Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.012
Juan Lu, Pengcheng Liu, Lijun Liu, Jianjun Zhu, Baochun Zhou, Yan-cui Zhu, Jingye Zhan, Qunying Bao
Objective To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia. Methods A prospective, cross-controlled, quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019. Patients with conventional blood glucose management served as the control group, and SGC blood glucose management was used as the intervention group. The enrolled patients were interchanged between the two groups every 24 h, and the end point was 96 h. The differences in blood glucose management quality indicators between the two groups were compared, including the average blood glucose level, the highest and lowest blood glucose level, the average blood glucose monitoring interval, and the accumulated insulin dosage. SPSS 23.0 was used to analyze the data. The paired t test was used for the normal distributed data. Otherwise, two nonparametric correlation sample tests was used. A P<0.05 was considered statistically significant. Results A total of 41 patients enrolled in this study during the study period. The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±1.42)mmol/L vs (10.02 ±1.49)mmol/L, P< 0.01]. The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91, P=0.023). The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60, P< 0.01). However, the frequency of hypoglycemia, the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0, 5) vs 0 (0, 2), P< 0 01; 1 36 ±0 23 vs 1 89 ±0 28, P< 0.01; and (139.61 ±77.06)U vs (107.49 ±64.41)U, P<0.01]. Conclusions SGC can optimize the control of blood glucose in the target blood glucose range, but it can easily lead to mild hypoglycemia, and to a certain extent increases the workload of medical staff. Key words: SGC; ICU patients; Stress hyperglycemia; Blood glucose management
目的探讨空间血糖控制(SGC)对ICU应激性高血糖患者血糖管理质量的影响。方法对2018年1月至2019年1月icu致应激性高血糖患者进行前瞻性、交叉对照、准试验观察。采用常规血糖管理的患者为对照组，采用SGC血糖管理的患者为干预组。将入组患者每24 h互换一次，终点为96 h。比较两组血糖管理质量指标的差异，包括平均血糖水平、最高和最低血糖水平、平均血糖监测间隔时间、胰岛素累积剂量。采用SPSS 23.0软件对数据进行分析。正态分布数据采用配对t检验。否则，使用两个非参数相关样本检验。P<0.05为差异有统计学意义。结果研究期间共有41例患者入组。干预组平均血糖值明显低于对照组[(8.60±1.42)mmol/L vs(10.02±1.49)mmol/L, P< 0.01]。高血糖发生率明显低于对照组(16.59±8.56 vs 18.73±7.91,P=0.023)。血糖值在目标血糖范围内出现的频率显著高于对照组(53.07±19.11 vs 29.44±19.60,P< 0.01)。但干预组低血糖发生次数、血糖监测次数及胰岛素累积剂量均高于对照组[1 (0,5)vs 0 (0,2)， P< 0.01;1 36±0.23 vs 1 89±0.28,P< 0.01;(139.61±77.06)U vs(107.49±64.41)U, P<0.01。结论SGC可优化血糖控制在目标血糖范围内，但易导致轻度低血糖，并在一定程度上增加了医护人员的工作量。关键词:SGC;ICU患者;应激性高血糖;血糖管理
{"title":"The value of space glucose control in ICU stress hyperglycemia management","authors":"Juan Lu, Pengcheng Liu, Lijun Liu, Jianjun Zhu, Baochun Zhou, Yan-cui Zhu, Jingye Zhan, Qunying Bao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.012","url":null,"abstract":"Objective \u0000To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia. \u0000 \u0000 \u0000Methods \u0000A prospective, cross-controlled, quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019. Patients with conventional blood glucose management served as the control group, and SGC blood glucose management was used as the intervention group. The enrolled patients were interchanged between the two groups every 24 h, and the end point was 96 h. The differences in blood glucose management quality indicators between the two groups were compared, including the average blood glucose level, the highest and lowest blood glucose level, the average blood glucose monitoring interval, and the accumulated insulin dosage. SPSS 23.0 was used to analyze the data. The paired t test was used for the normal distributed data. Otherwise, two nonparametric correlation sample tests was used. A P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000A total of 41 patients enrolled in this study during the study period. The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±1.42)mmol/L vs (10.02 ±1.49)mmol/L, P< 0.01]. The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91, P=0.023). The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60, P< 0.01). However, the frequency of hypoglycemia, the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0, 5) vs 0 (0, 2), P< 0 01; 1 36 ±0 23 vs 1 89 ±0 28, P< 0.01; and (139.61 ±77.06)U vs (107.49 ±64.41)U, P<0.01]. \u0000 \u0000 \u0000Conclusions \u0000SGC can optimize the control of blood glucose in the target blood glucose range, but it can easily lead to mild hypoglycemia, and to a certain extent increases the workload of medical staff. \u0000 \u0000 \u0000Key words: \u0000SGC; ICU patients; Stress hyperglycemia; Blood glucose management","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1395-1399"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69953637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.014
Weibo Gao, L. Dou, Maojing Shi, Haiyan Zhang, Chun-bo Wu
Objective To investigate the clinical characteristics, coagulation function and associated prognostic factors of acute aortic dissection. Methods The clinical data of 119 patients with acute aortic dissection (AAD) admitted to Beijing University People's Hospital from November 2008 to January 2016 were analyzed. All the participants were confirmed by computed tomography angiography, and the onset time was less than 14 days. Data of blood routine test, coagulation function at the first admission were collected, and surgical intervention and prognosis were recorded. All the patients, according to the prognosis, or whether disseminated intravascular coagulation (DIC) occurred, were divided into two groups, and the differences between the two groups were compared. Logistic regression analysis was applied to analyze independent risk factors related to in-hospital death in AAD patients. Results In 119 patients with AAD, the average age was (52.9±14.2) years, with a male/female ratio of 5.3:1. Pain was the most common clinical manifestation in patients with AAD, accounting for more than 90.0%. The nature of pain was mostly expansible and/or transitive pain. Dominant DIC occurred in 13 cases (10.9%), and 7 patients died (53.8%). There were significant differences between the DIC group and non-DIC group in neutrophil/lymphocyte ratio (NLR), platelet count, fibrinogen, D-dimer, FDP, PT, APTT and mortality rate (P<0.05). All the 16 patients in the death group were type A AAD, among which, 7 patients (43.8%) developed with DIC. There were significant differences between the death group and survival group in NLR, platelet count, fibrinogen, D-dimer, FDP, PT, APTT, DIC proportion and surgical operation rate (P<0.05).Logistic regression analysis showed that NLR and platelet count were independent risk factors of in-hospital death (P<0.05). Conclusions D-dimer has a high diagnostic and prognosis value for AAD. The mortality increased with the activation and depletion of platelet. Once DIC occurs, the prognosis is extremely poor. NLR and platelet count are independent risk factors for in-hospital death in patients with AAD. Key words: Acute aortic dissection; D-dimer; Neutrophil to lymphocyte ratio; Disseminated intravascular coagulation; Prognosis
{"title":"Analysis of coagulation function and prognostic factors of acute aortic dissection","authors":"Weibo Gao, L. Dou, Maojing Shi, Haiyan Zhang, Chun-bo Wu","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.014","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics, coagulation function and associated prognostic factors of acute aortic dissection. \u0000 \u0000 \u0000Methods \u0000The clinical data of 119 patients with acute aortic dissection (AAD) admitted to Beijing University People's Hospital from November 2008 to January 2016 were analyzed. All the participants were confirmed by computed tomography angiography, and the onset time was less than 14 days. Data of blood routine test, coagulation function at the first admission were collected, and surgical intervention and prognosis were recorded. All the patients, according to the prognosis, or whether disseminated intravascular coagulation (DIC) occurred, were divided into two groups, and the differences between the two groups were compared. Logistic regression analysis was applied to analyze independent risk factors related to in-hospital death in AAD patients. \u0000 \u0000 \u0000Results \u0000In 119 patients with AAD, the average age was (52.9±14.2) years, with a male/female ratio of 5.3:1. Pain was the most common clinical manifestation in patients with AAD, accounting for more than 90.0%. The nature of pain was mostly expansible and/or transitive pain. Dominant DIC occurred in 13 cases (10.9%), and 7 patients died (53.8%). There were significant differences between the DIC group and non-DIC group in neutrophil/lymphocyte ratio (NLR), platelet count, fibrinogen, D-dimer, FDP, PT, APTT and mortality rate (P<0.05). All the 16 patients in the death group were type A AAD, among which, 7 patients (43.8%) developed with DIC. There were significant differences between the death group and survival group in NLR, platelet count, fibrinogen, D-dimer, FDP, PT, APTT, DIC proportion and surgical operation rate (P<0.05).Logistic regression analysis showed that NLR and platelet count were independent risk factors of in-hospital death (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000D-dimer has a high diagnostic and prognosis value for AAD. The mortality increased with the activation and depletion of platelet. Once DIC occurs, the prognosis is extremely poor. NLR and platelet count are independent risk factors for in-hospital death in patients with AAD. \u0000 \u0000 \u0000Key words: \u0000Acute aortic dissection; D-dimer; Neutrophil to lymphocyte ratio; Disseminated intravascular coagulation; Prognosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1407-1412"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47767054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.015
Zhou Xian, X. Tao
Objective To investigate the application value of afterload-related cardiac performance(ACP) in patients with sepsis-induced cardiomyopathy. Methods A total of 148 patients with septic shock admitted by the department of critical care of Wuhan fourth hospital from April 2013 to March 2018 were retrospectively included, all included patients were divided into LVEF 80%), mild heart function impairment group (60% < ACP≤80%), moderate heart function impairment group (40% < ACP≤60%), and severe heart function impairment group (ACP≤40%) according to ACP value, the mortality rate at 28 days was compared in the 4 groups. The measurement data were compared by grouped t test, the rates were compared by chi-square test. Results The mortality rate was 58.2% in the LVEF < 50% group, and 30.9% in the LVEF≥50% group, with statistically significant differences (χ2=11.171, P<0.01). The values of ACP in the LVEF < 50% group were (39.3±16.4) %, and those in the LVEF≥50% group were (69.1±14.9) %, with statistically significant differences (t=11.571, P<0.01).The mortality rate was 14.81% in the normal group, 44.00% in the mild, 58.82% in the moderate and 90.00% in the severe group. The differences between the normal group and the mild and moderate groups were statistically significant, while those between the severe group and the mild and moderate groups were statistically significant. Conclusion Afterload-related cardiac performance is of great value for the diagnosis and prognosis in patients with sepsis-induced cardiomyopathy. Key words: Sepsis-induced cardiomyopathy; Septic shock; Afterload-related cardiac performance; Cardiac output; Systemic vascular resistance
{"title":"The application value of afterload-related cardiac performance in patients with sepsis-induced cardiomyopathy","authors":"Zhou Xian, X. Tao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.015","url":null,"abstract":"Objective \u0000To investigate the application value of afterload-related cardiac performance(ACP) in patients with sepsis-induced cardiomyopathy. \u0000 \u0000 \u0000Methods \u0000A total of 148 patients with septic shock admitted by the department of critical care of Wuhan fourth hospital from April 2013 to March 2018 were retrospectively included, all included patients were divided into LVEF 80%), mild heart function impairment group (60% < ACP≤80%), moderate heart function impairment group (40% < ACP≤60%), and severe heart function impairment group (ACP≤40%) according to ACP value, the mortality rate at 28 days was compared in the 4 groups. The measurement data were compared by grouped t test, the rates were compared by chi-square test. \u0000 \u0000 \u0000Results \u0000The mortality rate was 58.2% in the LVEF < 50% group, and 30.9% in the LVEF≥50% group, with statistically significant differences (χ2=11.171, P<0.01). The values of ACP in the LVEF < 50% group were (39.3±16.4) %, and those in the LVEF≥50% group were (69.1±14.9) %, with statistically significant differences (t=11.571, P<0.01).The mortality rate was 14.81% in the normal group, 44.00% in the mild, 58.82% in the moderate and 90.00% in the severe group. The differences between the normal group and the mild and moderate groups were statistically significant, while those between the severe group and the mild and moderate groups were statistically significant. \u0000 \u0000 \u0000Conclusion \u0000Afterload-related cardiac performance is of great value for the diagnosis and prognosis in patients with sepsis-induced cardiomyopathy. \u0000 \u0000 \u0000Key words: \u0000Sepsis-induced cardiomyopathy; Septic shock; Afterload-related cardiac performance; Cardiac output; Systemic vascular resistance","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1413-1416"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44480595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.008
Jianxin Gao, M. Lian, Juanjuan Wang, Fengying Chen
Objective To evaluate the protective effect of ulinastatin (UTI) on myocardial injury after post-cardiac arrest syndrome (PCAS) of cardiopulmonary resuscitation in pigs. Methods Twelve male 3-4 months pigs were randomly divided into two groups, UTI group and control group. The ventricular fibrillation (VF) animal model was replicated by programmed stimulation method. Among the 12 pigs, 11 pigs were successfully resuscitated by CPR after 5 min VF, of which, 6 pigs were in the UTI group and 5 pigs in the control group. Immediately after resuscitation, pigs in the UTI group was given 100 kU dissolved in 5 mL normal saline with slowly injection every 3 h until 24 h after recovery (no drug was given at 24 h). In the control group, 5 mL normal saline was given with same delivery time and frequency as that in the UTI group. The venous blood of the pigs was collected at VF, 2, 4, 6, 12, and 24 h after ROCS, and tumor necrosis factor -α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD), malondialdehyde (MDA), and ischemia modified albumin (IMA) were measured by enzyme-linked immunosorbent assay (ELISA) method. Because IMA was sensitive and increased rapidly, venous blood was detected at 1 h after ROSC, and the rest test time were same with the rest of the blood factors. Statistical analysis was performed using LSD-t test and variance analysis. The pigs were sacrificed 24 h after ROSC, and specimens from heart tissue were taken for HE staining. Results Before ventricular fibrillation in three groups, there was no significant difference in serum levels of inflammatory cytokines, oxidative stress indexes, and myocardial ischemia markers between the two groups (P>0.05). At 2 h after ventricular fibrillation, the levels of TNF-α and IL-6 level in the UTI group was significantly lower than those in the control group. At 4 h, MDA level in the UTI group was significantly lower than that in the control group (P 0.05). HE staining results showed that the damage degree of myocardial tissue in the UTI group was significantly lower than that in the control group at 24 h after ROSC. Conclusions UTI can significantly antagonize inflammatory response, reduce oxidative stress, and improve the myocardial tissue injury after resuscitation. It can protect myocardial injury after cardiopulmonary resuscitation. Key words: Ulinastatin; Cardiopulmonary resuscitation; Post-cardiac arrest syndrome; Tumor necrosis factor -αInterleukin-6; Superoxide dismutase; Ischemia modified albumin
{"title":"Protective effect of ulinastatin on myocardial injury after cardiopulmonary resuscitation in pigs","authors":"Jianxin Gao, M. Lian, Juanjuan Wang, Fengying Chen","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.008","url":null,"abstract":"Objective \u0000To evaluate the protective effect of ulinastatin (UTI) on myocardial injury after post-cardiac arrest syndrome (PCAS) of cardiopulmonary resuscitation in pigs. \u0000 \u0000 \u0000Methods \u0000Twelve male 3-4 months pigs were randomly divided into two groups, UTI group and control group. The ventricular fibrillation (VF) animal model was replicated by programmed stimulation method. Among the 12 pigs, 11 pigs were successfully resuscitated by CPR after 5 min VF, of which, 6 pigs were in the UTI group and 5 pigs in the control group. Immediately after resuscitation, pigs in the UTI group was given 100 kU dissolved in 5 mL normal saline with slowly injection every 3 h until 24 h after recovery (no drug was given at 24 h). In the control group, 5 mL normal saline was given with same delivery time and frequency as that in the UTI group. The venous blood of the pigs was collected at VF, 2, 4, 6, 12, and 24 h after ROCS, and tumor necrosis factor -α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD), malondialdehyde (MDA), and ischemia modified albumin (IMA) were measured by enzyme-linked immunosorbent assay (ELISA) method. Because IMA was sensitive and increased rapidly, venous blood was detected at 1 h after ROSC, and the rest test time were same with the rest of the blood factors. Statistical analysis was performed using LSD-t test and variance analysis. The pigs were sacrificed 24 h after ROSC, and specimens from heart tissue were taken for HE staining. \u0000 \u0000 \u0000Results \u0000Before ventricular fibrillation in three groups, there was no significant difference in serum levels of inflammatory cytokines, oxidative stress indexes, and myocardial ischemia markers between the two groups (P>0.05). At 2 h after ventricular fibrillation, the levels of TNF-α and IL-6 level in the UTI group was significantly lower than those in the control group. At 4 h, MDA level in the UTI group was significantly lower than that in the control group (P 0.05). HE staining results showed that the damage degree of myocardial tissue in the UTI group was significantly lower than that in the control group at 24 h after ROSC. \u0000 \u0000 \u0000Conclusions \u0000UTI can significantly antagonize inflammatory response, reduce oxidative stress, and improve the myocardial tissue injury after resuscitation. It can protect myocardial injury after cardiopulmonary resuscitation. \u0000 \u0000 \u0000Key words: \u0000Ulinastatin; Cardiopulmonary resuscitation; Post-cardiac arrest syndrome; Tumor necrosis factor -αInterleukin-6; Superoxide dismutase; Ischemia modified albumin","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1373-1378"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47464070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.011
Jinmou Gao, Ling-wen Kong, Hui Li, D. Du, Chao-pu Liu, Chang-hua Li, Jun Yang, S. Zhao
Objective To explore the early diagnosis, therapeutic methods and efficacy for blunt cardiac injury (BCI). Methods All BCI patients from September 2003 to August 2018 were studied retrospectively in respect of sex, age, cause of injury, diagnostic methods, therapeutic procedures, and outcome. The patients were divided into two groups: nonoperative group (n=305) and operative group (n=43). The two groups were compared and analyzed. Results Totally 348 BCI patients accounted for 18.3% of 1 903 patients with blunt thoracic injury (BTI), and the mortality rate was 10.1%. The main cause of injury was traffic accident with an incidence of 48.3%. The diagnostic methods included electrocardiogram (ECG), enzymes and troponin I, echocardiography, and CT scanning, or confirmed by emergency thoracatomy. In the nonoperative group, patients were mainly myocardial contusion, with a mortality rate of 6.9%. In the operative group, patients were mainly cardiac rupture and pericardial hernia, and the mortality was 32.6%. The incidence of negative ECG between the two groups was not significantly different (16.7% vs 11.6%, P>0.05). The incidence of shock and mortality in the operative group were significantly higher than those in the the nonoperative group (P<0.01). The number of death directly resulted from BCI in the operative group was greater than that in the nonoperative group (P<0.05). Conclusions For BTI patients, BCI must be highly suspected, and necessary examinations should be given. To manage myocardial contusion without surgery, it is necessary to protect the heart, alleviate edema of myocardium, and control arrhythmia with drugs. To deal with those patients requiring operation, early recognition and expeditious thoracotomy are essential. Key words: Wounds and injuries; Blunt cardiac injury; Myocardial contusion; Cardiac rupture; Emergent thoracotomy
{"title":"Blunt cardiac injury: analysis of 348 patients","authors":"Jinmou Gao, Ling-wen Kong, Hui Li, D. Du, Chao-pu Liu, Chang-hua Li, Jun Yang, S. Zhao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.011","url":null,"abstract":"Objective \u0000To explore the early diagnosis, therapeutic methods and efficacy for blunt cardiac injury (BCI). \u0000 \u0000 \u0000Methods \u0000All BCI patients from September 2003 to August 2018 were studied retrospectively in respect of sex, age, cause of injury, diagnostic methods, therapeutic procedures, and outcome. The patients were divided into two groups: nonoperative group (n=305) and operative group (n=43). The two groups were compared and analyzed. \u0000 \u0000 \u0000Results \u0000Totally 348 BCI patients accounted for 18.3% of 1 903 patients with blunt thoracic injury (BTI), and the mortality rate was 10.1%. The main cause of injury was traffic accident with an incidence of 48.3%. The diagnostic methods included electrocardiogram (ECG), enzymes and troponin I, echocardiography, and CT scanning, or confirmed by emergency thoracatomy. In the nonoperative group, patients were mainly myocardial contusion, with a mortality rate of 6.9%. In the operative group, patients were mainly cardiac rupture and pericardial hernia, and the mortality was 32.6%. The incidence of negative ECG between the two groups was not significantly different (16.7% vs 11.6%, P>0.05). The incidence of shock and mortality in the operative group were significantly higher than those in the the nonoperative group (P<0.01). The number of death directly resulted from BCI in the operative group was greater than that in the nonoperative group (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000For BTI patients, BCI must be highly suspected, and necessary examinations should be given. To manage myocardial contusion without surgery, it is necessary to protect the heart, alleviate edema of myocardium, and control arrhythmia with drugs. To deal with those patients requiring operation, early recognition and expeditious thoracotomy are essential. \u0000 \u0000 \u0000Key words: \u0000Wounds and injuries; Blunt cardiac injury; Myocardial contusion; Cardiac rupture; Emergent thoracotomy","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1390-1394"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46213184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.007
Zhi Yong, ZhiJun Jiang, Meiyuan Zhang, Zhiwen Fan, Weilan Sun
Objective To investigate the regulation of emodin on microRNA expressions in mouse model with sepsis by GeneChip microRNA array. Methods Forty two c57 mice were randomly (random number) divided into 3 groups: sham operation group (sham group, n=14),sepsis group(n=14) and emodin group (n=14). The sepsis model of the mouse was subjected to cecal ligation and puncture (CLP). Mice in emodin group received intraperitoneal injection of emodin (40 mg/kg) half an hour before operation and every 12 hours after CLP. All mice were sacrificed 48 h after surgery and part of the ileum were removed for intestine tissue stained with hematoxylin eosin. The levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and intestinal fatty acid binding protein (I-FABP) in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Total RNA of ileum tissues was extracted from the sepsis group and emodin group, and then subjected to miRNA microarray. The results of microarray were further verified by quantitative real-time PCR (qRT-PCR). Target genes of differentially expressed miRNAs were predicted and subjected to gene ontology (GO) and KEGG pathway enrichment analysis. Data of multi-groups were analyzed by one way variance (ANOVA) and inter-group comparisons were made by SNK-q tests. Mann-Whitney U test was used when homogeneity of variance were not met. The value of P<0.05 was considered statistically significant. Results Compared to the sepsis group, the levels of serum TNF-α, IL-6 and I-FABP in the emodin group were decreased significantly. MiRNA microarray showed that 23 miRNAs were differentially expressed in the emodin group as compared to the sepsis group, among which 17 miRNAs were up-regulated and 6 miRNAs were down-regulated. qRT-PCR results were consistent with miRNA array data. Target genes of 10 selected miRNAs were predicted and subjected to bioinformatic analysis. A total of 3 410 target genes were significantly enriched in 2 072 GO biological process terms, 246 GO cellular component items and 277 GO molecular function terms. Moreover, KEGG pathway analysis showed that these differential miRNAs were involved in the regulation of PI3K-Akt signaling pathway, MAPK signaling pathway, and TNF signaling pathway. Conclusions Emodin can regulate the expression of multiple microRNAs, and play an important role in protecting the intestinal mucosal barrier via a variety of targets and pathways. Key words: Emodin; Sepsis; Intestinal mucosa; MicroRNA; Expression profiles; Bioinformatics
{"title":"Emodin regulates microRNA expressions of ileum in sepsis mice model","authors":"Zhi Yong, ZhiJun Jiang, Meiyuan Zhang, Zhiwen Fan, Weilan Sun","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.007","url":null,"abstract":"Objective \u0000To investigate the regulation of emodin on microRNA expressions in mouse model with sepsis by GeneChip microRNA array. \u0000 \u0000 \u0000Methods \u0000Forty two c57 mice were randomly (random number) divided into 3 groups: sham operation group (sham group, n=14),sepsis group(n=14) and emodin group (n=14). The sepsis model of the mouse was subjected to cecal ligation and puncture (CLP). Mice in emodin group received intraperitoneal injection of emodin (40 mg/kg) half an hour before operation and every 12 hours after CLP. All mice were sacrificed 48 h after surgery and part of the ileum were removed for intestine tissue stained with hematoxylin eosin. The levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and intestinal fatty acid binding protein (I-FABP) in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Total RNA of ileum tissues was extracted from the sepsis group and emodin group, and then subjected to miRNA microarray. The results of microarray were further verified by quantitative real-time PCR (qRT-PCR). Target genes of differentially expressed miRNAs were predicted and subjected to gene ontology (GO) and KEGG pathway enrichment analysis. Data of multi-groups were analyzed by one way variance (ANOVA) and inter-group comparisons were made by SNK-q tests. Mann-Whitney U test was used when homogeneity of variance were not met. The value of P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000Compared to the sepsis group, the levels of serum TNF-α, IL-6 and I-FABP in the emodin group were decreased significantly. MiRNA microarray showed that 23 miRNAs were differentially expressed in the emodin group as compared to the sepsis group, among which 17 miRNAs were up-regulated and 6 miRNAs were down-regulated. qRT-PCR results were consistent with miRNA array data. Target genes of 10 selected miRNAs were predicted and subjected to bioinformatic analysis. A total of 3 410 target genes were significantly enriched in 2 072 GO biological process terms, 246 GO cellular component items and 277 GO molecular function terms. Moreover, KEGG pathway analysis showed that these differential miRNAs were involved in the regulation of PI3K-Akt signaling pathway, MAPK signaling pathway, and TNF signaling pathway. \u0000 \u0000 \u0000Conclusions \u0000Emodin can regulate the expression of multiple microRNAs, and play an important role in protecting the intestinal mucosal barrier via a variety of targets and pathways. \u0000 \u0000 \u0000Key words: \u0000Emodin; Sepsis; Intestinal mucosa; MicroRNA; Expression profiles; Bioinformatics","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1366-1372"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46193029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.11.004
Tingting Zhang, Yanling Feng
Objective To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years, so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system. Methods A total of 427 754 pre-hospital emergency patients were collected from January 1, 2011 to December 31, 2008 in Urumqi. Epidemiological methods were performed for statistical description and analysis. The single-factor gray model [GM (1,1)], multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year. The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction. Results The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (χ2=7 659.707, P<0.01), and the incidence rate of male patients was 1.95 times higher than that of female patients. The trauma patients aged 35-59 years accounted for the largest proportion (42%), and the incidence of the disease was the highest among those aged≥ 60 years old (644.23/100 000). The incidence of pre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017), with a high incidence in summer (27 123, 31.03%), especially in August (9 535, 10.91%), most of which occurred in the new urban area (high-tech zone) (23 157, 26.50%). The single-factor gray model [GM (1,1)] , multi-factor gray model, and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118, 11 715 and 13 305, respectively, and the MAE were 451.125 0, 607.428 6, and 205.125 0, respectively. The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999, respectively, and the MAE were 47.129 0 and 110.370 4, respectively. Conclusions The pre-hospital trauma in Urumqi is mainly male and young work-age adults, the incidence of the elderly is the highest, summer is the season of high incidence, and the new urban area (high-tech zone) is the primary district. The moving average model (MA1) model has a more accurate annual prediction, and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction. The pre-hospital trauma emergency medical care demand will continue to increase in the next five years. The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies. Key words: Urumqi; Trauma; Pre-hospital emergency medical care; Current situation; Prediction
{"title":"Prevalence and prediction of pre-hospital medical trauma in Urumqi","authors":"Tingting Zhang, Yanling Feng","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.11.004","url":null,"abstract":"Objective \u0000To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years, so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system. \u0000 \u0000 \u0000Methods \u0000A total of 427 754 pre-hospital emergency patients were collected from January 1, 2011 to December 31, 2008 in Urumqi. Epidemiological methods were performed for statistical description and analysis. The single-factor gray model [GM (1,1)], multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year. The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction. \u0000 \u0000 \u0000Results \u0000The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (χ2=7 659.707, P<0.01), and the incidence rate of male patients was 1.95 times higher than that of female patients. The trauma patients aged 35-59 years accounted for the largest proportion (42%), and the incidence of the disease was the highest among those aged≥ 60 years old (644.23/100 000). The incidence of pre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017), with a high incidence in summer (27 123, 31.03%), especially in August (9 535, 10.91%), most of which occurred in the new urban area (high-tech zone) (23 157, 26.50%). The single-factor gray model [GM (1,1)] , multi-factor gray model, and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118, 11 715 and 13 305, respectively, and the MAE were 451.125 0, 607.428 6, and 205.125 0, respectively. The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999, respectively, and the MAE were 47.129 0 and 110.370 4, respectively. \u0000 \u0000 \u0000Conclusions \u0000The pre-hospital trauma in Urumqi is mainly male and young work-age adults, the incidence of the elderly is the highest, summer is the season of high incidence, and the new urban area (high-tech zone) is the primary district. The moving average model (MA1) model has a more accurate annual prediction, and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction. The pre-hospital trauma emergency medical care demand will continue to increase in the next five years. The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies. \u0000 \u0000 \u0000Key words: \u0000Urumqi; Trauma; Pre-hospital emergency medical care; Current situation; Prediction","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1350-1356"},"PeriodicalIF":0.0,"publicationDate":"2019-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41420539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.008
Fangmin Ge, Qiang Li, G. Lin, Yiqi Ni, Minhai Zhang, L. Wang, Xu Wang, Chunshuang Wu, Qian Li, Mao Zhang
Objective To explore a new platform for pre-hospital and in-hospital emergency medical services based on a new generation of 5G communication technology, providing a basis for further improving the level of emergency medical services. Methods This study was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2017 to April 2019. Based on the latest requirements of emergency medical services at home and abroad, the cross-enterprise and multi-disciplinary technical forces were organized to build platform. Firstly, to determine the process of pre-hospital and in-hospital emergency medical services, various modules and technical routes were constructed under 5G conditions and individual technologies were tested one by one. Then they were gradually integrated into two platforms of ambulance and hospital emergency. Finally, the simulation test is carried out under the support of the whole 5G network. Results The pre-hospital and in-hospital emergency medical service platform based on 5G technology comprises of 5G ambulance, 5G panoramic VR real-time display system, 5G remote ultrasonic examination system, medical drone system, and 5G emergency command platform. 5G ambulance contains medical equipments such as multi-function monitor, ventilator, defibrillation monitor, portable B-ultrasound, high-definition remote video interactive system based on 5G network, VR immersive real-time panoramic experience system, and GPS positioning system. 5G panoramic VR real-time display system includes VR panoramic camera and VR glasses. The wearer with VR glasses can view the real-time situation on the ambulance, which makes a preliminary judgment on the patient's condition and provides rescue guidance. 5G remote ultrasonic examination system integrates robot technology, real-time remote control technology, and ultrasonic imaging technology. The specialist can control the movement of the ultrasonic probe set on the 5G ambulance by manipulating the mechanical arm. The patient's image and color super-picture can also be simultaneously returned to the specialist. The medical drone system enables the medical resources to be allocated in the shortest possible time through the 5G networked drones, so as to eliminate the delay caused by traffic congestion. 5G emergency command platform can integrate, transmit, and display data from multiple sources and forms through web pages in assistance of AI and internet of things. Conclusions The new platform for pre-hospital and in-hospital emergency medical services based on 5G technology can realize more fluent information exchange in pre-hospital and in-hospital, and realize the functions that are difficult to achieve under the previous network conditions. Key words: 5G communication technology; Emergency medical service system; Pre-hospital and in-hospital communication
{"title":"Construction of Pre-hospital and In-hospital Emergency Medical Service System Based on 5G Communication Technology","authors":"Fangmin Ge, Qiang Li, G. Lin, Yiqi Ni, Minhai Zhang, L. Wang, Xu Wang, Chunshuang Wu, Qian Li, Mao Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.008","url":null,"abstract":"Objective \u0000To explore a new platform for pre-hospital and in-hospital emergency medical services based on a new generation of 5G communication technology, providing a basis for further improving the level of emergency medical services. \u0000 \u0000 \u0000Methods \u0000This study was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2017 to April 2019. Based on the latest requirements of emergency medical services at home and abroad, the cross-enterprise and multi-disciplinary technical forces were organized to build platform. Firstly, to determine the process of pre-hospital and in-hospital emergency medical services, various modules and technical routes were constructed under 5G conditions and individual technologies were tested one by one. Then they were gradually integrated into two platforms of ambulance and hospital emergency. Finally, the simulation test is carried out under the support of the whole 5G network. \u0000 \u0000 \u0000Results \u0000The pre-hospital and in-hospital emergency medical service platform based on 5G technology comprises of 5G ambulance, 5G panoramic VR real-time display system, 5G remote ultrasonic examination system, medical drone system, and 5G emergency command platform. 5G ambulance contains medical equipments such as multi-function monitor, ventilator, defibrillation monitor, portable B-ultrasound, high-definition remote video interactive system based on 5G network, VR immersive real-time panoramic experience system, and GPS positioning system. 5G panoramic VR real-time display system includes VR panoramic camera and VR glasses. The wearer with VR glasses can view the real-time situation on the ambulance, which makes a preliminary judgment on the patient's condition and provides rescue guidance. 5G remote ultrasonic examination system integrates robot technology, real-time remote control technology, and ultrasonic imaging technology. The specialist can control the movement of the ultrasonic probe set on the 5G ambulance by manipulating the mechanical arm. The patient's image and color super-picture can also be simultaneously returned to the specialist. The medical drone system enables the medical resources to be allocated in the shortest possible time through the 5G networked drones, so as to eliminate the delay caused by traffic congestion. 5G emergency command platform can integrate, transmit, and display data from multiple sources and forms through web pages in assistance of AI and internet of things. \u0000 \u0000 \u0000Conclusions \u0000The new platform for pre-hospital and in-hospital emergency medical services based on 5G technology can realize more fluent information exchange in pre-hospital and in-hospital, and realize the functions that are difficult to achieve under the previous network conditions. \u0000 \u0000 \u0000Key words: \u00005G communication technology; Emergency medical service system; Pre-hospital and in-hospital communication","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1223-1227"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43993032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.016
Yan Zhang, Xiaoliang Wu, Jinchao Hou, B. Cheng, Qixing Chen, X. Fang
Objective To investigate the association of SNPs in TET2 gene with the susceptibility and prognosis of sepsis. Methods Ninety-nine patients diagnosed with sepsis and 107 controls were enrolled in the study. The septic patients were further divided into survivors (56 cases) and non-survivors (43 cases) according to the outcome of 28-day hospitalization. Patients without sepsis after major surgery were enrolled as the controls. The genotypes of the five loci (rs6839705, rs7670522, rs7679673, rs7698522 and rs10010325) with high minor allele frequency in the TET2 were screened according to the existing research reports and the SNP database of the NCBI website. The five loci were detected by TaqMan probe based allelic discrimination assays using real-time polymerase chain reaction (PCR). The data were calculated for genetic association study through χ2 test and Fisher’s exact probability method. Results There was no significant difference in genotype frequencies of the five tested SNPs in TET2 gene between septic patients and controls or between survivors and non-survivors in septic patients (P > 0.05). Furthermore, the allelic frequencies of the five SNPs between septic patients and controls or between survivors and non-survivors in septic patients also had no significant difference (P > 0.05). Conclusions This study showed that the five SNPs in TET2 gene (rs6839705, rs7670522, rs7679673, rs7698522, and rs10010325) were not associated with the susceptibility and prognosis of sepsis, which needs to be further confirmed by large-sample studies. Key words: Sepsis; DNA hydroxymethylase TET2; Single nucleotide polymorphism (SNP); Genotype; Allele; Case-control study
{"title":"Correlation between single nucleotide polymorphism of TET2 gene and susceptibility and prognosis of sepsis","authors":"Yan Zhang, Xiaoliang Wu, Jinchao Hou, B. Cheng, Qixing Chen, X. Fang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.016","url":null,"abstract":"Objective \u0000To investigate the association of SNPs in TET2 gene with the susceptibility and prognosis of sepsis. \u0000 \u0000 \u0000Methods \u0000Ninety-nine patients diagnosed with sepsis and 107 controls were enrolled in the study. The septic patients were further divided into survivors (56 cases) and non-survivors (43 cases) according to the outcome of 28-day hospitalization. Patients without sepsis after major surgery were enrolled as the controls. The genotypes of the five loci (rs6839705, rs7670522, rs7679673, rs7698522 and rs10010325) with high minor allele frequency in the TET2 were screened according to the existing research reports and the SNP database of the NCBI website. The five loci were detected by TaqMan probe based allelic discrimination assays using real-time polymerase chain reaction (PCR). The data were calculated for genetic association study through χ2 test and Fisher’s exact probability method. \u0000 \u0000 \u0000Results \u0000There was no significant difference in genotype frequencies of the five tested SNPs in TET2 gene between septic patients and controls or between survivors and non-survivors in septic patients (P > 0.05). Furthermore, the allelic frequencies of the five SNPs between septic patients and controls or between survivors and non-survivors in septic patients also had no significant difference (P > 0.05). \u0000 \u0000 \u0000Conclusions \u0000This study showed that the five SNPs in TET2 gene (rs6839705, rs7670522, rs7679673, rs7698522, and rs10010325) were not associated with the susceptibility and prognosis of sepsis, which needs to be further confirmed by large-sample studies. \u0000 \u0000 \u0000Key words: \u0000Sepsis; DNA hydroxymethylase TET2; Single nucleotide polymorphism (SNP); Genotype; Allele; Case-control study","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1261-1265"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48424139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.010
Qiang Li, Yu Tian, Minhai Zhang, Yinghao Zhao, G. Lin, Hang Yu, L. Wang, Xiaoping Zhou, Xu Wang, Mao Zhang, J. Li
Objective To develop medical emergency support information system for large-scale social activities based on 5G communication technology to improve efficiency of emergency medical services. Methods The project was completed in Hangzhou, China, from March 2016 to September 2019. Based on the medical service of large social activities, five information terminals are constructed, including on-site mobile terminal, on-board first aid terminal, expert remote consultation terminal, hospital terminal, and command dispatch center. The system can realize the real-time communication of medical information, patient's vital signs, audio, picture and video information, and can also make intelligent scheduling decisions for patients. Results 5G Emergency Medical information System for Large-scale Social Activities has been completed, which consists of three parts: command and control platform, on-site rescue platform, and evacuation support platform. The command and monitoring platform displays the information of on-site medical teams, ambulances, hospitals and experts through web pages, and realizes multi-party video communication at any time, as well as text, voice and image information of patients' current condition, so as to realize command, dispatch and display statistical summary information. On-site rescue terminal includes patient information input, video signal acquisition and physiological information acquisition equipment. It realizes multiple methods of patient information input, vital signs and physiological information acquisition, multi-angle video acquisition and transmission to the command center. The evacuation support platform includes vehicle emergency terminal, remote expert consultation terminal, hospital terminal and UAV system. Vehicle terminal can scan and transfer with on-site ambulance team, record physiological information during transit, and also acquire and transmit monitor, electrocardiogram and ultrasound information. Hospital terminals can obtain patient information at the first time and prepare for first-aid in hospital. The remote expert terminal can be dispatched by the command center and the hospital terminal, and can join the remote consultation at any time. Unmanned aerial vehicle (UAV) system can transfer medical material between any locations. Conclusions This system can guarantee the patients to be transported from the scene to the ambulance and finally to the hospital during the large-scale social activities. In the whole process, the information transmission and dispatching decision-making are initially realized, and the statistical report forms can be made. However, to fully exert its advantages, it still needs the support of the complete 5G network and continuous optimization in real scenarios. Key words: Large-scale social activities; Emergency medical treatment; Information system; 5G technology
{"title":"Construction of emergency medical service system based on 5G communication technology for large-scale social activities","authors":"Qiang Li, Yu Tian, Minhai Zhang, Yinghao Zhao, G. Lin, Hang Yu, L. Wang, Xiaoping Zhou, Xu Wang, Mao Zhang, J. Li","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.010","url":null,"abstract":"Objective \u0000To develop medical emergency support information system for large-scale social activities based on 5G communication technology to improve efficiency of emergency medical services. \u0000 \u0000 \u0000Methods \u0000The project was completed in Hangzhou, China, from March 2016 to September 2019. Based on the medical service of large social activities, five information terminals are constructed, including on-site mobile terminal, on-board first aid terminal, expert remote consultation terminal, hospital terminal, and command dispatch center. The system can realize the real-time communication of medical information, patient's vital signs, audio, picture and video information, and can also make intelligent scheduling decisions for patients. \u0000 \u0000 \u0000Results \u00005G Emergency Medical information System for Large-scale Social Activities has been completed, which consists of three parts: command and control platform, on-site rescue platform, and evacuation support platform. The command and monitoring platform displays the information of on-site medical teams, ambulances, hospitals and experts through web pages, and realizes multi-party video communication at any time, as well as text, voice and image information of patients' current condition, so as to realize command, dispatch and display statistical summary information. On-site rescue terminal includes patient information input, video signal acquisition and physiological information acquisition equipment. It realizes multiple methods of patient information input, vital signs and physiological information acquisition, multi-angle video acquisition and transmission to the command center. The evacuation support platform includes vehicle emergency terminal, remote expert consultation terminal, hospital terminal and UAV system. Vehicle terminal can scan and transfer with on-site ambulance team, record physiological information during transit, and also acquire and transmit monitor, electrocardiogram and ultrasound information. Hospital terminals can obtain patient information at the first time and prepare for first-aid in hospital. The remote expert terminal can be dispatched by the command center and the hospital terminal, and can join the remote consultation at any time. Unmanned aerial vehicle (UAV) system can transfer medical material between any locations. \u0000 \u0000 \u0000Conclusions \u0000This system can guarantee the patients to be transported from the scene to the ambulance and finally to the hospital during the large-scale social activities. In the whole process, the information transmission and dispatching decision-making are initially realized, and the statistical report forms can be made. However, to fully exert its advantages, it still needs the support of the complete 5G network and continuous optimization in real scenarios. \u0000 \u0000 \u0000Key words: \u0000Large-scale social activities; