Abstract:Objective To analyze the comparison of the efficacy of two surgical methods,percutaneous verte-broplasty(PKP)and pedicle screw fixation,in patients with thoracolumbar vertebral fractures.Methods Through a retrospective analysis of the clinical data of 204 cases of thoracolumbar spinal fractures admitted to hospitals in Heilong-jiang Province from January 2021 to December 2024,the patients were divided into the PKP group(106 cases,undergoing percutaneous kyphoplasty)and the screw rod group(98 cases,undergoing screw rod system internal fixation)based on the actual surgical treatment plan adopted.The advantages and disadvantages of the two surgical methods,namely PKP and screw rod system internal fixation,were compared in terms of operation time,intraoperative blood loss,postoperative func-tional scores,and postoperative pain.Results The average surgical time in the PKP group was(76.11±23.69)minutes,significantly shorter than that of the pedicle screw fixation group(182.67±42.32)minutes,with a statistically significant difference(P<0.001).The intraoperative blood loss in the PKP group was less than that in the pedicle screw fixation group(15.58±5.28)vs.(214.29±115.92)mL,with a statistically significant difference(P<0.001).Postoperative pain scores:The VAS score at 24 hours post-operation in the PKP group was significantly lower than that in the pedicle screw fixation group,(2.85±0.76)vs.(4.62±0.89),with a statistical-ly significant difference(P<0.001).However,at 72 hours post-operation and at discharge,the VAS scores in the PKP group were slightly lower than those in the pedicle screw fixation group,but the differences were not statistical-ly significant(P>0.05),indicating that PKP caused less pain perception in the early postoperative period,while in the later postoperative period,the pain effects of the two methods were similar.Postoperative functional recovery scores:The ODI improvement rate in the PKP group at 3 days post-operation was(80.25±7.32)%,while in the pedicle screw fixation group it was(75.18±8.15)%,with no statistically significant difference(P=0.15).The satisfaction rate after PKP was 89.62%,and the satisfaction rate after pedicle screw fixation was also 84.69)%,with no statistically significant difference(P=0.250).The complication rate in the PKP group was 4.72%,while in the pedicle screw fixation group it was 8.16%,with no statistically significant difference(P=0.321).Conclusion Both surgical methods have certain advantages in the treatment of thora-columbar fractures,and both can effectively improve postoperative pain and functional status in patients with thoracolum-bar fractures.However,the PKP(Percutaneous Kyphoplasty)group has better short-term effects than the pedicle screw-rod system internal fixation group,characterized by shorter operation time,less intraoperative blood loss,faster pain relief,and quicker postoperative functional recovery.

Abstract:Objective To investigate the effects of a combined treatment regimen of Ligustrazine Injection and Butylphthalide on neurological function and hemorheological parameters in patients with Acute Cerebral Infarction(ACI).Methods A total of 190 ACI patients admitted to our hospital from January 2024 to December 2024 were divided into two groups using a random number table method,with 95 patients in each group.Both groups received conventional therapy.The control group received additional Butylphthalide treatment,while the observation group received Ligustrazine Injection in addition to the control group's regimen.The treatment course for both groups was 14 days.The clinical efficacy,neurological function,activities of daily living,hemorheological parameters,and biomarker levels were compared between the two groups.The incidence of adverse reactions and prognosis were also statistically analyzed.Results Compared with the control group,the observation group had a significantly higher total effective rate.After treatment,the observa-tion group showed significantly lower National Institutes of Health Stroke Scale(NIHSS)scores,lower levels of various hemorheological parameters,and lower levels of S100 calcium-binding protein B(S100B),neuron-specific enolase(NSE),and homocysteine(Hcy),while the Barthel Index(BI)was significantly higher(P<0.05).However,there was no signifi-cant difference in the incidence of adverse reactions between the two groups(P>0.05).Compared with the control group,the observation group had a lower modified Rankin Scale(mRS)score at 3 months post-treatment(P<0.05).Conclu-sion The combination of Ligustrazine Injection and Butylphthalide is effective in treating ACI patients.It can effectively reduce the degree of neurological deficit,improve hemorheological parameters,enhance activities of daily living,promote neurological repair and long-term functional recovery,with a good safety profile.

