Abstract:Objective To investigate the impact of pre-hospital emergency care on the clinical prognosis of surgical patients with craniocerebral trauma.Methods A retrospective cohort study was conducted,selecting 100 patients with craniocerebral trauma who were admitted to Changsha Central Hospital from March 2024 to March 2025 as the study subjects.According to the different pre-hospital emergency care received,they were divided into a con-trol group(routine emergency care group,n=50)and an observation group(systematized pre-hospital emergency care group,n=50).The emergency response time,prognosis[Glasgow Coma Scale(GCS),Glasgow Outcome Scale(GOS),National Institutes of Health Stroke Scale(NIHSS),Activities of Daily Living(ADL)scale],and incidence of compli-cations were compared between the two groups.Results The on-site emergency time,pre-examination assessment time,in-hospital diagnosis time,and preoperative preparation time in the observation group were significantly short-er than those in the control group(P<0.001).Before the intervention,there were no significant differences in GCS scores(P=0.250),GOS scores(P=0.229),NIHSS scores(P=0.336),or ADL scores(P=0.360)between the two groups.After the intervention,the GCS,GOS,and ADL scores significantly increased,and the NIHSS scores significantly de-creased in both groups.Furthermore,the observation group had significantly higher GCS,GOS,and ADL scores(P<0.05)and a significantly lower NIHSS score(P<0.001)than the control group.The total incidence of complications in the observation group was significantly lower than that in the control group(8.00%vs 26.00%,P=0.017).Conclu-sion Systematized pre-hospital emergency care is beneficial for shortening the emergency response time for patients with craniocerebral trauma,improving patient prognosis,and reducing the risk of postoperative complications.

Abstract:Objective To explore the value of serum B-type natriuretic peptide(BNP)combined with non-invasive hemodynamic monitoring in assessing cardiac function in children with sepsis.Methods A total of 100 children with sepsis diagnosed and treated at Tongren People's Hospital from October 2022 to October 2024 were selected as the sepsis group,and another 50 children with ordinary infections during the same period were selected as the ordinary infection group.Serum BNP levels were measured in both the sepsis and ordinary infection groups,as well as in the sepsis group before treatment and at 24h and 96h after treatment.Based on the 33.3rd per-centile(P₃₃)and 66.7th percentile(P₆₇)values of the 100 children with sepsis(P₃₃=636 pg/mL,P₆₇=4351 pg/mL),the sepsis group was further divided into a normal BNP range group,a mildly elevated BNP group,a moderately elevated BNP group,and a severely elevated BNP group.The levels of non-invasive hemodynamic monitoring car-diac function indicators were compared among sepsis children with different serum BNP levels.Pearson correlation analysis was used to analyze the correlation between serum BNP levels and non-invasive hemodynamic monitoring cardiac function indicators.Results Serum BNP levels were significantly higher in the sepsis group than in the ordinary infection group(P<0.001).Compared with pre-treatment levels,serum BNP levels in the sepsis group showed a gradual decreasing trend with prolonged treatment time,with levels before treatment>24h after treatment>96h after treatment(P<0.001).According to serum BNP test results,the sepsis group was divided into:normal BNP range group(11 cases),mildly elevated BNP group(25 cases),moderately elevated BNP group(52 cases),and severely elevated BNP group(12 cases).As BNP levels increased,some hemodynamic indicators changed significantly:HR,SVV,and STR levels showed an increasing trend,while SV and SI showed a decreasing trend(P<0.05);however,other indicators such as CO,CI,and MAP showed no statistically significant differences among the groups(P>0.05).Correlation analysis results showed that in children with sepsis,BNP was negative-ly correlated with SV and SI(P<0.05),and positively correlated with HR,SVV,and STR(P<0.05).Conclu-sion Serum BNP levels show good correlation with non-invasive hemodynamic indicators.Combined monitoring of both can provide a more comprehensive assessment of cardiac function in children with sepsis.

