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Out of hospital cardiac arrest resuscitation outcome in North India—CARO study

World Journal of Emergency Medicine 2017年第3期8卷 200-205页

作者： Chennappa Kalvatala Krishna Hakim Irfan Showkat Meenakshi Taktani Vikram Khatri Department of Cardiology Moolchand Medcity Department of Cardiology National Heart Institute

BACKGROUND: To evaluate the outcome of cardiopulmonary resuscitation(CPR) in out-ofhospital cardiac arrests(OHCA) in India and factors infl uencing the ***: The outcome and related factors like demographics, aspects of the OHCA event, return of spontaneous circulation(ROSC) and survival to discharge, among the 80 adult patients presenting to emergency department experiencing OHCA considered for resuscitation between January 2014 to April 2015, were analyzed, according to the guidelines of the Utstein consensus ***: The survival rate to hospital admission was 32.5%, the survival rate to hospital discharge was 8.8% and with good cerebral performance category(CPC1) neurological status was 3.8%. Majority of OHCA was seen in elderly individuals between 51 to 60 years, predominately in males. Majority of OHCA were witnessed arrests(56.5%) with 1.3% bystander CPR rate, 92.5% arrests occurred at home, 96% presented with initial non-shockable rhythm and 92.5% with presumed cardiac etiology but survival was better in those who experienced OHCA at public place, in witnessed arrests, in patients who had shockable presenting rhythm and in those where CPR duration was ≤20 ***: Witnessed arrests, early initiation of CPR by bystanders, CPR duration ≤20 minutes, initial presenting shockable rhythm, OHCA with non-cardiac etiology are associated with a good outcome. To improve the outcome of CPR and the low survival rates after an OHCA event in India, focused strategies should be designed to set up an emergency medical system(EMS), to boost the rates of bystander CPR and education of the lay public in basic CPR.

关键词： Out-of-hospital cardiac discharge Shockable rhythm Bystander CPR arrest cardiopulmonary resuscitation Survival to Witnessed arrest CPR duration Cardiac etiology

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Trends in mortality of emergency departments patients in China

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World Journal of Emergency Medicine 2019年第3期10卷 152-155页

作者： Chang Pan Xiao-ran Huang Jiao-jiao Pang Kai Cheng Feng Xu Yu-guo Chen Department of Emergency Medicine and Chest Pain Center Qilu Hospital of Shandong University Jinan China Clinical Research Center for Emergency and Critical Care Medicine of Shandong Province Institute of Emergency and Critical Care Medicine of Shandong University Qilu Hospital of Shandong University Jinan China Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province Qilu Hospital of Shandong University Jinan China The Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of Education Chinese Ministry of Health and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineQilu Hospital of Shandong University Jinan China Department of Emergency Medicine Department of Emergency and Critical Care Medicine Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China Medical College Shantou University Shantou China

BACKGROUND: Emergency medical service system (EMSS) in China is becoming more important. However, studies on mortality of emergency departments (EDs) patients in tertiary hospitals and on the trends in mortality of ED patients all over China are stagnant. The objective of this study was to quantify and describe the trends in mortality of ED patients in China. METHODS: Nine tertiary teaching hospitals were selected from tertiary teaching hospitals in different regions. The annual numbers of ED visits and deaths of these hospitals in 2004, 2009 and 2014 were recorded and analyzed. Chi-square test was used to compare the mortality of the EDs’ visits. Moreover, data on the mortality of ED patients in China from 2005 to 2015 were summarized and analyzed from the China Health and Family Planning Statistical Yearbooks (2006–2016). RESULTS: From 2004 to 2014, the overall annual mortalities in EDs increased among the tertiary hospitals (P<0.001). However, the overall annual mortality in EDs all over China decreased from 0.12% in 2005 to 0.08% in 2015. And the mortalities of EDs patients in the eastern, central and western regions of China all decreased. In addition, the average mortality of EDs patients in northern China was obviously higher than that in southern China (P<0.05). CONCLUSION: The ED mortality was increased in tertiary hospitals while decreased all over China during the past decade, which may be partly caused by some critical challenges faced by China’s EMSS, such as overcrowding and long length of stay in EDs of tertiary hospitals.

