Abstract:Objective To explore the impact of optimized emergency nursing procedures on improving rescue efficiency and success rates in patients with acute left heart failure.Methods A randomized controlled study was con-ducted,involving 70 patients with acute left heart failure admitted between April 2023 and April 2025.The patients were divided into an observation group(n=35)and a control group(n=35).The control group received conventional emergency nursing care,while the observation group was managed using a systematically optimized emergency nursing procedure,in-cluding rapid triage to activate the green channel,structured team division of labor,sequential operation management,and targeted training.Emergency time indicators,rescue success rates,and complication rates were compared between the two groups.Results Compared with the control group,the observation group showed significantly shorter times in triage assessment,establishment of intravenous access and blood sampling,intravenous medication administration,and electro-cardiogram examination(P<0.001).The observation group also demonstrated significantly higher improvement rates at 30 minutes(57.14%vs.28.57%),significant improvement rates at 60 minutes(88.57%vs.51.43%),and final rescue success rates(94.29%vs.77.14%),along with a significantly lower total complication rate(8.57%vs.28.57%)(P<0.05).Con-clusion Optimizing emergency nursing procedures can significantly shorten rescue time,improve rescue efficiency and success rates,and effectively reduce the risk of complications in patients with acute left heart failure.

Abstract:Objective To investigate the impact of combining a Traditional Chinese Medicine(TCM)protocol with foundational treatments(debridement,antibiotics,vacuum sealing drainage[VSD],and supportive care)on clinical efficacy and wound healing in patients with necrotizing fasciitis.Methods Fifty patients with necrotizing fasciitis admitted to Nan-jing Hospital of TCM between February 2022 and February 2025 were selected as the study subjects and randomly divided into a control group(n=25)and an observation group(n=25)using a random number table method.The control group received foundational treatment(debridement+antibiotics+VSD+supportive care).The observation group received the foundational treatment combined with oral administration and external application of Chinese herbs for clearing heat and toxins,and cool-ing blood and resolving stasis.Outcome measures compared between the two groups included therapeutic indicators(time for body temperature to normalize,wound healing time,hospital stay length),treatment effectiveness rate,complication rate.Lev-els of Vascular Endothelial Growth Factor(VEGF)and basic Fibroblast Growth Factor(bFGF)in wound granulation tissue were measured on the day of surgery,at week 2,and at week 4 postoperatively.Results Compared with the control group,the observation group showed significantly shorter times for body temperature to normalize,wound healing time,and hospital stay length(all P<0.001).The total treatment effectiveness rate was significantly higher in the observation group(96.00%vs.76.00%,P=0.042),and the total incidence of com-plications was significantly lower(4.00%vs.24.00%,P=0.042).At both week 2 and week 4 postoperatively,the levels of VEGF and bFGF in the observation group were significantly higher than those in the control group(P<0.05).Repeated measures analysis of variance showed significant interaction effects(VEGF:F=17.352,P<0.001;bFGF:F=8.344,P=0.013).Conclusion Based on the foundational treatment regimen of debridement,antibiotics,VSD,and supportive care,the addition of TCM treatment can more effectively promote wound healing,improve therapeutic outcomes,and reduce the risk of complications in patients with necrotizing fasciitis.The mechanism of action may be related to the further upregulation of VEGF and bFGF expression levels in the local wound area.

Abstract:Objective To compare and analyze the clinical efficacy of single-port laparoscopic surgery versus traditional open surgery in the treatment of ovarian tumor torsion in children.Methods A retrospective cohort study was conducted,which consecutively enrolled 40 children with ovarian tumor torsion admitted to Anhui Hospital of Fudan University Pediatric Hospital from January 2020 to January 2025.Based on the surgical approach,they were divided into two groups:the observation group(single-port laparoscopic surgery,n=20)and the control group(traditional open surgery,n=20).Perioperative indicators(operation time,intraoperative blood loss,postoperative intestinal function recovery time,postoperative hospital stay),postoperative complication rates were compared between the two groups.A 6-month follow-up was conducted to evaluate ovarian atrophy and tumor recurrence.Results The observation group had less intraoperative blood loss but longer operation time than the control group(P<0.05).The postoperative intestinal function recovery time and hospital stay in the observation group were shorter than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was 5.00%,significantly lower than the 40.00%in the control group(P<0.05).During the follow-up period,there was no statistically significant difference in ovarian atrophy rate or tumor recur-rence rate between the two groups(P>0.05).Conclusion Single-port laparoscopic surgery for pediatric ovarian tumor torsion is superior to traditional open surgery in reducing intraoperative blood loss,promoting postoperative recovery,and lowering complication rates,demonstrating good emergency therapeutic efficacy and short-term safety.