Abstract:Objective To analyze the application effect of structured comprehensive nursing in patients with chron-ic obstructive pulmonary disease(COPD)complicated by respiratory failure treated with non-invasive mechanical ventila-tion.Methods A total of 60 patients with COPD complicated by respiratory failure treated with non-invasive mechani-cal ventilation and admitted to The Second Affiliated Hospital of Guizhou Medical University from May 2023 to April 2025 were selected as the study subjects.According to the random number table method,they were divided into an observation group(receiving structured comprehensive nursing intervention for non-invasive mechanical ventilation,n=30)and a con-trol group(receiving standard nursing care for non-invasive mechanical ventilation,n=30).Blood gas indices[arterial par-tial pressure of oxygen(PaO₂),arterial partial pressure of carbon dioxide(PaCO₂),oxygen saturation(SaO₂)],pulmonary function indices[forced expiratory volume in the first second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC)],length of hospital stay,incidence of complications,and satisfaction were compared between the two groups.Re-sults Before nursing,there were no significant differences in PaO₂,PaCO₂,SaO₂,PEF,FEV1,and FVC levels between the two groups(P>0.05).At 72 hours after nursing inter-vention,the above blood gas indices and pulmonary function indices in both groups improved significantly.The levels of PaO₂,SaO₂,PEF,FEV1,and FVC in the observation group were significantly higher than those in the control group(P<0.05),while the PaCO₂ level was sig-nificantly lower than that in the control group(P<0.05).The average length of hospital stay in the observation group was significantly shorter than that in the control group,P<0.001.The incidence of complications in the observation group was significantly lower than that in the control group(16.67%vs.46.67%,P=0.013).The satisfaction level in the observation group was significantly higher than that in the control group(96.67%vs.73.33%,P=0.011).Conclusion In patients with COPD complicated by respiratory failure treated with non-invasive mechanical ventilation,structured comprehensive nursing intervention can effectively improve blood gas analysis indices and pulmonary function,shorten the length of hos-pital stay,reduce the risk of complications,and enhance patient satisfaction.

Abstract:Objective To explore the application effect of the crisis management combined with the doctor-nurse integration trauma care model in patients with severe trauma.Methods A total of 40 severe trauma patients admitted to our hospital from August 2023 to January 2024 were selected as the control group and received conventional care.An-other 40 severe trauma patients admitted from February 2024 to August 2024 were selected as the observation group and received the crisis management combined with the doctor-nurse integration trauma care model.The emergency treatment time indicators(time from patient arrival to emergency department,time to complete Focused Assessment with Sonography for Trauma[FAST],time to complete CT examination,time to establish intravenous access),emergency time efficiency(time from emergency department to surgery,diagnosis confirmation time,length of stay in the resuscitation room)were compared between the two groups.The Shock Index(SI)at 12h and 24h after treatment,mortality rate,disability rate,and length of hospital stay were recorded and compared.Results The time from patient arrival to the emergency depart-ment,time to complete FAST,time to complete CT examination,and time to establish intravenous access in the observation group were all shorter than those in the control group(P<0.05).Furthermore,time from emergency department to surgery,diagnosis confirmation time,and length of stay in the resuscitation room were significantly shorter in the observation group(P<0.001).The mortality rate(5.00%vs.20.00%)and disability rate(12.50%vs.32.50%)in the observation group were significantly lower than those in the control group(P<0.05).The length of hospital stay in the observation group was also significantly shorter than that in the control group(P<0.05).The proportion of patients with SI>1 at 24h after treatment was lower than that at 12h in both groups,but the difference between the two groups was not statistically significant(P>0.05).Furthermore,there were no significant differences in the proportion of patients with SI>1 between the two groups at 12h or 24h after treatment(P>0.05).Conclusion The crisis management combined with the doctor-nurse integration trauma care model can shorten the treatment time for severe trauma patients,improve emergency efficiency,effectively reduce mortality and disability rates,shorten the hospital stay,and ultimately improve clinical outcomes.