关键词： Mortality Emergency departments Tertiary hospitals Trends

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Opportunity and challenge of rehabilitation medicine in China

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Medical Review 2024年第2期4卷 87-89页

作者： Mouwang Zhou Erdan Dong Department of Rehabilitation Medicine Peking University third HospitalBeijingChina Research Center for cardiopulmonary Rehabilitation University of Health and Rehabilitation Sciences Qingdao Hospital(Qingdao Municipal Hospital)QingdaoShandong 266071China School of Health and Life Sciences University of Health and Rehabilitation SciencesQingdaoShandong 266071China Department of Cardiology and institute of Vascular Medicine Peking University Third HospitalBeijingChina and State Key Laboratory of Vascular Homeostasis and Remodeling Beijing 100191China

Rehabilitation medicine is an emerging discipline in China which is just like most countries in the *** China’s reform and opening up,economic development,and the increasing demand for health among the people,rehabilitation medicine which focuses on functional recovery has gradually attracted the attention of society and the people.

关键词： medicine rehabilitation discipline

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Prediction of Pulmonary Arterial Pressure Level after Repair of Congenital Cardiac Communications and Discharge from the Hospital: Role of Down Syndrome and Early Postoperative Hemodynamics

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Congenital Heart Disease 2022年第3期17卷 351-363页

作者： Eloisa Sassa Carvalho Maria Francilene SSouza Kelly Cristina O.Abud Claudia R.P.Castro Juliano G.Penha Ana Maria Thomaz Vanessa A.Guimaraes Antonio Augusto Lopes Heart institute(InCor) University of Sao Paulo School of MedicineSão PauloBrazil

Background:Postoperative pulmonary hypertension limits the success of surgical treatment in some patients with unrestrictive congenital cardiac *** patients at risk of developing postoperative pulmonary hypertension is important to individualize follow-up ***:We analyzed a prospective cohort of 52 pediatric patients(age 3 to 35 months)looking for perioperative predictors of mildly elevated pulmonary arterial pressure 6 months after surgery,defined as a systolic pressure greater than 30 mmHg by transthoracic *** corresponds to a mean pulmonary arterial pressure of>20 ***,echocardiographic and hemodynamic parameters were *** hemodynamics was assessed by directly measuring pulmonary and systemic arterial pressures using indwelling *** postoperative pulmonary hemodynamics was defined as the mean pulmonary/systemic mean arterial pressure ratio(PAP/SAP)obtained per patient during the first 6 h of postoperative ***:Among the factors that were investigated as possible predictors,perioperative hemodynamics and the presence of Down syndrome were initially selected using univariate analysis(pcardiopulmonary bypass(r=0.70,p0.35 was 76%sensitive and 74%specific at predicting a systolic pulmonary arterial pressure of>30 mmHg 6 months after surgery(hazard ratio with 95%CI 8.972[2.428–33.158],p=0.002).Conclusion:The hypertensive early postoperative behavior of the pulmonary circulation was strongly but not exclusively associated with Down syndrome,and it was char

关键词： Pulmonary hypertension congenital heart disease Down syndrome pediatric cardiac surgery

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Effect of Amino Acid Cardioplegia on Myocardial Metabolism and Function of Ischemic Canine Heart

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1997年第4期17卷 239-243页

作者：张凯伦蓝鸿钧程光明傅平黄毅徐志娟冯汉萍 institute of Cardiovascular Diseases Tongji Medical University Wuhan