Abstract:Objective To investigate the effects of ultrasound-guided sciatic nerve block combined with combined spinal-epidural anesthesia(CSEA)on intraoperative hemodynamics,postoperative recovery quality,and pain in patients un-dergoing surgery for femoral neck fractures.Methods A retrospective analysis was conducted on the clinical data of 80 patients who underwent surgery for femoral neck fractures between June 2021 and May 2025.Based on the anesthesia pro-tocol,patients were divided into a control group(39 cases,receiving CSEA alone)and a study group(41 cases,receiving ultrasound-guided sciatic nerve block combined with CSEA).Intraoperative hemodynamic parameters,total ropivacaine dosage,postoperative recovery quality,pain scores,and adverse reactions were compared between the two groups.Re-sults There was no statistically significant difference in the total dosage of ropivacaine between the two groups(P>0.05).Compared with the control group,the study group demonstrated superior heart rate and mean arterial pressure at 30 min-utes and 1 hour after anesthesia induction,as well as at the end of surgery,indicating more stable hemodynamics(P<0.05).The study group also exhibited a shorter postoperative awakening time and a lower incidence of emergence agitation(P<0.05).Furthermore,the Visual Analog Scale(VAS)scores at 6,12,and 24 hours postoperatively were significantly lower in the study group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In femoral neck fracture sur-gery,with an equivalent total dosage of ropivacaine,the use of ultrasound-guided sciatic nerve block combined with CSEA,compared to CSEA alone,can more effectively maintain intraoperative hemodynamic stability,improve postoperative re-covery quality,provide superior postoperative analgesia,without increasing the risk of adverse reactions.

Abstract:Objective To investigate the emergency treatment efficacy of penehyclidine hydrochloride combined with atropine in patients with acute organophosphorus pesticide poisoning(AOPP)and its impact on myocardial enzyme profiles.Methods A retrospective analysis was conducted on the clinical data of 70 AOPP patients admitted to Sanming Second Hospital from April 2022 to July 2024.Based on the actual emergency medications used,they were divided into a study group(35 cases,penehyclidine hydrochloride combined with atropine)and a control group(35 cases,atropine alone).The emergency treatment efficacy,levels of myocardial enzymes[creatine kinase(CK),creatine kinase-MB(CK-MB),lac-tate dehydrogenase(LDH)],time for cholinesterase(CHE)to return to normal,hospital stay,adverse reactions,endpoint outcomes,and medication dosage were compared between the two groups.Results The total effective rate of emergency treatment in the study group was significantly higher than that in the control group(94.29%vs.74.29%,P=0.022).Before treatment,there was no significant difference in CK,CK-MB,and LDH levels between the two groups(P>0.05).After treatment,the levels of these myocardial enzymes significantly decreased in both groups,with the study group showing sig-nificantly lower levels of CK(P<0.001),CK-MB(P<0.001),and LDH(P<0.001)compared to the control group.The time for CHE to return to normal(P<0.001)and hospital stay(P<0.001)were significantly shorter in the study group than in the control group.There was no significant difference in the total incidence of adverse reactions between the two groups(31.43%vs.42.86%,P=0.322).The incidenc-es of rebound phenomenon,mechanical ventilation,mortality,and intermediate syndrome in the study group were significantly lower than those in the control group(P<0.05).Conclusion Penehyclidine hydrochloride combined with atropine can effectively improve the emergency treat-ment efficacy for AOPP patients,ameliorate myocardial enzyme profiles,promote CHE recovery,shorten hospital stay,and reduce the risk of severe adverse outcomes such as rebound phenomenon,mechanical ventilation,and death,offering supe-rior clinical benefits.