Abstract:Objective To investigate the application effect of a targeted emergency management model in the emergency treatment of maintenance hemodialysis(MHD)patients complicated with acute severe myocardi-tis.Methods Seventy-six MHD patients complicated with acute severe myocarditis admitted to our hospital from March 2023 to March 2025 were selected as the study subjects.They were randomly divided into an obser-vation group and a control group using a random number table,with 38 patients in each group.The control group received conventional emergency measures,while the observation group received the targeted emergency manage-ment model based on conventional measures.This model included intensified electrocardiographic monitoring,pre-cise volume management,timely application of continuous renal replacement therapy(CRRT),immunomodulation,and individualized nutritional support.The incidence of arrhythmias,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],myocardial enzyme profiles[creatine kinase-MB(CK-MB),cardiac troponin I(cTnI),lactate dehydro-genase(LDH)],renal function indicators[serum cre-atinine(Scr),blood urea nitrogen(BUN),endogenous creatinine clearance rate(Ccr)],and the total clinical effectiveness rate were compared between the two groups after treatment.Results After treatment,the incidence of arrhythmias in the observation group(18.42%)was significantly lower than that in the control group(39.47%),and the difference was statistically significant(P<0.05).The improvement in cardiac function was more pronounced in the observation group,with LVEF significantly higher than that in the control group,and LVEDD and LVESD significantly lower than those in the control group(all P<0.001).Meanwhile,the improvement ampli-tudes in myocardial enzyme profiles(CK-MB,cTnI,LDH)and renal function indicators(Scr,BUN,Ccr)in the ob-servation group were significantly superior to those in the control group(all P<0.001).The total clinical effective-ness rate in the observation group was significantly higher than that in the control group(81.58%vs.60.52%,P<0.05).Conclusion In the emergency treatment of MHD patients complicated with acute severe myocarditis,the application of the targeted emergency management model can effectively reduce the risk of arrhythmias,significant-ly improve cardiac and renal function,alleviate myocardial injury,and enhance the success rate of clinical rescue.

Abstract:Objective To construct a"5S"method based on the"One Drive,Three Cycles"management model,apply it to scenario simulation teaching,and evaluate its application effect,so as to provide a reference for improving the comprehensive emergency response abil-ity and nursing management quality of junior pediatric nurses.Methods Junior nurses(with≤3 years of experience)working in 18 pediatric clinical depart-ments of our hospital from January 2024 to December 2024 were selected.They were divided into a control group and a study group,with 188 nurses in each group,based on whether the"5S"method under the"One Drive,Three Cycles"management model was implement-ed.The control group received conventional teaching methods,including monthly professional training,quarterly theoretical assessments,and single-item operational skill assessments.The study group received clinical teaching using the"5S"method based on the"One Drive,Three Cycles"management model.A comprehensive emergency ability evaluation system for junior pediatric nurses was constructed,and two rounds of expert correspondence were conducted using the Delphi method to validate this system.Using this evaluation system,a comprehensive assessment was conducted on both groups across six dimensions:condition recognition(10%),personnel arrival(5%),emergency management(69%),teamwork(10%),emergency response duration(3%),and humanistic care(3%).The total scores of comprehensive emergency ability and the number of individuals with major issues were compared between the two groups.The time to condition assessment,time to activate emergency response,time from recognizing cardiac arrest to initiating CPR,time to personnel arrival,time to medication administration,time from ventricular fibrillation occurrence to defibrillation,and total duration of emergency operations were record-ed.The average duration of various operations was compared between the two groups.Results There were no statistically significant differences in general data such as age,gender,education level,professional title,and work experience between the two groups of nurses(P>0.05).The positive coefficients for both rounds of expert corre-spondence were 100%.The expert authority coefficient,Cronbach's α coefficient,was 0.923,and the Cronbach's α coefficients for each dimension ranged from 0.80 to 1.00.The Kendall's coordination coefficients were 0.438 and 0.499,respectively(P<0.001).The study group scored higher than the control group in condition recognition,emergency management,teamwork,and emergency response duration.The total score for comprehensive emergen-cy ability was higher in the study group.Furthermore,the times for condition assessment,activating emergency response,initiating CPR after recognizing cardiac arrest,medication administration,defibrillation after ventricular fibrillation occurrence,and the total operation duration were all shorter in the study group compared to the control group,with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in terms of personnel arrival time and humanistic care scores(P>0.05).Conclusion Constructing the"5S"method through the"One Drive,Three Cycles"management model helps build a team of clinical nursing staff with solid professional knowledge and excellent operational skills,thereby further enhancing the emergency response capability and operational level of junior pediatric nurses.This enables them to effectively handle sudden situations in clinical work and provides ideas for improving the quality of clinical nursing management.