To evaluate the effect of amino acid cardioplegia on myocardial metabolism and function of ischemic canine heart, canine cardiopulmonary bypass (CPB) model was established and the dog heart was subjected to a 120 min ischemic arrest. Animals were divided into 3 groups, group 1:warm blood cardioplegia induction and terminal perfusion plus 4 C ST. Thomas hospital solution (STS)during ischemia;group 2: warm blood cardioplegia enriched with amino acid (L-asparte and L-glutamate 13 mmol/L each) and STS without amino acid (A.G.) and group 3:both warm blood cardioplegic solution and STS enriched with A. G..The result demonstrated that the cardiac function of animals in group 2 and 3 had a significantly better recovery after ischemic-re-perfusion. By the end of ischemia the content of myocardial ATP in group 3 was distinctly higher than that in group 1(P<0. 05), with the release of cardiac enzyme being the least. Myocardial ultra-structure almost remained intact before and after ischemia. Our experiment suggests that the cardioplegia arrest with warm blood and cold crystalloid solution enriched with amino acids could diminish the ischemia-re-perfusion injuries of the heart and enhance the effect of myocardial protection.

关键词： amino acid cardioplegia myocardial metabolism and function myocardial protection

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SUPER Score Contributes to Warning and Management in Early-Stage COVID-19

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Infectious Medicine 2023年第4期2卷 308-314页

作者： Yuan Bian Qi Han Yue Zheng Yu Yao Xinhui Fan Ruijuan Lv Jiaojiao Pang Feng Xu Yuguo Chen Department of Emergency Medicine Qilu Hospital of Shandong UniversityJinan 250012China Chest Pain Center Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineInstitute of Emergency and Critical Care Medicine of Shandong UniversityQilu Hospital of Shandong UniversityJinan 250012China Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceShandong Provincial Engineering Laboratory for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinan 250012China The Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese Ministry of Health and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineQilu Hospital of Shandong UniversityJinan 250012China

Background:Some COVID-19 patients deteriorate to severe cases with relatively higher case-fatality rates,which increases the medical *** necessitates identification of patients at risk of severe *** assessment plays a crucial role in identifying patients at risk of severe *** study is to assess the effectiveness of SUPER score as a predictor of severe COVID-19 ***:We consecutively enrolled COVID-19 patients admitted to a comprehensive medical center in Wuhan,China,and recorded clinical characteristics and laboratory *** SUPER score was calculated using pa-rameters including oxygen saturation,urine volume,pulse,emotional state,and respiratory *** addition,the area under the receiver operating characteristic curve(AUC),specificity,and sensitivity of the SUPER score for the diagnosis of severe COVID-19 were calculated and compared with the National Early Warning Score 2(NEWS2).Results:The SUPER score at admission,with a threshold of 4,exhibited good predictive performance for early identification of severe COVID-19 cases,yielding an AUC of 0.985(95%confidence interval[CI]0.897-1.000),sensitivity of 1.00(95%CI 0.715-1.000),and specificity of 0.92(95%CI 0.775-0.982),similar to NEWS2(AUC 0.984;95%CI 0.895-1.000,sensitivity 0.91;95%CI 0.587-0.998,specificity 0.97;95%CI 0.858-0.999).Com-pared with patients with a SUPER score<4,patients in the high-risk group exhibited lower lymphocyte counts,interleukin-2,interleukin-4 and higher fibrinogen,C-reactive protein,aspartate aminotransferase,and lactate dehydrogenase ***:In conclusion,the SUPER score demonstrated equivalent accuracy to the NEWS2 score in predicting severe *** application in prognostic assessment therefore offers an effective early warning system for critical management and facilitating efficient allocation of health resources.

关键词： COVID-19 Early warning NEWS2 SUPER score

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Vaspin alleviates pathological cardiac hypertrophy by regulating autophagy-dependent myocardial senescence

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Emergency and Critical Care Medicine 2024年第1期4卷 4-15页

作者： Haiying Rui Huaxiang Yu Dan Zou Kai Chi Ping Xu Xiaoshuai Song Lulu Liu Xuting Wu Jinxin Wang Li Xue Department of Emergency Medicine and Chest Pain Center Qilu Hospital of Shandong UniversityJinanShandongChina Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine Institute of Emergency and Critical Care Medicine of Shandong UniversityQilu Hospital of Shandong UniversityJinanShandongChina Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceShandong Provincial Engineering Laboratory for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanShandongChina The Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese Ministry of Health and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineQilu Hospital of Shandong UniversityJinanShandongChina.