Abstract:Objective To explore the application effect of hierarchical management based on quantitative assess-ment in patients with acute respiratory failure in the Emergency Intensive Care Unit(EICU).Methods A retrospective case-control study design was adopted,enrolling 120 patients with acute respiratory failure admitted between February 2022 and February 2024.Patients were divided into two groups according to the nursing model they received:the control group(58 cases)received routine nursing care,while the observation group(62 cases)received hierarchical management nursing care based on quantitative assessment.The disappearance times of main symptoms(dyspnea,cough,wheezing),arterial blood gas parameters[arterial partial pressure of oxygen(PaO₂),arterial partial pressure of carbon dioxide(PaCO₂)]before and after intervention,complication incidence,length of hospital stay,mortality rate,and patient satisfaction were compared between the two groups.Results The disappearance times of dyspnea,cough,and wheezing in the obser-vation group were significantly shorter than those in the control group.After 3 days of intervention,PaO₂ in the obser-vation group was higher than that in the control group(P<0.001),while PaCO₂ was lower than that in the control group(P=0.009).The overall complication incidence in the observation group was lower than that in the control group(P=0.029).The average length of hospital stay in the observation group was shorter than that in the control group(P<0.001),pa-tient satisfaction scores were higher(P<0.001),and the mortality rate was also significantly lower(3.23％vs.15.52％,P=0.020).Conclusion The application of hierarchical management based on quantitative assessment in EICU patients with acute respiratory failure can effectively promote the alleviation of clinical symptoms,improve oxygen-ation and ventilation function,reduce complication incidence and mortality rate,shorten hospital stay,and enhance patient satisfaction.

Abstract:Objective To investigate the clinical efficacy of Buyang Huanwu Decoction combined with standard Western medicine in the treatment of acute cerebral infarction complicated with brain-heart syndrome.Methods Sev-enty-two patients with acute cerebral infarction complicated with brain-heart syndrome admitted to our hospital from June 2022 to January 2025 were selected and randomly divided into an observation group and a control group,with 36 cases in each group.The control group received conventional Western medicine treatment(including improving cerebral circu-lation,neurotrophy,antiplatelet aggregation,and controlling blood pressure and blood glucose).The observation group received oral Buyang Huanwu Decoction in addition to the control group's treatment.The treatment course for both groups was 14 days.The National Institutes of Health Stroke Scale(NIHSS)score,incidence of arrhythmia,levels of myocardial enzymes(CK,CK-MB,LDH),rate of ECG ST-T segment changes,and total clinical effective rate were compared be-tween the two groups before and after treatment.Results After treatment,the NIHSS score in the observation group was significantly lower than that in the control group,and the difference was statistically significant P<0.001).The inci-dence of arrhythmia in the observation group was lower than that in the control group(11.11%vs.27.78%,P=0.041),and the difference was statistically significant.The levels of myocardial enzymes(CK,CK-MB,LDH)and the abnormal rate of ST-T segments in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The total clinical effective rate in the observation group was significantly higher than that in the control group(94.44%vs.72.22%,P=0.007),and the difference was statistically significant.Conclusion Based on conventional Western medicine treatment,the combined application of Buyang Huanwu Decoction can more effectively improve neurological function,reduce myocardial injury,and lower the risk of arrhythmia in patients with acute cerebral infarction complicated with brain-heart syndrome.

Abstract:Objective To explore the clinical intervention effect of magnet nursing based on the Identity-Situ-ation-Background-Assessment-Recommendation(ISBAR)communication model in emergency patients with diabetes mellitus complicated with hypertensive emergency.Methods A randomized controlled study was conducted.Eighty patients with diabetes mellitus and hypertensive emergency admitted to the Emergency Department of the Second Affiliated Hospital of Fujian Medical University between January 2024 and January 2025 were selected and randomly divided into an observation group and a control group using a random number table,with 40 cases in each group.The control group received routine emergency communication and nursing,while the observation group received magnet nursing based on the ISBAR communication model.Blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],blood glucose indicators[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG)],time to achieve blood glucose target,Self-Rating Anxiety Scale/Self-Rating Depression Scale(SAS/SDS)scores,and nursing satisfaction were compared between the two groups before nursing and 7 days after nursing.Results After nursing,the SBP,DBP,FPG,and 2hPG of patients in both groups significantly decreased compared to before nursing(all P<0.05),and the decrease in the obser-vation group was greater than that in the control group(all P<0.05).The time to achieve blood glucose target in the ob-servation group was significantly shorter than that in the control group(P=0.006).The SAS and SDS scores of patients in both groups decreased compared to before nursing(all P<0.05),and the scores in the observation group were lower than those in the control group(all P<0.05).The nursing satisfaction rate in the observation group was 97.50%,significantly higher than the 87.50%in the control group(P<0.05).Conclusion The application of magnet nursing based on the ISBAR communication model in emergency patients with diabetes mellitus complicated with hypertensive emergency can more effectively control blood pressure and blood glucose,shorten the time to achieve blood glucose target,alleviate patient anxiety and depression,and improve nursing satisfaction.It demonstrates good clinical ap-plication value.

Abstract:Objective To investigate the effect of an integrated rescue model in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 98 acute STEMI patients admitted to Guihang Guiyang Hospital from January 2024 to December 2024 were selected as the study subjects.According to a com-puter-generated random sequence,all patients were randomly divided into two groups:the study group(n=49,integrated rescue model)and the control group(n=49,conventional rescue model).The key rescue process time points and hospitali-zation duration,myocardial enzyme indicators,rescue efficacy,and the incidence of major adverse cardiac events(MACE)were compared between the two groups.Results Compared with the control group,the study group showed significant-ly shorter time intervals from symptom onset to first medical contact(S-to-FMC,P=0.001),from first medical contact to ECG completion(FMC-to-ECG,P<0.001),from ECG completion to balloon dilation(ECG-to-B,P<0.001),from door to balloon dilation(D-to-B,P<0.001),and hospitalization duration(P<0.001).Before treatment,there were no signif-icant differences in the levels of creatine kinase(CK,P=0.418)and creatine kinase isoenzyme MB(CK-MB,P=0.374)between the two groups.After treatment,the levels of CK and CK-MB decreased in both groups(P<0.001);furthermore,compared with the control group,the study group had significantly lower levels of CK and CK-MB(P<0.001).Com-pared with the control group,the study group had a significantly higher total effective rate of rescue(95.92%vs.81.63%,P=0.025)and a significantly lower incidence of MACE(12.24%vs.30.61%,P=0.027).Conclusion The integrated rescue model can significantly shorten the key rescue process time points and hospitalization duration in acute STEMI pa-tients,improve myocardial enzyme indicators,enhance rescue efficacy,and reduce the risk of major adverse cardiac events.

Abstract:Objective To investigate the impact of personalized nursing measures on complications and progno-sis in burn patients during surgery.Methods The clinical data of 58 burn patients who underwent surgical treatment at the 73rd Group Army Hospital from March 2023 to March 2025 were included.Using a random number table method,they were divided into a study group(implementing personalized nursing protocol,n=29)and a control group(implement-ing routine nursing protocol,n=29).Rehabilitation time,incidence of complications,negative emotions,pain levels,and satisfaction were compared between the two groups.Results Compared with the control group,the study group had significantly shorter times to first ambulation,skin graft fusion,and hospital stay(P<0.001).The total incidence of com-plications during surgery was significantly lower in the study group(13.79%vs.41.38%,P=0.008).Patient satisfaction was significantly higher in the study group(96.55%vs.75.86%,P=0.022).Preoperatively,there were no significant differences in SAS scores(P=0.437)or SDS scores(P=0.392)between the two groups.At 7 days postoperatively,both SAS and SDS scores decreased in both groups,with the study group showing significantly lower scores than the control group(P<0.001).On postoperative day 1,there was no significant difference in VAS scores between the two groups(P=0.327).On postoper-ative days 3 and 5,VAS scores decreased in both groups,with the study group exhibiting significantly lower scores than the control group(P<0.001).Conclusion Personalized nursing services can effectively reduce the risk of complications during surgery in burn patients,promote postoperative recovery,alleviate negative emotions,reduce postoperative pain lev-els,and enhance patient satisfaction.

Abstract:Objective To investigate the clinical characteristics of older patients with upper gastrointestinal bleed-ing(上消化道出血).Methods In this retrospective study,90 patients with 上消化道出血 treated at our hospital from January 2023 to January 2025 were enrolled and stratified by age into an older group(≥60 years;40 case)and a non-el-derly group(<60 years;50 case).Baseline characteristics,etiologies,clinical presentations,and outcomes were compared between groups.Results The older group had significantly higher proportions of hypertension,diabetes,cerebrovascu-lar disease,and of having at least one comorbidity(all P<0.05).Regarding etiologic distribution,gastric ulcer was more frequent in the older group(27.50%vs.10.00%,P=0.031),whereas duodenal ulcer was less frequent(17.50%vs.44.00%,P=0.008).Clinically,the older group had lower incidences of hematemesis(35.00%vs.58.00%,P=0.030)and abdominal pain(30.00%vs.52.00%,P=0.036),but a higher incidence of shock(25.00%vs.8.00%,P=0.027).Multivariable logistic regression confirmed older age as an independent risk factor for shock(OR=3.44;95%CI:1.27～9.32;P=0.015).Rates of clinical cure and mortality did not differ significantly between groups;however,the rate of discharge against medical advice due to clinical deterioration was higher in the older group(20.00%vs.6.00%,P=0.044),and length of hospital stay was significantly longer(P<0.001).Conclusion Older patients with 上消化道出血 commonly have multiple comorbidities,with gastric ulcer being a predominant etiology.Their clinical presentation is less typical(less hematemesis and abdominal pain),yet their condition is more severe(higher risk of shock),hospital stays are longer,and overall prognosis is poorer.

Abstract:Objective To systematically evaluate the application effect of Enhanced Recovery After Surgery(ERAS)nursing in postoperative patients with Type A aortic dissection.Methods Randomized controlled trials(RCTs)inves-tigating the impact of ERAS nursing on postoperative patients with Type A aortic dissection were searched electronically in PubMed,EMbase,The Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP Chinese Sci-Tech Journal Data-base,and CBM.Meta-analysis was performed using RevMan 5.4 software.Results A total of 7 studies involving 517 patients were included.The meta-analysis results showed that ERAS nursing significantly shortened ICU length of stay[MD=-2.68,95%CI(-3.79～-1.57),P<0.001],hospital length of stay[MD=-5.43,95%CI(-6.67～-4.19),P<0.001],and time to first ambulation[MD=-5.14,95%CI(-8.24～-2.64),P<0.001].It also reduced negative emotion scores[MD=-3.04,95%CI(-3.21～-2.94),P<0.001],pain intensity scores[MD=-4.18,95%CI(-7.30～-3.12),P<0.001],and the inci-dence of adverse events[RR=0.23,95%CI(0.09～0.53),P<0.001],while improving nursing satisfaction[RR=2.05,95%CI(1.47～2.71),P<0.001].Conclusions Current evidence suggests that ERAS nursing may help shorten ICU and hospital length of stay,and reduce the risk of pain and adverse events in patients after Type A aortic dissection surgery.

Abstract:Objective To compare the clinical efficacy and safety of active core rewarming versus active peripheral re-warming in patients with mild hypothermia induced by seawater immersion.Methods Seventy-eight patients with mild hypo-thermia due to seawater immersion admitted between June 2020 and June 2024 were enrolled and randomly assigned to a control group(n=39)and an observation group(n=39)using a random number table.The control group received active peripheral re-warming(warming blanket),while the observation group received active core rewarming(intravenous infusion of warmed fluids+inhalation of warmed humidified oxygen).The rewarming efficiency(core temperature,mean rewarming rate),physiological indicators(heart rate,blood pressure,respiratory rate)at 2 hours post-rewarming,blood gas parameters at 6 hours post-rewarm-ing,and the incidence of complications were compared between the two groups.Results The core temperature at 1,2,3,and 4 hours post-rewarming and the mean rewarming rate in the observation group were significantly higher than those in the control group(all P<0.05).At 2 hours post-rewarming,heart rate,systolic blood pressure,diastolic blood pressure,and respiratory rate in the observation group were significantly higher than those in the control group(P<0.05).At 6 hours post-rewarming,oxygen saturation,pH,and PaO2 in the observation group were significantly higher,while PaCO2 was significantly lower than those in the control group(P<0.001).The total incidence of complications in the observation group was significantly lower than that in the control group(7.69%vs.25.64%),and the difference was statistically significant(P=0.033).Conclusion For mild hypothermia induced by seawater immersion,compared to active peripheral rewarming,active core rewarming can elevate core temperature more rapidly,more effectively improve vital signs,correct acidosis and hypoxemia,and significantly reduce the incidence of complications.It is a safer and more effective rewarming strategy.

Abstract:Objective To investigate the antioxidant stress role and regulatory mechanism of the Nrf2-Keap1-ARE signaling pathway in traumatic lung injury(TLI)in rats.Methods Healthy male Wistar rats were randomly divided into a control group,a TLI model group,and an Nrf2 agonist pretreatment group.The TLI model was established by impacting the right chest using a biological impact machine.Rats in the Nrf2 agonist pretreatment group received an intraperitoneal injection of the specific Nrf2 agonist sulforaphane(5 mg/kg)30 minutes before modeling.At 24 hours post-modeling,arterial blood gas parameters were measured,the lung wet/dry(W/D)weight ratio was calculated,and the activities of myeloperoxidase(MPO)and superoxide dismutase(SOD)were determined.The mRNA expression levels of Keap1,heme oxygenase-1(HO-1),and NAD(P)H quinone oxidoreductase 1(NQO1)in lung tissue were detected by real-time quantita-tive PCR,and the expression of Nrf2 nuclear protein was detected by Western blot.Results Compared with the control group,the TLI group showed significantly decreased arterial blood pH and PaO2,and significantly increased PaCO2,lung W/D ratio,and MPO activity,while SOD activity was significantly decreased(P<0.05).Concurrently,the mRNA expres-sion of Keap1 in lung tissue was up-regulated,while the nuclear protein expression of Nrf2 and the mRNA expression of its downstream target genes HO-1 and NQO1 were down-regulated in the TLI group(P<0.05).Compared with the TLI group,Nrf2 agonist pretreatment effectively reversed the aforementioned indicators:arte-rial blood oxygenation improved,pulmonary edema alleviated,MPO activity decreased,and SOD activity increased.At the molecular level,Keap1 mRNA expression was inhibited,Nrf2 nuclear protein accumulated,and the mRNA expression of HO-1 and NQO1 was up-regulated(P<0.05).Conclusions Oxidative stress is an important pathogenesis of TLI.Activation of the Nrf2-Keap1-ARE signaling pathway can inhibit Keap1 expression,promote Nrf2 nuclear translocation,thereby up-regulating the expression of downstream antioxidant genes such as HO-1 and NQO1,ultimately alleviating ox-idative stress injury and improving lung function after TLI.

Abstract:Objective To analyze the risk factors for early-onset preeclampsia(EOPE)and its impact on pregnancy outcomes in pregnant women with a history of cesarean section for hypertensive disorders of pregnancy(HDP).Meth-ods A retrospective study was conducted on 200 singleton pregnant women with a prior HDP cesarean section who received regular antenatal care and delivered at our hospital between January 2022 and January 2024.Based on the occur-rence of EOPE(diagnostic criterion:gestation<34 weeks),the participants were divided into an EOPE group(69 cases)and a non-EOPE group(131 cases).Baseline characteristics,clinical features,and maternal and neonatal outcomes were collected and compared between the two groups.Logistic regression analysis was used to identify independent risk factors for EOPE.Results Univariate analysis showed that the EOPE group had higher maternal age,higher pre-pregnancy weight,lower gestational weight gain,and a higher proportion of chronic hypertension(P<0.05).Multivariate logistic regression analysis further confirmed that higher pre-pregnancy weight(OR=1.522,95%CI:1.069～2.166),inadequate ges-tational weight gain(OR=3.973,95%CI:1.435～10.998),and chronic hypertension(OR=28.860,95%CI:5.237～159.011)were independent risk factors for EOPE(all P<0.05).Regarding pregnancy outcomes,the EOPE group had significantly higher incidences of fetal growth restriction(11.59%vs.0.76%,P=0.002),neonatal mortality(5.80%vs.0%,P=0.010),and longer maternal hospital stay(P<0.001).Neonatal birth weight and Apgar scores were significantly lower in the EOPE group(all P<0.001).Conclusion For pregnant women with a prior HDP cesarean section,higher pre-pregnancy weight,inadequate gestational weight gain,and chronic hypertension are independent risk factors for EOPE in subsequent pregnancies.EOPE significantly increases the risk of adverse maternal and neonatal outcomes.Clinical at-tention should be strengthened through pre-pregnancy counseling,enhanced prenatal monitoring,and early intervention for this high-risk population.

Abstract:Objective To investigate the application effect of a combined emergency protocol involving Early Goal-Directed Sedation(EGDS)and Intravascular Hypothermia Therapy(IVHT)in the treatment of severe craniocere-bral injury.Methods One hundred patients with severe craniocerebral injury admitted to Jinjiang Anhai Hospital from January 2022 to June 2025 were selected as the study subjects.According to the random number table method,they were divided into an observation group(EGDS combined with IVHT,n=50)and a control group(conventional treatment,n=50).The 30-day mortality,incidence of hydrocephalus,neurological function,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),cerebral perfusion pressure(CPP),intracranial pressure(ICP)],cerebral oxidative metabolism pa-rameters[jugular venous lactate(Lac),jugular venous oxygen saturation(SjvO2),cerebral arterial oxygen content(CaO2),cerebral oxygen extraction rate(CERO2),cerebral arteriovenous oxygen content difference(a-vDO2)],and incidence of complications were compared between the two groups.Results The 30-day mortality(P=0.022)and 30-day incidence of hydrocephalus(P=0.003)in the observation group were lower than those in the control group.Before treatment,there were no significant differences in mRS score,BI score,HR,MAP,CPP,ICP,Lac,SjvO2,CaO2,CERO2,and a-vDO2 between the two groups(P>0.05).After treatment,the above neu-rological function scores,hemodynamic and cerebral oxidative metabolism parameters changed in both groups.The observation group showed significantly higher mRS score(P<0.001),BI score(P<0.001),MAP(P=0.036),CPP(P=0.006),SjvO2(P=0.003),and CaO2(P=0.001),and significantly lower HR(P<0.001),ICP(P<0.001),Lac(P<0.001),CERO2(P<0.001),and a-vDO2(P<0.001)compared to the con-trol group.The incidence of complications in the observation group was significantly lower than that in the control group(P=0.038).Conclusion In the treatment of patients with severe craniocerebral injury,the combined emergency protocol of EGDS and IVHT can reduce 30-day mortality and the incidence of hydrocephalus,improve neurological function and cerebral oxidative metabolism,stabilize hemodynamics,and lower the risk of complications.

Abstract:Objective To investigate the impact of different plasma-to-red blood cell(RBC)transfusion ratios on the therapeutic outcomes in patients with severe traumatic hemorrhage.Methods A total of 98 patients with severe trau-matic hemorrhage admitted to The First Hospital of Longyan from January 2023 to December 2024 were selected as the study subjects.Based on the actual transfused plasma-to-RBC ratio,patients were divided into a low-ratio group(plasma∶RBC<1∶2,n=32),a medium-ratio group(1∶2≤ratio≤1∶1,n=34),and a high-ratio group(ratio>1∶1,n=32).Coag-ulation function,transfusion volumes,complication rates,and mortality were compared among the three groups.Re-sults At 24 hours post-transfusion,there were statistically significant differences in coagulation parameters among the three groups(P<0.05).Prothrombin time(PT)and activated partial thromboplastin time(APTT)in the low-ratio group were significantly longer than those in the medium-and high-ratio groups,while fibrinogen(FIB)was significantly lower(P<0.05).However,there were no significant differences in coagulation parameters between the medium-and high-ratio groups(P>0.05).No significant difference was observed in RBC transfusion volume among the three groups(P>0.05),but there was a significant difference in plasma transfusion volume(P<0.001).The total incidence of complications in the medium-ratio group(11.76%)was significantly lower than that in the low-ratio group(37.50%)and the high-ratio group(43.75%)(P<0.05).Regarding mortality,the 24-hour mortality rates in both the medium-and high-ratio groups were sig-nificantly lower than that in the low-ratio group(P<0.05).The 30-day mortality rate in the medium-ratio group(20.59%)was significantly lower than that in the low-ratio group(46.88%)and the high-ratio group(43.75%)(P<0.05).Conclusion For patients with severe traumatic hemorrhage,employing a plasma-to-RBC transfusion ratio be-tween 1∶2 and 1∶1 demonstrates comprehensive advantages in improving coagulation function,reducing complication rates,and lowering long-term mortality,which can be considered as the preferred transfusion strategy in clinical practice.

Abstract:Objective To explore the distribution of pathogenic bacteria,seasonal characteristics,drug resistance,and changing trends of bacterial pulmonary infections in stroke patients during the rehabilitation phase.Methods A total of 360 stroke rehabilitation patients with bacterial pulmonary infections and positive sputum culture results,who were admitted to Wuzhou Workers'Hospital from January 2019 to January 2022,were selected as the study subjects.Drug susceptibility testing was performed on the isolated pathogenic bacteria.Results A total of 379 strains of pathogenic bacteria were isolated from the sputum of the 360 patients.Among them,Gram-positive bacteria accounted for 87 strains(22.96%),and Gram-negative bacteria accounted for 292 strains(77.04%).Seasonal analysis showed that the number of in-fections in winter was 174 cases(48.33%),significantly higher than in other seasons(P<0.005),and pulmonary infections caused by Acinetobacter baumannii were more common in winter.Drug susceptibility results indicated that the resistance rate of Staphylococcus aureus to penicillin G was 98.67%;the resistance rate of Streptococcus pneumoniae to erythromy-cin was 83.33%;the resistance rates of Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae to ciprofloxacin,aztreonam,and cefuroxime were 59.57%,78.48%,and 77.78%,respectively.Further annual trend analysis revealed that the resistance rates of Acinetobacter baumannii to ciprofloxacin and ceftazidime showed a significant upward trend(P<0.05),while the resistance rate of Klebsiella pneumoniae to cefuroxime showed a significant downward trend(P<0.05).Conclusion Pulmonary infections in stroke rehabilitation patients exhibit a high incidence in winter,primarily caused by Gram-negative bacil-li such as Acinetobacter baumannii and Pseudomonas aeruginosa.The resistance of these pathogens to commonly used antimicrobial agents is severe,particularly with rising resistance rates of Acinetobacter baumannii to ciprofloxacin and ceftazidime.In clinical practice,emphasis should be placed on seasonal prevention and control.When empirical therapy is ineffective,precise antimicrobial treatment must be implemented based on local resistance surveillance data and individual drug susceptibility results to improve patient prognosis and curb the spread of drug-resistant bacteria.

Abstract:Objective To compare and analyze the application effects of temporary central venous catheters versus autogenous arteriovenous fistulas in patients undergoing hemodialysis.Methods The clinical data of 60 hemodialysis patients admitted to our hospital from March 2023 to March 2025 were retrospectively analyzed.According to the type of vascular access,they were divided into a temporary catheter group(n=30)and a fistula group(n=30).Dialysis adequacy(blood flow rate,Kt/V value,urea clearance rate),complication incidence,puncture-related indicators(first puncture suc-cess rate,pain VAS score),and quality of life(KDQOL-SF score)were compared between the two groups.Results The dialysis adequacy in the fistula group was significantly better than that in the temporary catheter group,with higher blood flow rate,Kt/V value,and urea clearance rate(P<0.05).The total incidence of complications in the fistula group was significantly lower than that in the catheter group(16.67%vs.46.67%,P=0.013).However,regarding puncture,the first puncture success rate in the temporary catheter group was higher than that in the fistula group(93.33%vs.73.33%,P=0.038),and the patients'puncture pain VAS score was lower(P<0.001).Furthermore,the fistula group showed signif-icantly better scores in all dimensions of the KDQOL-SF quality of life scale compared to the temporary catheter group(P<0.001).Conclusion Autogenous arteriovenous fistula demonstrates significant advantages in improving dialysis adequacy,reducing complications,and enhancing long-term quality of life,making it the ideal access for long-term dialysis patients.Temporary central venous catheters offer the benefits of high puncture success rate,less pain,and rapid establishment,making them suitable for emer-gency dialysis or as a bridge before fistula maturation.The choice of access type should be individualized based on the pa-tient's specific condition.

Abstract:Objective To investigate the efficacy of different occluders combined with mechanical venti-lation in the treatment of patients with postoperative bronchopleural fistula(BPF)complicated by respiratory fail-ure.Methods One hundred patients with postoperative BPF complicated by respiratory failure in the Depart-ment of Thoracic Surgery of Hui'an County Hospital from January 2023 to January 2025 were retrospective selected and divided into two groups according to the treatment method.The control group(n=50)received mechanical ven-tilation combined with an atrial septal occluder,while the observation group(n=50)received mechanical ventilation combined with a customized bronchial occluder assisted by 3D printing imaging technology.Arterial blood gas indices,laboratory indicators,pain level,psychological status,quality of life,clinical efficacy,incidence of adverse events,and prognostic indicators were statistically analyzed and compared between the two groups.Results The observation group showed significantly higher levels of oxygen saturation,partial pressure of oxygen,total effec-tive rate,and GQOLI-74 scores(material life,physical,psychological,and social function)compared to the control group(P<0.05).The levels of partial pressure of carbon dioxide,hs-CRP,PCT,pain scores,anxiety and depression scores,and the incidence of adverse events were significantly lower in the observation group than in the control group(P<0.05).The average duration of mechanical ventilation and ICU stay in the observation group were signif-icantly shorter than those in the control group(P<0.05).Conclusion Compared to the atrial septal occluder,the customized bronchial occluder assisted by 3D printing imaging technology combined with mechanical ventilation demonstrates superior efficacy in treating patients with postoperative BPF complicated by respiratory failure.It more effectively improves arterial blood gas and lab-oratory indicators,alleviates pain,improves psycholog-ical status,enhances quality of life,and reduces the incidence of adverse events.