Abstract:Objective To explore the effect of comprehensive nursing intervention on the postoperative quality of life in patients with subarachnoid hemorrhage.Methods Sixty-eight patients with subarachnoid hem-orrhage admitted to Xiamen Xinglin Hospital from January 2024 to December 2024 were enrolled and randomly assigned via a random number table to either an observation group(n=34,receiving comprehensive nursing inter-vention)or a control group(n=34,receiving routine nursing intervention).The quality of life(Stroke-Specific Qual-ity of Life scale,SS-QOL),activities of daily living(ADL scale),limb motor function(Fugl-Meyer Assessment,FMA),and the incidence of complications were compared between the two groups.Results Before the inter-vention,no significant differences were observed between the two groups in the SS-QOL scores(including physical function,language function,cognitive function,and role function),ADL scores,or FMA scores(P>0.05).After the intervention,all scores increased significantly in both groups.Compared to the control group,the observation group demonstrated significantly higher scores across all four SS-QOL dimensions,ADL,and FMA(P<0.001).The total incidence of complications in the observation group was significantly lower than that in the control group(8.82%vs.29.41%,P=0.031).Conclusion For patients with subarachnoid hemorrhage,comprehensive nursing interven-tion administered postoperatively can effectively enhance quality of life,improve the ability to perform activities of daily living,promote the recovery of limb motor function,and reduce the risk of complications.

Abstract:Objective To analyze the on-site primary trauma care(PTC)capability and its influencing factors among emergency medical rescue personnel in Chongqing.Methods A total of 332 emergency medical rescue personnel from emergency centers,emergency departments of general hospitals,and primary medical institutions at all levels in Chongqing were selected by cluster sampling.A self-designed questionnaire was used to collect general in-formation,assess PTC knowledge and operational skills,and conduct statistical analysis.Results The average PTC knowledge score of the 332 emergency medical rescue personnel was(18.54±3.70),and the average PTC operational skill score was(26.52±5.31).Significant differences in PTC knowledge and operational skill scores were observed among rescue personnel with different working years,professional titles,and types of institutions(P<0.05).Those with longer working years,higher professional titles,and higher-level institutions achieved higher scores.Multiple linear regression analysis further indicated that professional title and institution type were independent influencing factors for PTC knowledge scores(P<0.05).Working years,professional title,and institution type were all independ-ent influencing factors for PTC operational skill scores(P<0.05).Conclusions The on-site PTC capability of emergency medical rescue personnel in Chongqing still has room for improvement.Personalized and targeted training should be implemented based on their working years,professional titles,and institution types to comprehen-sively enhance PTC capability.

Abstract:Objective To explore the effects of double plasma molecular adsorption system(DPMAS)com-bined with plasma exchange(PE)on biochemical indicators,coagulation function and prognosis in patients with hepatitis B virus(HBV)related acute on chronic liver failure(ACLF,referred to as HBV-ACLF),so as to provide reference for optimizing clinical treatment regimens for HBV-ACLF.Methods A retrospective analysis was per-formed on the clinical data of 86 HBV-ACLF patients admitted to our hospital from December 2023 to March 2025.The patients were divided into two groups according to different treatment regimens.The control group(43 cases)received PE alone,while the observation group(43 cases)received DPMAS combined with PE.Biochemical indi-cators and coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio(INR)and fibrinogen(FIB)]before and after treatment were compared between the two groups.The incidence of complications and 3～month follow～up survival rate were also statistically analyzed.Results Af-ter treatment,the levels of biochemical indicators in both groups were lower than those before treatment,and the observation group had lower levels than the control group(P<0.05).After treatment,the levels of PT,INR and APTT in the observation group were higher than those in the control group,while the level of FIB was lower than that in the control group(P<0.05).There was no significant difference in the incidence of complications such as hepatorenal syndrome,pulmonary infection,electrolyte disturbance and abdominal infection between the two groups(P>0.05).After 3 months of follow～up,the survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion For HBV-ACLF patients,DPMAS combined with PE treatment can more efficiently remove inflammatory factors and endotoxins in the body,which is conducive to improving liver function and increasing the 3～month survival rate of patients with good safety.However,the effect of this combined treatment regimen in improving coagulation function is not as good as that of PE alone,so comprehensive consider-ation of patients'coagulation function status is required in clinical application.

Abstract:Objective To investigate the emergency management measures and their clinical value for in-tracerebral hemorrhage(ICH)patients in the Intensive Care Unit(ICU).Methods A retrospective analysis was conducted on the clinical data of 102 ICH patients admitted to Pingtan Comprehensive Experimental Zone Hospital between January 2019 and December 2024.According to the different ICU emergency management modes,patients were divided into an observation group(optimized emergency measures,n=51)and a control group(conventional emergency measures,n=51).The primary outcomes(30-day mortality rate,Glasgow Outcome Scale score at dis-charge),clinical recovery time,rehabilitation status,and incidence of complications were compared between the two groups.Results Compared with the control group,the observation group had a significantly higher effective rate of emergency management(94.12%vs.80.39%,P=0.038).The recovery time of consciousness(P<0.001),in-tracranial pressure normalization time(P<0.001),and hospital stay(P<0.001)were all significantly shorter in the observation group.The total incidence of complications was significantly lower in the observation group(7.84%vs.23.53%,P=0.029).Before treatment,there were no significant differences in NIHSS scores(P=0.199)and BI scores(P=0.366)between the two groups.After treatment,NIHSS scores significantly decreased(P<0.001)and BI scores significantly increased(P<0.001)in both groups.Compared with the control group,the observation group had sig-nificantly lower NIHSS scores(P<0.001)and signifi-cantly higher BI scores(P=0.002).Conclusion The implementation of optimized emergency measures in the ICU for ICH patients is effective.It can significant-ly improve patient condition,promote the recovery of neurological function and activities of daily living,and reduce the risk of complications.