Background:Visceral adipose tissue-derived serine protease inhibitor(vaspin),a secretory adipokine,protects against insulin *** studies have demonstrated that serum vaspin levels are decreased in patients with coronary artery disease and that vaspin protects against myocardial ischemia-reperfusion injury and ***,it remains unclear whether vaspin exerts specific effects on pathological cardiac ***:An in vivo study was conducted using a cardiac hypertrophy model established by subcutaneous injection of isoproterenol(ISO)in C57BL/6 and vaspin-ko *** was administered intraperitoneally to mice,for further study.H9c2 cells and neonatal rat ventricular myocytes(NRVMs)were treated with ISO to induce *** vaspin fusion protein,the proteasome inhibitor MG132,and chloroquine diphosphate were used for further mechanistic ***:Here,we provide the first evidence that vaspin knockdown results in markedly exaggerated cardiac hypertrophy,fibrosis,and cardiomyocyte senescence in mice treated with ***,the administration of exogenous recombinant human vaspin protected NRVMs in vitro against ISO-induced hypertrophy and ***,vaspin significantly potentiated the ISO-induced decrease in *** rapamycin and chloroquine diphosphate regulated autophagy in vivo and in vitro,respectively,and participated in vaspin-mediated ***,the PI3K-AKT-mTOR pathway plays a critical role in vaspin-mediated autophagy in cardiac tissues and *** data showed that vaspin downregulated the p85 and p110 subunits of PI3K by linking p85 and p110 to NEDD4L-mediated ubiquitination ***:Our results show,for the first time,that vaspin functions as a critical regulator that alleviates pathological cardiac hypertrophy by regulating autophagy-dependent myocardial senescence,providing potential preventive and therapeutic targets for pathological cardiac hyper

关键词： Autophagic flux Myocardial senescence Pathological cardiac hypertrophy Ubiquitination Vaspin

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The optimal anticoagulation strategy for COVID-19,prophylactic or therapeutic?:a meta-analysis,trial sequential analysis,and meta-regression of more than 27,000 participants

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Emergency and Critical Care Medicine 2022年第3期2卷 148-166页

作者： Mingyue Guo Qi Han Jiaxuan Xing Feng Xu Jiali Wang Chuanbao Li Zechen Shan Yuan Bian Hao Wang Li Xue Qiuhuan Yuan Chang Pan Yanshan De Xingfang Wang Panpan Hao Shengchuan Cao Jiaojiao Pang Yuguo Chen Department of Emergency Medicine Qilu Hospital of Shandong UniversityJinanShandongChina Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine Institute of Emergency and Critical Care Medicine of Shandong UniversityChest Pain CenterQilu Hospital of Shandong UniversityJinanShandongChina Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceShandong Provincial Engineering Laboratory for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanShandongChina The Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese Ministry of Health and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineQilu Hospital of Shandong UniversityJinanShandongChina.

Background:Anticoagulants are promising regimens for treating coronavirus disease 2019(COVID-19).However,whether prophylactic or intermediate-to-therapeutic dosage is optimal remains under active ***:We comprehensively searched PubMed,Embase,Scopus,Web of Science,Cochrane Library,ClinicalTrials,and MedRxiv databases on April 26,*** independent researchers conducted literature selection and data extraction separately according to predetermined ***,this is the first meta-analysis on COVID-19,taking serious consideration regarding the dosage overlap between the 2 comparison groups of prophylactic anticoagulation(PA)and intermediate-to-therapeutic anticoagulation(I-TA).Results:We included 11 randomized controlled trials(RCTs)and 36 cohort studies with 27,051 COVID-19 *** analyzing all the RCTs,there was no significant difference in mortality between the PA and I-TA groups,which was further confirmed by trial sequential analysis(TSA)(odds ratio[OR]:0.93;95%confidence interval[CI]:0.71–1.22;P=0.61;TSA adjusted CI:0.71–1.26).The rate of major bleeding was remarkably higher in the I-TA group than in the PA group,despite adjusting for TSA(OR:1.73;95%CI:1.15–2.60;P=0.009;TSA adjusted CI:1.09–2.58).RCTs have supported the beneficial effect of I-TA in reducing thrombotic *** including all studies,mortality in the I-TA group was significantly higher than in the PA group(OR:1.38;95%CI:1.15–1.66;P=0.0005).The rate of major bleeding was similar to the analysis from RCTs(OR:2.24;95%CI:1.86–2.69;P<0.00001).There was no distinct difference in the rate of thrombotic events between the 2 regimen *** addition,in both critical and noncritical subgroups,I-TA failed to reduce mortality but increased major bleeding rate compared with PA,as shown in meta-analysis of all studies,as well as RCTs ***-regression of all studies suggested that there was no relationship between the treatment effect and the overall risk of mortality or maj

关键词： Anticoagulation COVID-19 Major bleeding Mortality Prophylactic Therapeutic

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A Systematic Approach to Pulmonary Valve Replacement in the Current Era

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Congenital Heart Disease 2021年第3期16卷 285-297页

作者： R.Allen Ligon Larry A.Latson Mark M.Ruzmetov Kak-Chen Chan Todd Roth Immanuel I.Turner Frank G.Scholl Steve Bibevski The Pediatric Heart institute Joe DiMaggio Children’s HospitalMemorial Regional Hospital-Memorial Healthcare SystemHollywoodFloridaUSA Division of Congenital Cardiothoracic Surgery The Pediatric Heart InstituteJoe DiMaggio Children’s HospitalFloridaUSA

Background:Pulmonary valve replacement(PVR)can be accomplished via surgical,transcatheter,or hybrid *** are inherent advantages to transcatheter PVR and hybrid PVR without cardiopulmonary *** review the methods and results of a standardized institutional approach to ***:Retrospective review of all PVR cases between February 2017 and February *** PVR entailed off-pump RVOT plication with percutaneous transcatheter ***:Primary transcatheter PVR was attempted in 37,hybrid PVR was performed in 11,and on-pump surgical PVR was performed in *** age at PVR was 27 years(6–65).Primary transcatheter PVR was successful in 35/37(2 converted to surgical).Standard surgical PVR was utilized for positive coronary compression testing(n=4),stent/valve system migration(n=2),or patient preference(n=3).In the hybrid group mean RVOT diameter was 34 mm(32–38).Median length of stay was 1 day for transcatheter PVR,5 for surgical,and 3 for hybrid(p=0.02).Median follow-up was 1.5 ***-interventions were one balloon valve dilation in a transcatheter PVR,and one valve dilation with subsequent transcatheter valve-in-valve PVR in the surgical *** hybrid patient expired 11 months post ***:A systematic approach to PVR utilizing all approaches in pre-defined order of preference leads to consistent outcomes in a wide variety of anatomic *** PVR may be accomplished in the majority of *** necessary,hybrid off-pump RVOT plication with transcatheter PVR avoids the need for cardiopulmonary bypass.

关键词： Transcatheter pulmonary valve replacement adult congenital heart disease congenital heart disease

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Emergency care for chest pain in China:the unmet challenges

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Emergency and Critical Care Medicine 2021年第2期1卷 82-85页

作者： Jiali Wang Feng Xu Jiaojiao Pang Wen Zheng Yuguo Chen Department of Emergency and Chest Pain Center Qilu HospitalCheeloo College of MedicineShandong UniversityJinanChina Clinical Research Center for Emergency and Critical Care Medicine of Shandong Province Institute of Emergency and Critical Care Medicine of Shandong UniversityQilu HospitalCheeloo College of MedicineShandong UniversityJinanChina Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceQilu HospitalCheeloo College of MedicineShandong UniversityJinanChina Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese Ministry of Health and Chinese Academy of Medical SciencesJinanChina State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine Qilu HospitalCheeloo College of MedicineShandong UniversityJinanChina

Jiali Wang and colleagues discuss challenges owing to the assessment and management of patients presenting to emergency department with acute chest pain in China and effective strategies to lessen the pressure on heal... 详细信息

关键词： Chest pain Emergency department Strategies

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