To explore the application effect of in situ scenario simulation(ISS) method in advanced cardiac life support (ACLS) training for eight-year clinical medicine students.

Eight-year clinical medicine students who underwent clinical internship in Peking Union Medical College Hospital from September 2021 to September 2022 were randomly divided into ISS group and traditional training group. After the training, assessment on the theoretical knowledge and practical operation was conducted. The training effect of the ISS group was evaluated by comparing and analyzing the results of theoretical knowledge and operation skill of ACLS.

A total of 89 trainees participated in ACLS training and completed the assessment, including 44 in the ISS group and 45 in the traditional training group, with no statistically significant difference in gender between the two groups (P=0.462). The theoretical and operation skill test scores of ISS group were better than those of the traditional training group [(80.36±6.46) vs.(65.33±10.43), (67.84±11.27)vs.(46.33±18.75)], both with significant statistical differences (both P=0.000). According to the students of the ISS group, through ISS training, the identification of critically ill patients, the mastery of ACLS process, and the awareness of teamwork significantly improved.

The teaching method of ISS can effectively improve the skill operation ability of ACLS and crisis response, and enhance the quality of recovery to some extent.

To analyze the clinical characteristics of acute diquat poisoning complicated by central nervous system injury (CNSI) and identify early risk factors, aiming to provide a theoretical basis for reducing mortality in diquat poisoning with CNSI.

Clinical data from patients with acute diquat poisoning admitted to the Emergency Department of Fuyang People's Hospital Affiliated to Anhui Medical University between October 2019 and October 2024 were retrospectively analyzed. Patients were divided into CNSI and non-CNSI groups based on complications. Clinical features were compared between groups, and variables with statistical significance were subjected to binary logistic regression to identify independent risk factors for CNSI. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive value of these factors.

A total of 63 eligible patients were included, with 18 deaths (28.57%) and 26 cases (41.27%) complicated by CNSI. The median time from diquat ingestion to CNSI onset was 15.5 (9.8, 31.3) hours. The CNSI group exhibited significantly higher mortality rates and required more frequent respiratory support and anti-shock therapy than the non-CNSI group (all P < 0.05). Multivariate binary logistic regression identified diquat plasma concentration (≥549.95 μg/L) and APACHE Ⅱ score as independent risk factors for CNSI (all P < 0.05). Both factors demonstrated predictive value for CNSI, with combined use showing superior predictive performance compared to individual indicators (all P < 0.05).

CNSI is a fatal complication of acute diquat poisoning with high mortality. Diquat plasma concentration (≥549.95 μg/L) and APACHE Ⅱ score are independent risk factors for CNSI, and their combined application enhances predictive accuracy. These findings underscore the importance of early risk stratification and targeted interventions in high-risk populations.

To investigate the efficacy of amiodarone and lidocaine in cardiac arrest patients.

We searched the PubMed, Embase, Cochrane Library, and Web of Science databases through to January 1, 2024. All studies comparing lidocaine, amiodarone, and placebo for cardiac arrest were included. Meta-analysis was performed, and the primary outcome was survival to hospital discharge. Secondary outcomes was survival to 24 h or hospital admission.

Three RCTs and seven non-randomized intervention studies were included. Compared with placebo, amiodarone can improve the likelihood of survival to 24 h/hospital admission (OR=1.32, 95% CI: 1.12-1.54) in RCTs, while this significance was not found in non-randomized intervention studies (OR=0.79, 95% CI: 0.39-1.61). In both RCTs and non-randomized intervention studies, amiodarone did not significantly improve discharge survival rate compared with placebo (OR=1.19, 95% CI: 0.98-1.44 and OR=1.14, 95% CI: 0.44-2.99). Lidocaine was more effective than placebo in improving both survival to 24 h/hospital admission (OR=2.36, 95% CI: 1.47-3.80) and discharge from hospital (OR=2.10, 95% CI: 1.21-3.64) in non-randomized intervention studies. Amiodarone showed no significant difference in improving survival to 24 h/admission to hospital compared with lidocaine in RCTs, while amidoraone was inferior to lidocaine in improving 24 h/admission survival rate (OR=0.72, 95% CI: 0.53-0.98) and discharge survival rate (OR=0.81, 95% CI: 0.76-0.87)in non-randomized intervention study.

Limited RCTs directly compared amiodarone and lidocaine. No significant difference was found between amiodarone and lidocaine in improving 24 h/admission survival rate in RCTs. While compared to amiodarone and placebo, lidocaine can improve 24 h/admission survival rate and discharge survival rate in non-randomized intervention studies.

To explore the risk factors of capillary leakage syndrome in patients with acute organophosphorus pesticide poisoning (AOPP), in order to provide reference for clinical screening and intervention timing.

The clinical manifestations, auxiliary examination and prognosis of AOPP patients admitted in Fuyang People's Hospital from November 2020 to June 2022 were prospectively analyzed, and the patients were divided into non-CLS group and CLS group based on the presence or absence of capillary leak syndrome (CLS). Patients were admitted to hospital as the starting point, and death or discharge as the endpoint. Multiple Logistic regression analysis was used to explore the risk factors of AOPP complicated with CLS.

A total of 38 AOPP patients were included, of which 17 (44.7%) were complicated with CLS. There were statistical differences in age (P=0.015), blood concentration of dichlorvos (P=0.001), blood concentration of dipterex(P < 0.001), creatinine (P < 0.001) and APACHEⅡ score (P < 0.001) between non-CLS group and CLS group. Multivariate Logistic regression analysis showed that blood concentration of dipterex ≥0.44 μg/mL and APACHEⅡ score≥10.5 were independent risk factors for AOPP complicated with CLS. The mortality rate of CLS group was higher than that of CLS group (P < 0.001).

Patients with AOPP are more likely to be complicated by CLS, and the mortality rate is higher. High-risk patients can be identified early by dipterex blood concentration and APACHE Ⅱ score, and early intervention can be carried out to improve the prognosis of patients.