Application of clinical thinking training system based on entrustable professional activities in emergency teaching.

Background: Standardized training for resident physicians (STRP) is essential for improving their clinical skills. The standardized training for resident physicians in emergency medicine differs from other disciplines, focusing more on knowledge related to medical emergencies and emergency care skills requiring urgency and real-time response. There are specific differences in knowledge content, teaching methods, curriculum design, and career development compared to other specialties.

Sulforaphane improves post-resuscitation myocardial dysfunction by inhibiting cardiomyocytes ferroptosis via the Nrf2/IRF1/GPX4 pathway.

Background: Ferroptosis is an important type of cell death contributing to myocardial dysfunction induced by whole body ischemia reperfusion following cardiac arrest (CA) and resuscitation. Sulforaphane (SFN), known as the activator of the nuclear factor E2-related factor 2 (Nrf2), has been proven to effectively alleviate regional myocardial ischemia reperfusion injury. The present study was designed to investigate whether SFN could improve post-resuscitation myocardial dysfunction by inhibiting cardiomyocytes ferroptosis and its potential regulatory mechanism.

Bergapten attenuates hemorrhagic shock induced multi-organ injury by inhibiting NLRP3 inflammasome activation and pyroptosis.

Objectives: Treatment of hemorrhagic shock (HS) induced multi-organ injury remains a challenge. Bergapten (BeG) is a bioactive coumarin-derived compound, and previous articles have suggested that BeG may serve as a prospective therapeutic modality for HS. This study was designed to investigate the efficacy of BeG in the treatment of HS and its underlying mechanisms.

A risk prediction model for efficient intubation in the emergency department: A 4-year single-center retrospective analysis.

Objective: To analyze the risk factors associated with intubated critically ill patients in the emergency department (ED) and develop a prediction model by machine learning algorithms.

Methods: This study was conducted in an academic tertiary hospital in Hangzhou, China. Critically ill patients admitted to the ED were retrospectively analyzed from May 2018 to July 2022.

On the way to the azygos vein: a road of return rather than ruined.

Background: The malposition of central venous catheters (CVCs) may lead to vascular damage, perforation, and even mediastinal injury. The malposition of CVC from the right subclavian vein into the azygos vein is extremely rare. Here, we report a patient with CVC malposition into the azygos vein via the right subclavian vein.

SULFORAPHANE ALLEVIATES POSTRESUSCITATION LUNG PYROPTOSIS POSSIBLY VIA ACTIVATING THE NRF2/HO-1 PATHWAY.

Introduction: Sulforaphane (SFN), known as the activator of the nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) pathway, has been proven to protect the lung against various pathological stimuli. The present study aimed to investigate the effect of SFN on lung injury induced by systemic ischemia reperfusion after cardiac arrest and resuscitation. Methods: After animal preparation, 24 pigs were randomly divided into sham group (n = 6), cardiopulmonary resuscitation group (CPR, n = 9), or CPR + SFN group (n = 9).

ALDA-1 TREATMENT ALLEVIATES LUNG INJURY AFTER CARDIAC ARREST AND RESUSCITATION IN SWINE.

Introduction: Alda-1, an aldehyde dehydrogenase 2 (ALDH2) activator, has been shown to protect the lung against a variety of diseases including regional ischemia-reperfusion injury, severe hemorrhagic shock, hyperoxia, and so on. The present study was designed to investigate the effectiveness of Alda-1 treatment in alleviating lung injury after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in swine. Methods: A total of 24 swine were randomized into three groups: sham (n = 6), CA/CPR (n = 10), and CA/CPR + Alda-1 (n = 8).

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study.

Background: We sought to demonstrate the superiority of a targeted therapy strategy involving high-flow nasal cannula oxygen (HFNCO) therapy and noninvasive ventilation (NIV) using lung ultrasound score (LUS) in comparison with standard care among patients in the intensive care unit (ICU) who undergo successful weaning to decrease the incidence of extubation failure at both 48 hours and seven days.

Methods: During the study period, 98 patients were enrolled in the study, including 49 in the control group and 49 in the treatment group. Patients in the control group and patients with an LUS score <14 points (at low risk of extubation failure) in the treatment group were extubated and received standard preventive care without NIV or HFNCO.

A new method using surface landmarks to locate resuscitative endovascular balloon occlusion of the aorta based on a retrospective CTA study.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can timely prevent the wounded from fatal hemorrhage. However, blind insertion of REBOA in field or emergency room may result in catheter malposition and serious complications. We aim to develop a new method based on surface landmarks to guide the accurate placement of REBOA in zone III of aorta without fluoroscopy.

Lung ultrasound score in establishing the timing of intubation in COVID-19 interstitial pneumonia: A preliminary retrospective observational study.

Purpose: To investigate the role of lung ultrasound score (LUS) in assessing intubation timing for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.

Materials And Methods: Seventy-two patients with critical coronavirus disease 2019 (COVID-19) were admitted to a makeshift intensive care unit (ICU). All patients underwent bedside lung ultrasonography one to two times per day.

Therapeutic effect of high-flow nasal cannula on severe COVID-19 patients in a makeshift intensive-care unit: A case report.

Introduction: Several intensive-care units (ICUs) in Wuhan are nonstandard wards that were repurposed from general wards. Considering the shortage of medical resources and the need to prevent nosocomic infection, the respiratory-treatment strategy in these nonstandard ICUs is different from those in general wards and standard ICUs. High-flow nasal cannula (HFNC) plays an important role in nonstandard ICUs and is beneficial to the patients therein.

Risk factors and clinical significance of trauma-induced coagulopathy in ICU patients with severe trauma.

Objective: To investigate the incidence and risk factors for trauma-induced coagulopathy (TIC) and the impact of TIC on outcomes of patients with severe trauma admitted to an emergency intensive care unit.

Methods: We retrospectively reviewed clinical data from 223 patients with severe trauma admitted to emergency intensive care unit within 24 h after injury. Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation II score, coagulation function, routine blood and biochemical tests, and blood gas parameters were obtained from medical records.

[Netrin-1 protein expression in gastric cancer and its correlation with clinicopathologic features and prognosis].

Objective: To evaluate the relationship between netrin-1 protein, clinicopathologic features and prognosis in gastric cancer patients.

Methods: Tissue micro-array and immunohistochemistry were used to detect expression of netrin-1 protein and Ki67. And clinicopathological relevance of netrin-1 protein and Ki67 in gastric cancer were analyzed.

Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter.

Objective: To evaluate the efficacy and safety of the treatment of traumatic hemothorax by closed pleural drainage using a central venous catheter (CVC), compared with using a conventional chest tube.

Methods: A prospective controlled study with the Ethics Committee approval was undertaken. A total of 407 patients with traumatic hemothorax were involved and they were randomly assigned to undergo closed pleural drainage with CVCs (n=214) or conventional chest tubes (n=193).

Basic fibroblast growth factor alleviates brain injury following global ischemia reperfusion in rabbits.

The aim of this study was to explore the protective effect of basic fibroblast growth factor (bFGF) on brain injury following global ischemia reperfusion and its mechanisms. Brain injury following global ischemia was induced by four vessels occlusion and systemic hypotension. Twenty-four rabbits were randomized into three groups: group A, only dissection of vessels; group B, intravenous infusion of normal saline after reperfusion for 6 h; group C, 30 microg/kg bFGF injected intravenously at the onset of reperfusion, then infused with 10 microg/(kg.