Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelin...Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.展开更多
Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital f...Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital from July 2020 to July 2023 were randomly divided into two groups.Group A received additional emergency ventilator treatment,and group B received conventional treatment.The efficacy was compared.Results:The curative effect of patients with severe acute left heart failure in group A was higher than that in group B(P<0.05);all blood gas indicators in group A were better than those in group B(P<0.05);all vital signs indicators in group A were better than those in group B(P<0.05);group A was more satisfied with the treatment of severe acute left ventricular heart failure than group B(P<0.05).Conclusion:Patients with severe acute left heart failure who receive emergency ventilator treatment can stabilize vital signs,improve blood oxygen supply,and enhance curative effect.展开更多
During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incinerati...During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.展开更多
Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.How...Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.However,myelin is lacking or dysfunctional in several neuropathies including demyelinating and dysmyelinating Charcot-M arie-To oth disease.Charcot-Marie-To oth disease represents the most prevalent inherited neuropathy in humans and is classified either as axonal,demyelinating or dysmyelinating,or as intermediate.The demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease constitute the majority of the disease cases and are most frequently due to mutations in the three following myelin genes:peripheral myelin protein 22,myelin protein ze ro and gap junction beta 1(coding for Connexin 32) causing Charcot-M arie-Tooth disease type 1A,Charcot-Marie-Tooth disease type 1B,and X-linked Charcot-M arie-Tooth disease type 1,respectively.The resulting perturbation of myelin structure and function leads to axonal demyelination or dysmyelination and causes severe disabilities in affected patients.No treatment to cure or slow down the disease progression is currently available on the market,howeve r,scientific discoveries led to a better understanding of the pathomechanisms of the disease and to potential treatment strategies.In this review,we describe the features and molecular mechanisms of the three main demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease,the rodent models used in research,and the emerging therapeutic approaches to cure or counteract the progression of the disease.展开更多
Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-...Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-warning and multiple ways of rapid treatment.Design/methodology/approach–The paper describes the key technologies that are involved in the development of the system,such as P-wave identification and earthquake early-warning,multi-source seismic information fusion and earthquake emergency treatment technologies.The paper also presents the test results of the system,which show that it has complete functions and its major performance indicators meet the design requirements.Findings–The study demonstrates that the high speed railways earthquake early-warning system serves as an important technical tool for high speed railways to cope with the threat of earthquake to the operation safety.The key technical indicators of the system have excellent performance:The first report time of the P-wave is less than three seconds.From the first arrival of P-wave to the beginning of train braking,the total delay of onboard emergency treatment is 3.63 seconds under 95%probability.The average total delay for power failures triggered by substations is 3.3 seconds.Originality/value–The paper provides a valuable reference for the research and development of earthquake early-warning system for high speed railways in other countries and regions.It also contributes to the earthquake prevention and disaster reduction efforts.展开更多
Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,w...Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,where stem cell-based therapies could be eclipsed by the deficiency of cells due to the hostile microenvironment as well as the transport and preservation processes.Effective emergency strategies are required to be convenient,biocompatible,and stable.Herein,we assess an emergency cell-free treatment using mesenchymal stem cell-derived exosomes,which have proven capable of comprehensive mitigation of the inhibitory lesion microenvironment.The clinically validated fibrin glue is utilized to encapsulate the exosomes and in-situ gelates in transected rat spinal cords to provide a substrate for exosome delivery as well as nerve tissue growth.The emergency treatment alleviates the inflammatory and oxidative microenvironment,inducing effective nerve tissue repair and functional recovery.The therapy presents a promising strategy for effective emergency treatment of central nervous system trauma。展开更多
BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Altho...BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Although the life of STBI patients can be saved through treatment,the sequelae of consciousness,speech,cognitive impairment,stiffness,spasm,pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family.In the past,routine nursing was often used to treat/manage STBI;however,problems,such as improper cooperation and untimely communication,reduced therapeutic effectiveness.AIM To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.METHODS From January 2019 to December 2020,126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center.These patients were retrospectively selected as the research participants in the current study.The study participants were then divided into a control group(61 cases)and a study group(65 cases).The control group was treated with routine nursing.The study group adopted the proposed care bundle.The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale(GCS)were used to evaluate neurological function before and after emergency treatment.After 3 mo of rehabilitation,experimental outcomes were assessed.These included the GCS,Barthel Index,complication rate,muscle strength grade and satisfaction.RESULTS There was no significant difference in gender,age,cause of injury and GCS between the two groups.After emergency,the National Institutes of Health Stroke Scale/Score of the study group(10.23±3.26)was lower than that of the control group(14.79±3.14).The GCS score of the study group(12.48±2.38)was higher than that of the control group(9.32±2.01).The arrival time of consultation in the study group was 20.56±19.12,and the retention time in the emergency room was 45.12±10.21,which were significantly shorter than those in the control group.After 3 mo of rehabilitation management,the GCS and Barthel Index of the study group were 14.56±3.75 and 58.14±12.14,respectively,which were significantly higher than those of the control group.The incidence of complications in the study group(15.38%)was significantly lower than that in the control group(32.79%).The proportion of muscle strength≥grade III in the study group(89.23%)was significantly higher than that in the control group(50.82%).The satisfaction of patients in the study group was significantly higher than that in the control group.CONCLUSION Care bundles are used to optimize the nursing process.During first-aid,care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time.In early rehabilitation,they can effectively improve the consciousness of STBI patients,improve the activities of daily living,reduce the risk of complications,accelerate the recovery of muscle strength and improve their satisfaction.展开更多
BACKGROUND: Although the Australasian Triage Scale(ATS) has been developed two decades ago, its reliability has not been def ined; therefore, we present a meta-analyis of the reliability of the ATS in order to reveal ...BACKGROUND: Although the Australasian Triage Scale(ATS) has been developed two decades ago, its reliability has not been def ined; therefore, we present a meta-analyis of the reliability of the ATS in order to reveal to what extent the ATS is reliable.DATA SOURCES: Electronic databases were searched to March 2014. The included studies were those that reported samples size, reliability coefficients, and adequate description of the ATS reliability assessment. The guidelines for reporting reliability and agreement studies(GRRAS) were used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was done based on the method of moment's estimator.RESULTS: Six studies were included in this study at last. Pooled coefficient for the ATS was substantial 0.428(95%CI 0.340–0.509). The rate of mis-triage was less than fifty percent. The agreement upon the adult version is higher than the pediatric version.CONCLUSION: The ATS has shown an acceptable level of overall reliability in the emergency department, but it needs more development to reach an almost perfect agreement.展开更多
Approximately 7%-29%of patients with colorectal cancer present with colonic obstruction.The concept of self-expandable metal stent(SEMS)insertion as a bridge to surgery(BTS)is appealing.However,concerns on colonic ste...Approximately 7%-29%of patients with colorectal cancer present with colonic obstruction.The concept of self-expandable metal stent(SEMS)insertion as a bridge to surgery(BTS)is appealing.However,concerns on colonic stenting possibly impairing oncologic outcomes have been raised.This study aimed to review current evidence on the short-and long-term oncologic outcomes of SEMS insertion as BTS for left-sided malignant colonic obstruction.For short-term outcomes,colonic stenting facilitates a laparoscopic approach,increases the likelihood of primary anastomosis without a stoma,and may decrease postoperative morbidity.However,SEMS-related perforation also increases local recurrence and impairs overall survival.Moreover,colonic stenting may cause negative oncologic outcomes even without perforation.SEMS can induce shear forces on the tumor,leading to increased circulating cancer cells and aggressive pathological characteristics,including perineural and lymphovascular invasion.The conflicting evidence has led to discordant guidelines.Well-designed collaborative studies that integrate both oncologic outcomes and data on basic research(e.g.,alteration of circulating tumors)are needed to clarify the actual benefit of colonic stenting as BTS.展开更多
An investigation into emergency potable water treatment technologies was conducted to investigate China’s water pollution situation.In order to confirm optimum parameters,the technological efficiency of each pollutan...An investigation into emergency potable water treatment technologies was conducted to investigate China’s water pollution situation.In order to confirm optimum parameters,the technological efficiency of each pollutant was obtained.About 100 contaminants were tested to find the emergency treatment technologies,most of which were found to be positive.This paper presents the three largest and most significant water pollution incidents in China to date,analyzing cases such as the nitrobenzene pollution incident in the Songhua River in November 2005,the cadmium pollution incident in the Beijiang River in December 2005,and the water crisis with odorous tap water in Wuxi City in May 2007.展开更多
BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recomme...BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recommended as the optimal emergent treatment approach for reducing the likelihood of complications following injury.However,the prior literature suggests the success rate of PER to be relatively low due to complicated urethral disruption.We report a modified PER approach that serves to improve both the success rate and safety of the treatment.CASE SUMMARY A 19-year-old male patient presented with multiple pelvic fractures and complete urethral disruption following a high-velocity traffic accident.The patient’s abdominal computed tomography and retrograde urethrography results revealed complete urethral disruption at the bulbar urethra,with hematoma and contrast medium extravasation that extended into the extraperitoneal space.The conventional retrograde PER by cystoscope failed due to severe disruption and considerable hematoma.Modified simultaneous antegrade and retrograde PER was performed by means of semi-rigid ureteroscopy via a suprapubic Foley catheter and cystoscopy via the external urethra.An antegrade guidewire was passed through the bladder neck and then pulled out through the external urethral meatus with a cystoscope.Urethral continuity was achieved after a 16-Fr silicone Foley catheter was indwelled into the bladder along the guidewire.The patient recovered well,achieving voiding continence and avoiding further operation for urethral stricture.CONCLUSION Modified PER via suprapubic Foley catheter represents a promising and safe treatment approach in patients with posterior urethral injuries.展开更多
Purpose This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system.Methods We performed a retrospective cohort stud...Purpose This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system.Methods We performed a retrospective cohort study involving patients with severe trauma.Patients who were admitted before the application of the Medicalsystem trauma system were divided into before system group;patients who were admitted after the application of the system were divided into after system group.Comparison was made between the two groups.For normally distributed data,means were reported along with standard deviation,and comparisons were made using the independent samples t test.Categorical data were compared using the Chi-square test.The Mann-Whitney U test was used to compare nonparametric variables.Results There were 528 patients admitted to the study during the study period.There was no significant statistical difference in the time from the start of trauma team to arrive at the resuscitation room between the two groups.The time from arrival at hospital to endotracheal intubation,to ventilator therapy,to blood transfusion,to completion of CT scan,to completion of closed thoracic drainage,to the start of operation,as well as the length of stay in resuscitation room and hospital were significantly lower after the application of the Medicalsystem trauma system.The mortality was decreased by 8.6%in the after system group compared with that in the before system group,but there was no statistical difference.Conclusion The Medicalsystem trauma system can optimize diagnosis and treatment process for trauma patients,and accordingly improve the treatment efficiency and shorten the treatment time.Therefore,the Medicalsystem trauma system deserves further popularization and promotion.展开更多
This article analyzes the basic situation of the cruise ship Costa Serena and Princess Diamond and the emergency treatment and control measures in response to the novel coronavirus epidemic,investigates the management...This article analyzes the basic situation of the cruise ship Costa Serena and Princess Diamond and the emergency treatment and control measures in response to the novel coronavirus epidemic,investigates the management differences between the two cruise ships and puts forward relevant suggestions.展开更多
Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute se...Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute severe organophosphorus pesticide poisoning.Methods:Several databases were searched.After formulating relevant inclusion and exclusion criteria,qualified studies were included,and the data were extracted.The outcome indicators were the success rate of rescue,the time of hospitalization,the incidence of com-plications,the time for the cholinesterase level to return to normal,the coma time,and the atropine dosage.The results were analyzed using risk ratios,weighted mean difference,standard mean difference,and 95%confidence interval.The Cochrane Collaboration tool was used to assess the risk of bias in all the included studies.In terms of statistical methods,we used RevMan software(version 5.3;The Nordic Cochrane Centre,The Cochrane Collaboration,Copenhagen,Denmark)and Stata(versions 14 and 16;StataCorp,College Station,TX,USA)for the data analysis.Results:We included 92 randomized controlled trials with 6899 participants.Compared with the conventional emergency treatment group(CET group),the hemoperfusion group(HP+CET group),and the hemodialysis group(HD+CET group),the use of hemoperfusion combined with hemodialysis based on CET(HP+HD+CET group)significantly increased the success rate of rescue and reduced hos-pitalization time,the incidence of complications,time for cholinesterase level to return to normal,coma time,and atropine dosage.Conclusion:Hemoperfusion combined with hemodialysis is effective in the treatment of acute severe organophosphorus pesticide poi-soning.In the future,more scientifically designed,large-scale,high-quality,multicenter randomized controlled trials are needed to validate this study further.展开更多
文摘Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.
