microscopy. Oxidative stress markers (MDA, SOD, GSH), ROS, and Fe²⁺levels were measured via ELISA, DCFH-DA fluorescence, and ferrozine assay, respectively. Protein expression of HDAC3, SLC7A11, and GPX4 was assessed by Western blot.

Under transmission electron microscope, Caco-2 cells in the blank group exhibited regular morphology with abundant oval-shaped mitochondria and relatively clear mitochondrial cristae structures. In contrast, the H/R group showed disrupted cell membrane integrity, irregular surface contours, deformed cytoplasmic mitochondria, obscured mitochondrial membrane structures, and reduced or disappeared cristae. Mitochondria in the DHFZT group maintained regular morphology and orderly arrangement. Biochemical assays revealed that MDA and Fe²⁺ levels in the H/R group were significantly higher than those in the blank group (12.28±1.70 vs 9.11±0.82, q=6.47, P<0.05; 0.23±0.02 vs 0.06±0.03, q=13.21, P<0.05), while SOD and GSH levels were lower (9.09±0.41 vs 12.66±0.66, q=4.79, P<0.05; 3.33±0.22 vs 7.51±0.46, q=21.31, P<0.05). The 10% DHFZT group demonstrated reduced MDA and Fe²⁺levels compared to the H/R group (9.55±0.52 vs 12.28±1.70, q=5.57, P < 0.05; q=13.30, P<0.05) and elevated SOD and GSH levels (13.37±1.22 vs 9.09±0.41, q=5.73, P<0.05; 7.31±0.33 vs 3.33±0.22, q=20.28, P<0.05). ROS levels were significantly higher in the H/R group than in the blank group (91.67±7.37 vs 28.48±2.17, q=28.37, P<0.05), while the Lip-1 group and 10% DHFZT group showed reduced ROS levels compared to the H/R group (44.03±3.64 vs 91.67±7.37, q=21.39, P<0.05; 55.92±2.51 vs 91.67±7.37, q=16.05, P<0.05). Western blot analysis indicated that SLC7A11 and GPX4 levels in the H/R group were lower than those in the blank group (q=4.69, 5.38, P<0.05), whereas HDAC3 levels were higher (q=81.13, P<0.05). Both Lip-1 and 10% DHFZT groups exhibited upregulated SLC7A11 and GPX4 levels (q=11.05, 28.76 and q=26.79, 32.21, respectively; P<0.05) and downregulated HDAC3 levels (q=121.00 and q=59.42, P<0.05) compared to the H/R group.

Dahuang Fuzi decoction-containing serum exerts a protective effect on hypoxia-reoxygenation (H/R)-induced Caco-2 cells injury. The underlying mechanism may involve the regulation of HDAC3 expression, which subsequently activates the SLC7A11/GPX4 signaling pathway, thereby alleviating lipid peroxidation accumulation and inhibiting ferroptosis.