BACKGROUND:This meta-analysis aimed to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients with cardiac arrest (CA).DATA RESOURCES: PubMed, EMBASE, Web of Science, and China Biological Medicine Database were searched for relevant articles. The baseline information and outcome data (survival, good neurological outcome at discharge, at 3-6 months, and at 1 year after CA) were collected and extracted by two authors. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using Review Manager 5.3. RESULTS:In six studies 2 260 patients were enrolled to study the survival rate to discharge and longterm neurological outcome published since 2000. A signifi cant effect of ECPR was observed on survival rate to discharge compared to CCPR in CA patients (RR 2.37, 95%CI 1.63-3.45, P<0.001), and patients who underwent ECPR had a better long-term neurological outcome than those who received CCPR (RR 2.79, 95%CI 1.96-3.97, P<0.001). In subgroup analysis, there was a significant difference in survival to discharge favoring ECPR over CCPR group in OHCA patients (RR 2.69, P=0.001). However, no signifi cant difference was found in IHCA patients (RR 1.84, 95%CI 0.91-3.73, P=0.09).CONCLUSION: ECPR showed a benefi cial effect on survival rate to discharge and long-term neurological outcome over CCPR in adult patients with CA.

A simple and eco-friendly strategy for the synthesis of E-ortho-hydroxystilbenes from two kinds of α,β-unsaturated aromatic lactones is described.

Background: Fulminant myocarditis has a sudden onset and rapid progress, which can easily cause multiple organ failure. Acute kidney injury is a common complication. ECMO (extracorporeal membrane oxygenation) and CRRT (continuous renal replacement therapy) have been used in the treatment of fulminant myocarditis, but the combination of the 2 has an impact on the prognosis. There is still a big controversy. Therefore, the purpose of this randomized controlled trial is to evaluate the nursing effect and long-term efficacy and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis. Methods: This is a prospective randomized controlled trial to study the effectiveness and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis. Approved by the clinical research ethics committee of our hospital. Patients were randomly assigned to 1 of 2 treatment options: Observation indicators include: basic vital signs, laboratory indicators, echocardiographic changes, complications, and outcomes. SPSS 25.0 (Chicago, IL) version statistical software package was used to analyze the data. Discussion: This study will evaluate the nursing effect and long-term efficacy and safety of ECMO combined with CRRT in the treatment of fulminant myocarditis. The results of this experiment will provide clinical evidence for the treatment of fulminant myocarditis with ECMO and CRRT. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/PAQBZ.

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Background To explore the influencing factors for in-hospital mortality in the neonatal intensive care unit (NICU) and to establish a predictive nomogram. Methods Neonatal data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Both univariate and multivariate logit binomial general linear models were used to analyse the factors influencing neonatal death. The area under the receiver operating characteristics (ROC) curve was used to assess the predictive model, which was visualized by a nomogram. Results A total of 1258 neonates from the NICU in the MIMIC-III database were eligible for the study, including 1194 surviving patients and 64 deaths. Multivariate analysis showed that red cell distribution width (RDW) (odds ratio [OR] 0.813, p=0.003) and total bilirubin (TBIL; OR 0.644, p&lt;0.001) had protective effects on neonatal in-hospital death, while lymphocytes (OR 1.205, p=0.025), arterial partial pressure of carbon dioxide (PaCO2; OR 1.294, p=0.016) and sequential organ failure assessment (SOFA) score (OR 1.483, p&lt;0.001) were its independent risk factors. Based on this, the area under the curve of this predictive model was up to 0.865 (95% confidence interval 0.813 to 0.917), which was also confirmed by a nomogram. Conclusions The nomogram constructed suggests that RDW, TBIL, lymphocytes, PaCO2 and SOFA score are all significant predictors for in-hospital mortality in the NICU.

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