Abstract:Objective To systematically analyze the types and distribution characteristics of deficiencies in the data of the inpatient medical record front page in the Intensive Care Unit(ICU),and to thoroughly explore the independent risk factors leading to these deficiencies,thereby providing an evidence-based basis for implementing precise quality control.Methods A retrospective quality control review was conducted on 524 inpatient medical record front pages from the ICU of Fuquan First People's Hospital between January 2022 and January 2025.Com-pare deficiency rates across different characteristic groups,and a binary Logistic regression model was employed to analyze independent influencing factors for front page deficiencies.Results A total of 200 medical records with deficiencies were detected,resulting in an overall deficiency rate of 38.17%.The main types of deficiencies were diagnosis-related(42.20%)and procedure/intervention-related(29.03%).Multivariate Logistic regression analysis revealed that shorter healthcare professional work experience,patient admission in the first or fourth quarter,longer hospital stay,and undergoing surgery or receiving ventilator therapy were independent risk factors for front page deficiencies.Among these,work experience<5 years(OR=4.22,95%CI:2.80～6.37)and patient use of a ventilator(OR=4.53,95%CI:2.15～9.54)had the highest effect values.Conclusions The completion of the ICU medical record front page in our hospital exhibits significant deficiencies,which result from the combined effects of multi-ple factors including the criticality of the patient's condition,insufficient experience of healthcare staff,and specific busy periods.It is recommended to subsequently develop targeted improvement strategies focusing on complex cases and junior staff,strengthening management during busy periods,and other dimensions to comprehensively enhance the quality of front page data.

Abstract:Objective To investigate the imaging features of Acute Respiratory Distress Syndrome(ARDS)on chest X-ray and computed tomography(CT),and to analyze their relationships with etiology,disease stage,severity,and to identify independent risk factors affecting patient prognosis.Methods A retrospective analy-sis was conducted on clinical and imaging data from 120 ARDS patients admitted to Dachuan District Hospital of Traditional Chinese Medicine between December 2023 and December 2024.Patients were classified according to the Berlin definition for ARDS severity.X-ray and CT manifestations across different etiologies and disease stages were analyzed.Multivariate logistic regression was employed to identify independent predictors of mortality.Re-sults On X-ray,83.33%of patients showed abnormalities in the early stage,primarily manifested as increased and thickened lung markings with scattered small patchy opacities(35.00%).During the exudative phase,"white lung"(53.33%)and pleural effusion(17.50%)were the pre-dominant features.In the recovery phase,lung shadows showed absorption with increased lung radiolucency in 35.83%of patients,while 9.17%developed fibrous stripes or reticulations,suggesting fibrosis.Imaging findings varied by etiology:the"white lung"sign was most frequent in the pulmonary infection group(67.27%),pleural effusion was highest in the sepsis group(38.71%),and early increased lung markings/small patchy shadows were most common in the severe trauma group(55.56%).Furthermore,the incidence of both"white lung"and pleu-ral effusion significantly increased with ARDS severity(P<0.001),with all severe ARDS patients exhibiting the"white lung"sign.Common CT findings included ground-glass opacities(71.67%),consolidation(43.33%),pleural effusion(34.17%),atelectasis(25.00%),fibrous reticulation(24.17%),and subpleural curvilinear shadows(18.33%).Multivariate logistic regression identified age(OR=1.48 per year),severe ARDS(OR=5.93),extensive consolida-tion(OR=5.58),large pleural effusion(OR=4.18),and severe atelectasis(OR=3.78)as independent predictors of mortality.Conclusion Chest X-ray can serve as an initial screening tool for ARDS,with findings closely related to etiology and disease stage.Chest CT provides more precise delineation of the diversity and extent of pulmonary lesions.Extensive consolidation,large pleural effusion,and severe atelectasis are independent imaging markers in-dicative of poor prognosis,offering significant value for clinical risk stratification and treatment decision-making.