Abstract:Objective This study aims to analyze and discuss the current status and hot issues in disaster medical rescue by focusing on the application of virtual reality(VR)in this field.Methods A total of 43 international and 41 domestic relevant journal articles published were identified through searches between 2006 and 2025 in Web of Science,CNKI,WanFang,and VIP databases.Bibliometric analysis was conducted using CiteSpace6.1 R6.Visual maps,including keyword co-occurrence networks and keyword clustering maps,were generated to reveal research hotspots and frontier trends in this field.Results Keyword analysis indicated that"virtual reality""disaster medicine"and"simulation train-ing"are domestic research hotspots,while"virtual reality""mass casualty incident"and"disaster medicine"represent fron-tier areas in international research.Conclusions VR-based disaster medicine training has become a current research area,and the analysis results provide a reference for further in-depth exploration.

Abstract:Objective To investigate the clinical efficacy and safety of early application of invasive mechanical ventilation in the emergency treatment of acute severe organophosphorus pesticide poisoning-induced respiratory fail-ure.Methods A total of 80 patients admitted to Putian Emergency Center between January 2023 and December 2024 were selected and randomly divided into a control group and an observation group using a random number table,with 40 patients in each group.The control group received standard basic treatment(thorough decontamination,antidotes pralidox-ime iodide and atropine,comprehensive supportive therapy,etc.),while the observation group received additional early invasive mechanical ventilation on this basis.Post-resuscitation comparisons were made between the two groups regarding cholinesterase(CHE)activity,oxidative stress indicators,prognosis(APACHE II score),pulmonary function,blood gas analysis,atropine dosage,recovery time,and adverse reactions.Results After rescue,the levels of CHE,GSH,GPx,and SOD in the observation group were significantly higher than those in the control group,while the levels of bilirubin,MDA,and the APACHE II score were significantly lower than those in the control group(all P<0.001).The pulmonary function indicators(MMEF,PEF,FVC,FEV1,FEV1/FVC)and PaO2,SaO2 in the observation group were superior to those in the control group,and PaCO2 was lower than that in the control group(P<0.001).Meanwhile,the atropine dosage in the observation group was significantly less than that in the control group(P<0.001),and the spontaneous breathing re-covery time,consciousness recovery time,and hos-pital stay were all shorter(P<0.001).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(5.00%vs.2.50%,P=1.000).Conclusion For acute severe pesticide poi-soning-induced respiratory failure,the early application of invasive mechanical ventilation based on standard treatment can effectively improve oxidative stress and pulmonary function,reduce atropine consumption,and accelerate patient recovery without increasing safety risks,demonstrating significant clinical value.

Abstract:Objective To investigate the impact of pre-hospital emergency care on the treatment outcomes of pa-tients with cerebral infarction.Methods A retrospective analysis was conducted on the clinical data of 120 cerebral infarction patients admitted to the Xiamen Medical Emergency Center from January 2021 to December 2024.Based on whether pre-hospital emergency care was implemented,patients were divided into an observation group(received pre-hos-pital emergency care and were transported to the hospital by ambulance,n=60)and a control group(transported to the hospital by family members,n=60).Neurological function,activities of daily living(ADL),thrombolytic therapy-related indicators,and complication incidence were compared between the two groups.Results Before treatment,there was no significant difference in NIHSS scores between the two groups(P>0.05).After treatment,NIHSS scores significantly decreased in both groups(P<0.001),with a more pronounced decrease in the observation group(P<0.001).Before treat-ment,there was no significant difference in Barthel Index between the two groups(P>0.05).After treatment,the Barthel Index significantly increased in both groups(P<0.001),with a more pronounced increase in the observation group(P<0.001).Compared to the control group,the door-to-needle time(DNT)was significantly shorter in the observation group(P<0.001),the proportion of DNT≤60 min was significantly higher(P<0.05),and the mortality rate was significantly lower(P<0.05).The complication incidence rate was 13.33%(8/60)in the observation group,significantly lower than 33.33%(20/60)in the control group(P<0.05).Conclusion Timely and effective pre-hos-pital emergency care can effectively improve neurological function and activities of daily living in cerebral infarction pa-tients,shorten DNT,and reduce the risk of mortality and complications.

Abstract:Objective To investigate the clinical application value of emergency nursing combined with a portable cardiopulmonary resuscitation(CPR)device in the resuscitation of adult patients with cardiac arrest(CA).Methods A retrospective observational study was conducted,which consecutively enrolled 119 adult CA patients admitted to our hos-pital from March 2023 to September 2024.According to the actual resuscitation protocol received,patients were divided into a control group(n=78,receiving emergency nursing+manual chest compressions)and an observation group(n=41,re-ceiving emergency nursing+portable CPR device).The rates of return of spontaneous circulation(ROSC)and survival to hospital discharge,blood gas parameters,post-ROSC cardiac function indicators,and the incidence of complications were compared between the two groups.Results The ROSC rate(80.49%vs.57.69%)and the survival to hospital discharge rate(53.66%vs.33.33%)in the observation group were significantly higher than those in the control group(all P<0.05).After resuscitation,the levels of arterial oxygen partial pressure(PaO2),pH,and left ventricular ejection fraction(LVEF)in the observation group were significantly better than those in the control group,while the levels of arterial carbon dioxide partial pressure(PaCO2),heart rate(HR),and left ventricular end-diastolic diameter(LVEDD)were significantly lower than those in the control group(P<0.05).Furthermore,the total incidence of complications in the observation group was significantly lower than that in the control group(4.88%vs.21.79%,P<0.05).Conclusion In the resuscitation of adult CA patients,compared with manual chest compressions,emergency nursing combined with a portable CPR device can sig-nificantly improve the ROSC rate and survival rate,effectively ameliorate blood gas and cardiac function parameters,and reduce the risk of complications,demonstrating significant clinical advantages.

Abstract:Objective To explore the application effect of a standardized emergency triage model based on the Modified Early Warning Score(MEWS)system in patients with acute chest pain.Methods A total of 80 patients with acute chest pain admitted to our hospital from October 2023 to October 2024 were selected and divided into an observation group and a control group using a random number table method,with 40 cases in each group.The control group received the conventional emergency triage model,while the observation group received a standardized triage model based on the MEWS score(covering heart rate,blood pressure,respiration,temperature,and consciousness).The key emergency time points(time from triage to blood draw,time to electrocardiogram examination,time to diagnosis confirmation),triage ac-curacy rate,incidence of triage adverse events,treatment success rate,hospital stay length,and total treatment cost were compared between the two groups.Results Compared with the control group,the observation group showed significant-ly shortened times for blood draw,ECG examination,and diagnosis confirmation.The observation group also had higher triage accuracy(97.50%vs.80.00%)and treatment success rates(97.50%vs.77.50%),and a lower incidence of triage ad-verse events(2.50%vs.20.00%);all differences were statistically significant(P<0.05).Meanwhile,patients in the obser-vation group had a shorter hospital stay and lower total treatment costs(P<0.05).Conclusion The application of the MEWS standardized triage model in patients with acute chest pain can effectively improve triage efficiency and accuracy,reduce triage adverse events,improve patient clinical outcomes,and optimize the utilization of medical resources.

Abstract:Objective To explore the clinical value of targeted nursing interventions in patients with ruptured in-tracranial aneurysm complicated by subarachnoid hemorrhage and neurogenic pulmonary edema.Methods A total of 80 patients with ruptured intracranial aneurysm complicated by subarachnoid hemorrhage and neurogenic pulmonary edema,admitted to the Department of Neurosurgery,Putian First Hospital between May 2023 and May 2025,were selected as the study subjects.They were divided into an observation group(n=40)and a control group(n=40)using a random number table method.Respiratory function,neurological function,and the incidence of complications were compared between the two groups.Results Before the intervention,there were no significant differences in PaO₂,PaCO₂,and SpO₂ levels be-tween the two groups(P>0.05).After the intervention,both groups showed significant improvement in PaO₂,PaCO₂,and SpO₂ levels.Compared with the control group,the observation group had significantly higher PaO₂ and SpO₂ levels and significantly lower PaCO₂ levels(P<0.001).Before the intervention,there were no significant differences in GCS and NI-HSS scores between the two groups(P>0.05).After the intervention,both groups showed significant improvement in GCS and NIHSS scores.Compared with the control group,the observation group had a significantly higher GCS score and a significantly lower NIHSS score(P<0.001).The total incidence of complications in the observation group was significantly lower than that in the control group(12.50%vs.32.50%,P=0.032).Conclusion For patients with ruptured intracranial aneurysm complicated by subarachnoid hemorrhage and neurogenic pulmonary edema,targeted nursing interventions are beneficial for improving respiratory function,promoting the recovery of neurological function,and reducing the risk of complications.

Abstract:Objective This study investigates the effects of esketamine on extubation-induced coughing and emer-gence agitation in pediatric patients undergoing surgery for obstructive sleep apnea syndrome(OSAS).Methods A retrospective analysis was conducted on the clinical data of 89 pediatric patients with OSAS who underwent surgical treat-ment at Ningde Mindong Hospital from January 2024 to July 2025.According to the anesthesia induction protocol,the patients were divided into an observation group(esketamine group,n=45)and a control group(conventional anesthesia group,n=44).The incidence and severity of extubation-induced coughing,emergence agitation,vital signs[before anes-thesia induction(T₀),during tracheal intubation(T₁),5 minutes after surgery initiation(T₂),at extubation(T₃),and 5 min-utes after extubation(T₄)],and adverse reactions were compared between the two groups.Results Compared with the control group,the observation group exhibited a significantly lower incidence of coughing(P=0.012),reduced severity of coughing,lower incidence of agitation(P=0.014),lower PAED scores(P<0.001),and shorter duration of agitation(P<0.001).At T₀,no significant differences were observed between the two groups in heart rate(HR,P=0.775),systolic blood pressure(SBP,P=0.387),diastolic blood pressure(DBP,P=0.784),or pulse oxygen saturation(SpO₂,P=0.206).However,at T₁,T₂,T₃,and T₄,the observation group demonstrated smaller fluctuations in HR,SBP,and DBP compared to the control group(P<0.001).SpO₂ remained within the normal range at all time points in both groups,with no significant differences(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(13.33%vs 27.27%,P=0.102).Conclusion In pediatric OSAS surgery,the administration of esketamine during an-esthesia induction significantly reduces the incidence of extubation-induced coughing and emergence agitation,minimizes perioperative hemodynamic fluctuations,and demonstrates good safety.

Abstract:Objective To explore the impact of prehospital emergency process optimization on CT examination time,door-to-needle time(DNT),and short-term and long-term prognosis in patients with acute stroke.Methods A retrospective analysis was conducted on the clinical data of 150 patients with acute stroke admitted to Pucheng County Hospital of Traditional Chinese Medicine,Fujian Province,from January 2023 to December 2024.According to the differ-ent prehospital emergency modes,they were divided into an observation group(optimized prehospital emergency process,n=75)and a control group(conventional prehospital emergency process,n=75).The emergency efficiency,early neurolog-ical improvement rate(NIHSS score decrease≥4 points or≤1 point after 7 days of intervention),long-term neurological function(NIHSS score),recovery of activities of daily living(ADL score),and the rate of favorable prognosis at 3 months(mRS score 0-2)were compared between the two groups.Results Compared with the control group,the observation group showed significantly shorter times from call to dispatch,on-scene management,transport,intravenous access estab-lishment,CT examination,and DNT(P<0.001).At 7 days post-intervention,the early neurological im-provement rate in the observation group was signifi-cantly higher than that in the control group(97.33%vs.88.00%,P=0.028).At 3 months post-intervention,the NIHSS score in the observation group was significantly lower,and the ADL score was significantly higher than those in the control group(P<0.001).Furthermore,the rate of favorable prognosis at 3 months was significantly better in the observation group(98.67%vs.89.33%,P=0.016).Conclusion Implementing an optimized prehospital emergency process for patients with acute stroke can effectively improve emergency efficiency,shorten CT examination time and DNT,promote early neurolog-ical recovery,and ultimately improve long-term neurological function,activities of daily living,and overall prognosis.It is worthy of clinical promotion and application.

Abstract:Objective To investigate the effect of applying a bed head elevation angle marker on reducing aspiration and related complications in long-term bedridden patients receiving nasogastric tube feeding.Methods A prospective randomized controlled study design was adopted.One hundred and twenty long-term bedridden nasogastric tube feeding pa-tients admitted to our hospital from March to December 2024 were selected as the study subjects and randomly divided into an experimental group and a control group using a random number table,with 60 patients in each group.In the control group,nurses elevated the bed head based on visual estimation of experience,while in the experimental group,a self-made bed head elevation angle marker was used to accurately elevate the bed head to 30°～45°.The incidence of aspiration,incidence of aspiration pneumonia,incidence of silent aspiration(detected by pepsin testing),gastric residual volume(GRV)exceeding standard rate,bed head angle compliance rate,and patient comfort(using Visual Analogue Scale/VAS)were compared be-tween the two groups.Results The incidence of aspiration(3.33%vs 21.67%),incidence of aspiration pneumonia(3.33%vs 13.33%),incidence of silent aspiration(8.33%vs 23.33%),and GRV exceeding standard rate(5.00%vs 23.33%)in the ex-perimental group were significantly lower than those in the control group(all P<0.05).Meanwhile,the bed head angle com-pliance rate in the experimental group reached 100%,significantly higher than the 75%in the control group(P<0.001),and the patient comfort VAS score in the experimental group was significantly higher than that in the control group(P=0.002).Conclusion The application of the bed head elevation angle marker can effectively improve the accuracy of bed head elevation,significantly reduce the risk of aspiration and related complications in long-term bedridden nasogastric tube feeding patients,and improve patient comfort.It is a simple and effective nursing intervention tool worthy of clinical promotion.

Abstract:Objective To investigate the effects of external diaphragm pacing(EDMS)combined with respira-tory pattern training(RMT)on pulmonary function,exercise tolerance,and inflammatory and oxidative stress in chronic obstructive pulmonary disease(COPD)patients receiving non-invasive ventilation(NIV).Methods According to the random number table method,78 COPD patients admitted to the Department of Respiratory and Critical Care Medicine of Yulin First People's Hospital from April 2021 to June 2023 were divided into a control group(n=38)and an observation group(n=40).The control group received external diaphragm pacing,while the observation group received external dia-phragm pacing combined with respiratory pattern training.Pulmonary function parameters,blood gas analysis parameters,dyspnea severity,maximal inspiratory pressure(MIP),6-minute walk test(6MWT)distance,inflammatory markers,and oxidative stress markers were compared between the two groups.Results After the intervention,the observation group showed significantly higher forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC ratio,arterial partial pressure of oxygen(PaO2),arterial oxygen saturation(SaO2),and MIP levels compared to the control group.The levels of arterial partial pressure of carbon dioxide(PaCO2),the modified British Medical Research Council(mMRC)dyspnea questionnaire score,and the levels of C-reactive protein(CRP)and malondialdehyde(MDA)were significantly lower in the observation group than in the control group.The 6MWT distance was significantly great-er in the observation group compared to the control group.All differences were statistically significant(all P<0.05).Conclusion In COPD patients receiving non-invasive ventilation,the combination of external diaphragm pacing and respiratory pattern training can improve pulmonary function,blood gas parameters,maximal inspiratory pres-sure,and exercise tolerance,alleviate dyspnea symptoms,and modulate systemic inflammatory response and oxidative stress response.

Abstract:Objective To explore the optimized emergency protocol for adolescent diabetic ketoacidosis compli-cated with hyperosmolar hyperglycemic coma(DKA-HHC)and its clinical application value.Methods A total of 150 adolescent patients with DKA-HHC admitted to our hospital from January 2023 to January 2025 were selected as the study subjects.They were randomly divided into an observation group and a control group using a random number table meth-od,with 75 patients in each group.The observation group received the optimized emergency protocol,while the control group received conventional emergency treatment.Blood glucose indicators(fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin),blood ketone,plasma osmolality,blood gas analysis indicators(pH,HCO₃⁻)and their recovery time were compared between the two groups.The rescue success rate and incidence of complications were also evaluated.Results Before treatment,there were no statistically significant differences in the observation indicators between the two groups(P>0.05).After treatment,all indicators improved in both groups.The observation group showed lower levels of fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,blood ketone,and plasma osmolality,and higher levels of pH and HCO₃⁻ compared to the control group,with statistically significant differences(P<0.05).The correction times for hyperglycemia,ketonemia,plasma hyperosmolality,and acidosis were shorter in the obser-vation group than in the control group.The rescue success rate was higher in the observation group(96.00％vs.86.67％,P=0.042),and the total incidence of complications was lower(8.00％vs.20.00％,P=0.034).Conclusion For adolescent patients with DKA-HHC,the optimized emergency protocol can effectively promote the recovery of blood glucose,blood ketone,plasma osmolality,and blood gas indicators,shorten the correction time of metabolic disturbances,improve the rescue success rate,and reduce the risk of complications.

Abstract:Objective To analyze and evaluate the application effect of the laryngeal mask in anesthesia and emer-gency resuscitation in primary hospitals.Methods One hundred patients requiring airway management admitted to our hospital from January 2023 to January 2025 were selected and divided into an observation group(laryngeal mask ventila-tion,n=50)and a control group(traditional endotracheal intubation,n=50)using a random number table method.The air-way establishment time,hemodynamic indicators[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)]at different time points,incidence of complications,and resuscitation success rate were compared between the two groups.Results The airway establishment time in the observation group was significantly shorter than that in the con-trol group(P<0.001).At 1 minute(T1)and 5 minutes(T2)after airway establishment,the fluctuations in SBP,DBP,and HR in the observation group were significantly smaller than those in the control group(P<0.001).The total incidence of complications in the observation group was lower than that in the control group(6.00%vs.24.00%,P=0.012).There was no significant difference in the resuscitation success rate between the two groups(78.95%vs.77.27%,P=0.897).Conclu-sion In anesthesia and emergency resuscitation in primary hospitals,compared with traditional endotracheal intubation,the laryngeal mask can establish an airway more rapidly,has less impact on patient hemodynamics,fewer complications,and can ensure an equivalent resuscitation success rate,demonstrating greater application advantages.

Abstract:Objective To investigate the application of a multidisciplinary team(MDT)model in improving emer-gency care for patients with acute traumatic shock.Methods Ninety-six patients with acute traumatic shock treated in the Emergency Department of the Second People's Hospital of Sanming City from August 2022 to September 2023 were randomly assigned by a random number table to a conventional group(n=48)receiving standard emergency care or a study group(n=48)receiving an MDT-based emergency care model.The duration of treatment and observation was ap-proximately 1 to 2 weeks,tailored to individual patient differences.The following were compared between groups:emer-gency department(ED)length of stay,time to physician attendance,preoperative preparation time,time required for blood sampling and diagnostic testing,dwell time in the emergency fast-track(green channel),and time to arrival of personnel from relevant departments;as well as total incidence of complications,resuscitation success rate,and family satisfaction rate.Results Compared with the conventional group,the study group had significantly shorter ED length of stay,time to physician attendance,preoperative preparation time,time required for blood sampling and diagnostic testing,green-channel dwell time,and time to arrival of personnel from relevant departments(all P<0.05).The total incidence of complications during emergency treatment was lower in the study group than in the conventional group(P<0.05).The resuscitation suc-cess rate and family satisfaction rate were significantly higher in the study group than in the conventional group(both P<0.05).Conclusion MDT-based emergency measures can shorten resuscitation time,reduce the incidence of complica-tions,improve resuscitation success,and enhance family satisfaction in patients with acute traumatic shock.