文摘Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital from July 2020 to July 2023 were randomly divided into two groups.Group A received additional emergency ventilator treatment,and group B received conventional treatment.The efficacy was compared.Results:The curative effect of patients with severe acute left heart failure in group A was higher than that in group B(P<0.05);all blood gas indicators in group A were better than those in group B(P<0.05);all vital signs indicators in group A were better than those in group B(P<0.05);group A was more satisfied with the treatment of severe acute left ventricular heart failure than group B(P<0.05).Conclusion:Patients with severe acute left heart failure who receive emergency ventilator treatment can stabilize vital signs,improve blood oxygen supply,and enhance curative effect.
基金supported by the National Natural Science Foundation of China(51621005)the Fundamental Research Funds for the Central Universities(2019FZA4010).
文摘During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.
基金supported by the Deutsche Forschungsgemeinshaft (to CJ)。
文摘Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.However,myelin is lacking or dysfunctional in several neuropathies including demyelinating and dysmyelinating Charcot-M arie-To oth disease.Charcot-Marie-To oth disease represents the most prevalent inherited neuropathy in humans and is classified either as axonal,demyelinating or dysmyelinating,or as intermediate.The demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease constitute the majority of the disease cases and are most frequently due to mutations in the three following myelin genes:peripheral myelin protein 22,myelin protein ze ro and gap junction beta 1(coding for Connexin 32) causing Charcot-M arie-Tooth disease type 1A,Charcot-Marie-Tooth disease type 1B,and X-linked Charcot-M arie-Tooth disease type 1,respectively.The resulting perturbation of myelin structure and function leads to axonal demyelination or dysmyelination and causes severe disabilities in affected patients.No treatment to cure or slow down the disease progression is currently available on the market,howeve r,scientific discoveries led to a better understanding of the pathomechanisms of the disease and to potential treatment strategies.In this review,we describe the features and molecular mechanisms of the three main demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease,the rodent models used in research,and the emerging therapeutic approaches to cure or counteract the progression of the disease.
基金This research is supported by the R&D Fund Project of China Academy of Railway Science Corporation Limited[Grant No.2022Y253].
文摘Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-warning and multiple ways of rapid treatment.Design/methodology/approach–The paper describes the key technologies that are involved in the development of the system,such as P-wave identification and earthquake early-warning,multi-source seismic information fusion and earthquake emergency treatment technologies.The paper also presents the test results of the system,which show that it has complete functions and its major performance indicators meet the design requirements.Findings–The study demonstrates that the high speed railways earthquake early-warning system serves as an important technical tool for high speed railways to cope with the threat of earthquake to the operation safety.The key technical indicators of the system have excellent performance:The first report time of the P-wave is less than three seconds.From the first arrival of P-wave to the beginning of train braking,the total delay of onboard emergency treatment is 3.63 seconds under 95%probability.The average total delay for power failures triggered by substations is 3.3 seconds.Originality/value–The paper provides a valuable reference for the research and development of earthquake early-warning system for high speed railways in other countries and regions.It also contributes to the earthquake prevention and disaster reduction efforts.
基金supported by the National Key Research and Development Project of Stem Cell and Transformation Research(2019YFA0112100,2019YFA0112102)National Natural Science Foundation of China(81973252,81803451 and 81620108028)。
文摘Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,where stem cell-based therapies could be eclipsed by the deficiency of cells due to the hostile microenvironment as well as the transport and preservation processes.Effective emergency strategies are required to be convenient,biocompatible,and stable.Herein,we assess an emergency cell-free treatment using mesenchymal stem cell-derived exosomes,which have proven capable of comprehensive mitigation of the inhibitory lesion microenvironment.The clinically validated fibrin glue is utilized to encapsulate the exosomes and in-situ gelates in transected rat spinal cords to provide a substrate for exosome delivery as well as nerve tissue growth.The emergency treatment alleviates the inflammatory and oxidative microenvironment,inducing effective nerve tissue repair and functional recovery.The therapy presents a promising strategy for effective emergency treatment of central nervous system trauma。
文摘BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Although the life of STBI patients can be saved through treatment,the sequelae of consciousness,speech,cognitive impairment,stiffness,spasm,pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family.In the past,routine nursing was often used to treat/manage STBI;however,problems,such as improper cooperation and untimely communication,reduced therapeutic effectiveness.AIM To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.METHODS From January 2019 to December 2020,126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center.These patients were retrospectively selected as the research participants in the current study.The study participants were then divided into a control group(61 cases)and a study group(65 cases).The control group was treated with routine nursing.The study group adopted the proposed care bundle.The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale(GCS)were used to evaluate neurological function before and after emergency treatment.After 3 mo of rehabilitation,experimental outcomes were assessed.These included the GCS,Barthel Index,complication rate,muscle strength grade and satisfaction.RESULTS There was no significant difference in gender,age,cause of injury and GCS between the two groups.After emergency,the National Institutes of Health Stroke Scale/Score of the study group(10.23±3.26)was lower than that of the control group(14.79±3.14).The GCS score of the study group(12.48±2.38)was higher than that of the control group(9.32±2.01).The arrival time of consultation in the study group was 20.56±19.12,and the retention time in the emergency room was 45.12±10.21,which were significantly shorter than those in the control group.After 3 mo of rehabilitation management,the GCS and Barthel Index of the study group were 14.56±3.75 and 58.14±12.14,respectively,which were significantly higher than those of the control group.The incidence of complications in the study group(15.38%)was significantly lower than that in the control group(32.79%).The proportion of muscle strength≥grade III in the study group(89.23%)was significantly higher than that in the control group(50.82%).The satisfaction of patients in the study group was significantly higher than that in the control group.CONCLUSION Care bundles are used to optimize the nursing process.During first-aid,care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time.In early rehabilitation,they can effectively improve the consciousness of STBI patients,improve the activities of daily living,reduce the risk of complications,accelerate the recovery of muscle strength and improve their satisfaction.
文摘BACKGROUND: Although the Australasian Triage Scale(ATS) has been developed two decades ago, its reliability has not been def ined; therefore, we present a meta-analyis of the reliability of the ATS in order to reveal to what extent the ATS is reliable.DATA SOURCES: Electronic databases were searched to March 2014. The included studies were those that reported samples size, reliability coefficients, and adequate description of the ATS reliability assessment. The guidelines for reporting reliability and agreement studies(GRRAS) were used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was done based on the method of moment's estimator.RESULTS: Six studies were included in this study at last. Pooled coefficient for the ATS was substantial 0.428(95%CI 0.340–0.509). The rate of mis-triage was less than fifty percent. The agreement upon the adult version is higher than the pediatric version.CONCLUSION: The ATS has shown an acceptable level of overall reliability in the emergency department, but it needs more development to reach an almost perfect agreement.
文摘Approximately 7%-29%of patients with colorectal cancer present with colonic obstruction.The concept of self-expandable metal stent(SEMS)insertion as a bridge to surgery(BTS)is appealing.However,concerns on colonic stenting possibly impairing oncologic outcomes have been raised.This study aimed to review current evidence on the short-and long-term oncologic outcomes of SEMS insertion as BTS for left-sided malignant colonic obstruction.For short-term outcomes,colonic stenting facilitates a laparoscopic approach,increases the likelihood of primary anastomosis without a stoma,and may decrease postoperative morbidity.However,SEMS-related perforation also increases local recurrence and impairs overall survival.Moreover,colonic stenting may cause negative oncologic outcomes even without perforation.SEMS can induce shear forces on the tumor,leading to increased circulating cancer cells and aggressive pathological characteristics,including perineural and lymphovascular invasion.The conflicting evidence has led to discordant guidelines.Well-designed collaborative studies that integrate both oncologic outcomes and data on basic research(e.g.,alteration of circulating tumors)are needed to clarify the actual benefit of colonic stenting as BTS.
基金the Ministry of Construction P.R.China(Grant No.06-k4-36).
文摘An investigation into emergency potable water treatment technologies was conducted to investigate China’s water pollution situation.In order to confirm optimum parameters,the technological efficiency of each pollutant was obtained.About 100 contaminants were tested to find the emergency treatment technologies,most of which were found to be positive.This paper presents the three largest and most significant water pollution incidents in China to date,analyzing cases such as the nitrobenzene pollution incident in the Songhua River in November 2005,the cadmium pollution incident in the Beijiang River in December 2005,and the water crisis with odorous tap water in Wuxi City in May 2007.
文摘BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recommended as the optimal emergent treatment approach for reducing the likelihood of complications following injury.However,the prior literature suggests the success rate of PER to be relatively low due to complicated urethral disruption.We report a modified PER approach that serves to improve both the success rate and safety of the treatment.CASE SUMMARY A 19-year-old male patient presented with multiple pelvic fractures and complete urethral disruption following a high-velocity traffic accident.The patient’s abdominal computed tomography and retrograde urethrography results revealed complete urethral disruption at the bulbar urethra,with hematoma and contrast medium extravasation that extended into the extraperitoneal space.The conventional retrograde PER by cystoscope failed due to severe disruption and considerable hematoma.Modified simultaneous antegrade and retrograde PER was performed by means of semi-rigid ureteroscopy via a suprapubic Foley catheter and cystoscopy via the external urethra.An antegrade guidewire was passed through the bladder neck and then pulled out through the external urethral meatus with a cystoscope.Urethral continuity was achieved after a 16-Fr silicone Foley catheter was indwelled into the bladder along the guidewire.The patient recovered well,achieving voiding continence and avoiding further operation for urethral stricture.CONCLUSION Modified PER via suprapubic Foley catheter represents a promising and safe treatment approach in patients with posterior urethral injuries.
基金This work was supported by China Scholarship Council(CSC NO.202006920081)Jiangsu Provincial Medical Youth Talent,China(QNRC2016724)+1 种基金Natural Science Research of Jiangsu Higher Education Institutions of China(18KJB320016)Basic Research on Medical and Health Application of the People’s Livelihood Science and Technology Project of Suzhou Science and Technology Bureau(SYS2020102).
文摘Purpose This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system.Methods We performed a retrospective cohort study involving patients with severe trauma.Patients who were admitted before the application of the Medicalsystem trauma system were divided into before system group;patients who were admitted after the application of the system were divided into after system group.Comparison was made between the two groups.For normally distributed data,means were reported along with standard deviation,and comparisons were made using the independent samples t test.Categorical data were compared using the Chi-square test.The Mann-Whitney U test was used to compare nonparametric variables.Results There were 528 patients admitted to the study during the study period.There was no significant statistical difference in the time from the start of trauma team to arrive at the resuscitation room between the two groups.The time from arrival at hospital to endotracheal intubation,to ventilator therapy,to blood transfusion,to completion of CT scan,to completion of closed thoracic drainage,to the start of operation,as well as the length of stay in resuscitation room and hospital were significantly lower after the application of the Medicalsystem trauma system.The mortality was decreased by 8.6%in the after system group compared with that in the before system group,but there was no statistical difference.Conclusion The Medicalsystem trauma system can optimize diagnosis and treatment process for trauma patients,and accordingly improve the treatment efficiency and shorten the treatment time.Therefore,the Medicalsystem trauma system deserves further popularization and promotion.
文摘This article analyzes the basic situation of the cruise ship Costa Serena and Princess Diamond and the emergency treatment and control measures in response to the novel coronavirus epidemic,investigates the management differences between the two cruise ships and puts forward relevant suggestions.
文摘Background:Acute severe organophosphorus pesticide poisoning is a common severe emergency in developing countries.Our meta-analysis aimed to clarify the efficacy of hemoperfusion combined with hemodialysis on acute severe organophosphorus pesticide poisoning.Methods:Several databases were searched.After formulating relevant inclusion and exclusion criteria,qualified studies were included,and the data were extracted.The outcome indicators were the success rate of rescue,the time of hospitalization,the incidence of com-plications,the time for the cholinesterase level to return to normal,the coma time,and the atropine dosage.The results were analyzed using risk ratios,weighted mean difference,standard mean difference,and 95%confidence interval.The Cochrane Collaboration tool was used to assess the risk of bias in all the included studies.In terms of statistical methods,we used RevMan software(version 5.3;The Nordic Cochrane Centre,The Cochrane Collaboration,Copenhagen,Denmark)and Stata(versions 14 and 16;StataCorp,College Station,TX,USA)for the data analysis.Results:We included 92 randomized controlled trials with 6899 participants.Compared with the conventional emergency treatment group(CET group),the hemoperfusion group(HP+CET group),and the hemodialysis group(HD+CET group),the use of hemoperfusion combined with hemodialysis based on CET(HP+HD+CET group)significantly increased the success rate of rescue and reduced hos-pitalization time,the incidence of complications,time for cholinesterase level to return to normal,coma time,and atropine dosage.Conclusion:Hemoperfusion combined with hemodialysis is effective in the treatment of acute severe organophosphorus pesticide poi-soning.In the future,more scientifically designed,large-scale,high-quality,multicenter randomized controlled trials are needed to validate this study further.