Abstract:Objective To investigate the comprehensive application value of an integrated Chinese-Western medicine emergency model formed by incorporating traditional Chinese acupuncture techniques into conventional Western medicine-based prehospital emergency care.Methods Eighty-three prehospital emergency patients(with emergency conditions limited to angina pectoris,syncope,and epileptic seizure)admitted to Quanzhou Decheng Hospital from July 2023 to July 2024 were selected and divided into a study group(n=42)and a control group(n=41)according to the emergency protocol.The control group received standardized Western medicine prehospital emer-gency care,while the study group received additional standardized acupuncture treatment on-site by an experienced traditional Chinese medicine practitioner based on the control group's protocol.The efficiency of the emergency process,efficacy of condition assessment,clinical emergency outcomes,and adverse events were compared between the two groups.Results The study group showed significantly shorter times than the control group across key efficiency indicators,including clinical sign judgment time,preliminary condition assessment time,rescue time,and time from onset to definitive treatment(P<0.001).The study group also demonstrated significantly higher rates of correct preliminary sign judgment(95.24%vs.78.05%)and correct disease diagnosis(97.62%vs.85.37%)com-pared to the control group(P<0.045).The total clinical emergency effectiveness rate was significantly better in the study group(95.24%vs.75.61%,P=0.011).Only 5 cases of mild,transient acupuncture-related adverse events were reported in the study group.Regarding disease-related serious adverse events,the incidence was significant-ly lower in the study group than in the control group(9.52%vs.26.83%,P=0.041).Conclusion This preliminary study suggests that the integrated Chinese-Western medicine model,formed by incorporating acupunc-ture into prehospital emergency care,can significantly improve the overall efficiency of the emergency process,the accuracy of condition judgment,clinical outcomes,and effectively reduce the risk of serious complications,demon-strating promising application prospects.

Abstract:Objective To explore the application effect of a medical computer-controlled temperature instru-ment combined with cold saline gastric lavage in the in-hospital emergency treatment of heat stroke.Methods A total of 120 patients with heat stroke admitted to Donghai County People's Hospital from May 2021 to July 2024 were selected as retrospective study subjects.Sixty patients treated with the traditional cooling emergency mode from May 2021 to December 2022 were assigned to the control group,while 60 patients treated with the medical computer-controlled temperature instrument combined with cold saline gastric lavage from January 2023 to July 2024 were assigned to the observation group.The changes in core body temperature,consciousness recovery,vital signs,and myocardial enzyme levels were compared between the two groups.Results Before treatment,there was no significant difference in core body temperature between the two groups(P=0.177).After treatment,the body temperature of patients in both groups showed a decreasing trend.At 1h,2h,4h,and 6h after treatment,the core body temperature in the observation group was significantly lower than that in the control group(P<0.001).The consciousness recovery time in the observation group was shorter than that in the control group(P<0.001),and the number of patients who regained consciousness was higher than that in the control group(P=0.011).After treatment,compared with the control group,the heart rate and respiratory rate in the observation group were sig-nificantly reduced(P<0.001).Regarding blood pressure,both systolic and diastolic blood pressure levels in the observation group were significantly higher than those in the control group(P<0.001).After treatment,the improvement in levels of creatine kinase,creatine ki-nase isoenzyme,and lactate dehydrogenase in the observation group was superior to that in the control group(P<0.001).Conclusion In the in-hospital emergency treatment of heat stroke,the use of a medical computer-con-trolled temperature instrument combined with cold saline gastric lavage can rapidly reduce the patient's core body temperature,promote consciousness recovery,stabilize vital signs,and protect cardiac function.

Abstract:Objective To investigate the effect of Yishen Yangxue Decoction on uremic patients with renal anemia undergoing hemodialysis.Methods Ninety～two uremic patients with renal anemia receiving hemodialysis in Jiangle General Hospital from January 2023 to August 2024 were enrolled and randomly divided into two groups using a random number table.The control group(n=46)received recombinant human erythropoietin(rhEPO)thera-py,while the observation group(n=46)received Yishen Yangxue Decoction in addition to the control treatment.The therapeutic efficacy,blood parameters,erythropoietin resistance index(ERI),average weekly rhEPO dosage,renal function,quality of life,and adverse reactions were compared between the two groups.Results The total effective rate was significantly higher in the observation group than in the control group(93.48%vs.78.26%,P<0.05).After treatment,the observation group showed significantly better results than the control group in terms of hemoglobin(Hb),hematocrit(HCT),serum ferritin(SF),transferrin saturation(TSAT),and quality of life scores.Meanwhile,the eryth-ropoietin resistance index,weekly rhEPO dosage,serum creatinine(Scr),and blood urea nitrogen(BUN)levels were significantly lower in the observation group than in the control group(P<0.05).The incidence of adverse reactions was lower in the observation group than in the control group(4.35%vs.17.39%,P<0.05).Conclusion Yishen Yangxue Decoction can improve the anemia status and renal function,reduce erythropoietin resistance and the re-quired rhEPO dosage in uremic hemodialysis patients with renal anemia,with a high safety profile.

Abstract:Objective To investigate the application effect of chest compression machines in prehospital emergency transport of patients with sudden cardiac death.Methods A retrospective cohort study was conduct-ed,selecting 201 patients with sudden cardiac death treated by the emergency center of Dangyang People's Hospital from January 2021 to January 2025.According to the different on-site emergency methods,they were divided into an observation group(using a chest compression machine,n=99)and a control group(receiving manual cardio-pulmonary resuscitation,n=102).The compression parameters during transport,blood gas indicators,resuscitation success rates,and incidence of complications were compared between the two groups.Results The number of compression interruptions and interruption time in the observation group were significantly lower than those in the control group(P<0.001),while the rates of achieving target compression depth and target compression frequency were significantly higher in the observation group(P=0.001).After 30 minutes of resuscitation,the levels of PaO₂and SpO₂ in the observation group were significantly higher,and the PaCO₂ level was significantly lower than those in the control group(P<0.001).The rate of return of spontaneous circulation(ROSC)in the observation group was significantly higher than that in the control group(62.63%vs.42.16%,P<0.05).The hospital admission survival rate,24-hour survival rate,and discharge survival rate in the observation group were all significantly higher than those in the control group,with statistically significant differences(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(4.04%vs.13.73%,P<0.05).Con-clusion The application of chest compression machines during prehospital emergency transport of patients with sudden cardiac death can effectively improve the quality of chest compressions and resuscitation outcomes,amelio-rate blood gas indicators,and reduce the incidence of complications.

Abstract:Objective To explore the application value of comprehensive nursing intervention in patients with severe cerebral hemorrhage complicated by pulmonary infection in the Intensive Care Unit(ICU).Meth-ods Fifty-eight patients with acute severe cerebral hemorrhage complicated by pulmonary infection,admitted to the ICU of Huaian 82 Hospital between January 2023 and December 2024,were enrolled.According to a random number table method,they were divided into an observation group(comprehensive nursing intervention,n=29)and a control group(routine nursing intervention,n=29).Clinical indicators,disease severity,inflammatory markers,satisfaction,and complication rates were compared between the two groups.Results The pulmonary infection control time and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).At admission,there were no significant differences in APACHE II scores,WBC,CRP,or PCT between the two groups(P>0.05).After the intervention,the APACHE II scores and the aforementioned inflammatory markers decreased significantly in both groups.Furthermore,at 3 days and 7 days post-intervention,the APACHE II scores,WBC,CRP,and PCT in the observation group were significantly lower than those in the control group(P<0.05).The nursing satisfaction rate in the observation group was significantly higher than that in the control group(96.55%vs.72.41%,P=0.011).The total incidence of complications in the observation group was significantly lower than that in the control group(6.90%vs.27.59%,P=0.037).Conclusion Comprehensive nursing intervention can ef-fectively shorten the infection control time and hospital stay for ICU patients with acute severe cerebral hemorrhage complicated by pulmonary infection,reduce systemic inflammation levels,improve nursing satisfaction,and lower the risk of complications.

Abstract:Objective To investigate the impact of pre-hospital emergency care on clinical efficacy and prog-nosis in elderly patients with hypertensive crisis.Methods Sixty-eight elderly patients with hypertensive crisis ad-mitted to Nantong Tongzhou District Hospital of Traditional Chinese Medicine from January 2023 to July 2024 were included as retrospective study subjects.Based on the actual emergency treatment method,they were divided into an observation group(receiving standardized pre-hospital emergency care,34 case)and a control group(transported to the hospital by family members and receiving routine in-hospital emergency care,34 case).Core process indicators,short-term efficacy,safety,endpoint outcomes,and long-term outcomes were compared between the two groups.Re-sults Compared with the control group,the observation group had significantly lower blood pressure upon arrival at the emergency room(P<0.05),and significantly shorter time from onset to first antihypertensive medication use and time to achieve target blood pressure(P<0.05).After treatment,systolic and diastolic blood pressures improved sig-nificantly in both groups;at 30 min and 60 min post-treatment,systolic and diastolic blood pressures in the observation group were significantly lower than those in the control group(P<0.001).The total incidence of adverse events in the observation group was significantly lower than that in the control group(5.88%vs.20.58%,P<0.05).The in-hospital mortality rate in the observation group was significantly lower than that in the control group(2.94%vs.23.53%,P<0.05).The hospital stay length(P=0.006)and the modified Rankin Scale score at discharge(P<0.001)were signifi-cantly lower in the observation group compared to the control group.After 3 months of follow-up,the quality of life scores improved significantly in both groups,and the score in the observation group was significantly higher than that in the control group(P<0.001).Conclu-sion For elderly patients with hypertensive crisis,the implementation of standardized pre-hospital emergency care can significantly improve emergency efficiency,achieve rapid and stable blood pressure control,reduce the risk of in-hospital mortality and adverse events,and contribute to improved long-term neurological function and quality of life.