Abstract:Objective To explore the independent risk factors for mortality in patients with bacterial pneumonia treated in the emergency department(ED)resuscitation room.Methods A retrospective analysis was conducted on the clinical data of 50 patients with bacterial pneumonia admitted to the ED resuscitation room of our hospital from June 2020 to June 2025.According to the outcome,patients were divided into a death group(n=15)and a survival group(n=35).Clinical data,laboratory indicators,and disease severity scores were collected and compared between the two groups.Univariate analysis was used to screen for statistically significant variables,and multivariate Logistic regression analysis(backward LR method)was further performed to identify independent risk factors for mortality.Results Univariate analysis showed that there were statistically significant differences between the death group and the survival group in terms of age,proportion of chronic obstructive pulmonary disease(COPD),Sequential Organ Failure Assessment(SOFA)score,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,levels of C-reactive protein(CRP),albumin(ALB),cardiac troponin T(cTnT),and D-dimer(all P<0.05).Multivariate Logistic regression analysis ultimately identified that SOFA score(OR=1.671,95%CI:1.294～2.153,P=0.024),CRP(OR=1.017,95%CI:1.004～1.029,P=0.013),and ALB(OR=0.904,95%CI:0.826～0.992,P=0.041)were independent risk factors for patient mortality.Conclusion Elevated SOFA score,elevated CRP level,and decreased ALB level are independent risk factors for mortality in patients with bacte-rial pneumonia in the ED resuscitation room.Clinical attention should focus on these indicators to facilitate early identifi-cation of high-risk patients and guide intervention,thereby improving prognosis

Abstract:Objective To compare and analyze the application value of tenecteplase versus alteplase in intravenous thrombolysis for acute ischemic stroke(AIS).Methods A total of 194 AIS patients admitted to Kaiping Central Hos-pital from May 2024 to August 2025 were selected as the study subjects.According to the random number table method,they were divided into an observation group(tenecteplase,n=97)and a control group(alteplase,n=97).Neurological func-tion recovery,clinical efficacy,prognosis,and bleeding events were compared between the two groups.Results Before thrombolysis,there was no significant difference in NIHSS scores between the two groups(P=0.227).After thrombolysis,NIHSS scores in both groups showed a significant decreasing trend over time.At 1h,24h,7d,and 14d after thrombolysis,the NIHSS scores of the observation group were significantly lower than those of the control group(P<0.001).There was no significant difference in the total clinical effective rate between the two groups(P=0.427).At 90 days after thrombolysis,the proportion of patients with favorable prognosis in the observation group was significantly higher than that in the control group(P=0.008).The total incidence of bleeding events in the observation group was significantly lower than that in the control group(P=0.005).Conclusion In intravenous thrombolysis for AIS,tenecteplase has comparable clinical efficacy to alteplase.However,tenecteplase is more conducive to the recovery of neurological function,improves long-term prog-nosis,reduces the risk of bleeding,and demonstrates higher safety.

Abstract:Objective To investigate the clinical value of early radical debridement combined with vacuum seal-ing drainage(VSD)versus traditional open dressing change in the treatment of perineal necrotizing fasciitis(PNF)after trauma.Methods A retrospective study was conducted,including 60 patients with post-traumatic PNF admitted be-tween January 2018 and July 2024.According to the actual surgical protocol,patients were divided into an observation group(early radical debridement+VSD,n=30)and a control group(conventional debridement+traditional open dressing change,n=30).The clinical efficacy,levels of inflammatory factors[white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6)],pain level[Visual Analogue Scale(VAS)],and recovery indicators(necrosis sloughing time,wound healing time,hospital stay)were compared between the two groups.Results The total clinical effective rate in the ob-servation group was significantly higher than that in the control group(96.67%vs.80.00%,P=0.044).On postoperative day 7,the levels of WBC,CRP,and IL-6 in the observation group were significantly lower than those in the control group(P<0.001).On postoperative days 1,3,and 7,the VAS scores in the observation group were significantly lower than those in the control group(P<0.05).The necrosis sloughing time,wound healing time,and hospital stay in the observation group were significantly shorter than those in the control group(P<0.001).Conclusion For patients with post-traumatic PNF,the application of early radical debridement combined with VSD can more effectively enhance clinical effica-cy,alleviate systemic inflammatory response and post-operative pain,accelerate wound healing,and shorten hospital stay.Its comprehensive effect is superior to traditional open dressing change.