Abstract:Objective To explore the application value of an optimized pre-hospital emergency mode on the emergency treatment outcomes and prognosis of patients with craniocerebral trauma caused by traffic acci-dents.Methods A retrospective study was conducted on 140 patients with craniocerebral trauma caused by traffic accidents admitted to our hospital from January 2023 to January 2025.According to the different pre-hospital emer-gency modes,they were divided into two groups.The control group(n=70)received conventional pre-hospital emer-gency care,while the observation group(n=70)received an optimized pre-hospital emergency mode based on the con-trol group's protocol.The optimized mode included establishing a professional trauma emergency team,developing a standardized emergency process(covering five stages:rapid assessment,emergency treatment,stabilization and trans-port,seamless handover,and psychological care),and strengthening psychological care.The emergency time indica-tors,Glasgow Coma Scale(GCS)scores,total number of complication episodes,mortality rate,and Glasgow Outcome Scale(GOS)scores at 3 months post-injury were compared between the two groups.Results Compared with the control group,the on-scene processing time,transport time,and total emergency time in the observation group were significantly shortened(P<0.001).Regarding neurological function,the GCS scores during transport and upon arrival at the hospital in the observation group were significantly higher than those in the control group(both P<0.001).The total number of complication episodes in the observation group was significantly lower than that in the control group(29 episodes vs.78 episodes,P<0.001),with significant reductions in the incidence of brain herniation,pulmonary infec-tion,electrolyte imbalance,and hypoxemia(P<0.05).The total 30-day mortality rate in the observation group was significantly lower than that in the control group(2.86%vs.12.86%,P=0.030).Long-term prognosis as-sessment showed that the GOS score at 3 months post-injury in the observation group was significantly better than that in the control group(P<0.001).Conclusions For patients with craniocerebral trauma caused by traffic accidents,the optimized pre-hospital emergency mode can effectively improve emergency efficiency,stabilize neurological func-tion,significantly reduce the incidence of complications and mortality,and ultimately improve long-term neurological functional prognosis,demonstrating significant clinical value.

Abstract:Objective To investigate the efficacy of a comprehensive intensive emergency treatment pro-tocol,based on continuous monitoring,active cooling,and health education,compared to conventional emergency care in children with febrile seizures caused by upper respiratory tract infections in the outpatient setting.Meth-ods Using a random number table,50 children with febrile seizures presenting to the outpatient department of Weng'an County People's Hospital from January 2024 to December 2024 were divided into an observation group(n=25)and a control group(n=25).The control group received conventional emergency care(maintaining airway patency,oxygen administration,anticonvulsive medication,basic fever management).The observation group re-ceived the comprehensive intensive emergency protocol in addition to conventional care,which included contin-uous oxygen administration for 12-14 hours,enhanced physical cooling,strict monitoring of vital signs using a multi-parameter monitor,and systematic health education.The time to seizure cessation,time to fever resolution,hospitalization duration,and clinical efficacy were compared between the two groups.Recurrence rate and inci-dence of sequelae were statistically analyzed after a 1-year follow-up.Multiple linear regression analysis was used to adjust for confounding factors.Results The baseline characteristics were comparable between the two groups(P>0.05).The time to seizure cessation,time to fever resolution,and total hospitalization duration in the ob-servation group were significantly shorter than those in the control group(P<0.001).Multiple regression analysis showed that"group assignment"remained an independent influencing factor for hospitalization duration after adjusting for age,gender,and body temperature at presentation(β=-1.75,95%CI:-2.36 to-1.14,P<0.001).The total clinical effective rate was significantly higher in the observation group than in the control group(96.00%vs.76.00%,P=0.042).During the follow-up period,the recurrence rate(4.00%vs.24.00%,P=0.042)and the inci-dence of sequelae(0.00%vs.16.00%,P=0.037)were both significantly lower in the observation group.Conclu-sion For children with febrile seizures caused by upper respiratory tract infections in the outpatient setting,the application of the comprehensive intensive emergency treatment protocol can effectively shorten the time to symp-tom relief and hospitalization duration,improve clinical efficacy,and significantly reduce the long-term risks of re-currence and sequelae,demonstrating superior outcomes compared to conventional emergency care.

Abstract:Objective To investigate the clinical value and safety of lateral ventricular puncture and two-way drainage of cerebrospinal fluid(CSF)in the treatment of severe subarachnoid hemorrhage.Methods The clinical data of 58 patients with severe subarachnoid hemorrhage who came to the Provincial Hospital of Fuzhou University from January 2023 to December 2024 were retrospectively analyzed.According to the drainage protocol,they were divided into control group(lateral ventricular puncture and drainage,n=29 cases)and observation group(lateral ventricular puncture and lumbar cisterna catheterization cerebrospinal fluid bidirectional drainage,n=29 cases).The clinical efficacy,neurological function,ability of daily living,levels of inflammatory factors,compli-cations and mortality were compared between the two groups.Results Compared with the control group,the total clinical response rate of the observation group was significantly higher[96.55%(28/29)vs 75.86%(22/29),P=0.022],the complication rate[6.90%(2/29)vs.27.59%(8/29),P=0.037]and the mortality rate[3.45%(1/29)vs.20.69%(6/29),P=0.044]in the observation group.Before treatment,there was no significant difference in NIHSS score(P=0.360)and ADL score(P=0.410)between the two groups.After treatment,the NIHSS score decreased and the ADL score increased in both groups.Compared with the control group,the NIHSS score in the observa-tion group was significantly lower(P<0.001),and the ADL score was significantly higher(P<0.001).Before treatment,there were no significant differences in hs-CRP(P=0.371),TNF-α(P=0.423)and IL-6(P=0.357)between the two groups.After treatment,the levels of inflamma-tory factors above the two groups decreased.Compared with the control group,the levels of hs-CRP(P<0.001),TNF-α(P<0.001)and IL-6(P<0.001)in the observation group were significantly lower.Conclusion In the treatment of patients with severe subarachnoid hemorrhage,lateral ventricular puncture and lumbar cisterna cath-eterization of cerebrospinal fluid bidirectional drainage have significant clinical effects,which can effectively im-prove patients'neurological function and daily living activities,reduce the level of inflammatory factors,reduce the risk of complications,and reduce the mortality of patients.

Abstract:Objective To explore the correlation between plasma Brain Natriuretic Peptide(BNP)and elec-trocardiographic QRS duration as well as T peak to T end interval(Tp-Te interval)in prehospital emergency pa-tients with heart failure.Methods The clinical data of 128 heart failure patients receiving prehospital emergency care from Sanming First Hospital Affiliated to Fujian Medical University between November 2022 and November 2023 were retrospectively analyzed.Additionally,60 healthy individuals who underwent physical examinations at our hospital during the same period were selected as the healthy control group.Cardiac function-related indicators were compared and analyzed between the heart failure patients and the healthy controls;these indicators were also compared among heart failure patients grouped by different cardiac function classifications and different plasma BNP levels.The correlations between plasma BNP and electrocardiographic QRS duration and Tp-Te interval were examined.Results Compared with the healthy con-trol group,patients in the heart failure group had signif-icantly lower Left Ventricular Ejection Fraction(LVEF)levels(P<0.001),while BNP,QRS duration,and Tp-Te interval were significantly higher(P<0.001).There were significant differences in LVEF,BNP levels,QRS duration,and Tp-Te interval among heart failure patients grouped by different cardiac function classifications.As the NYHA classification increased,LVEF levels showed a decreasing trend(P=0.017),while BNP levels(P<0.001),QRS duration(P=0.044),and Tp-Te interval(P=0.001)showed increasing trends.Significant differences existed in QRS duration and Tp-Te interval among heart failure patients grouped by different plasma BNP levels;both QRS duration and Tp-Te interval in the low BNP level group were significantly lower than those in the high BNP level group(P<0.001).Plasma BNP levels in prehospital emergency heart failure patients were positively correlated with both electrocardiographic QRS duration(ρ=0.685,P<0.001)and Tp-Te interval(ρ=0.723,P<0.001);a positive correlation was also found between electrocardio-graphic QRS duration and Tp-Te interval(ρ=0.625,P<0.001).Conclusion In the prehospital emergency set-ting,plasma BNP levels in heart failure patients are positively correlated with electrocardiographic QRS duration and Tp-Te interval,and all three parameters change significantly with worsening NYHA functional class.Combined detection of these three indicators can provide important reference for the rapid and non-invasive assessment of heart failure severity in prehospital care.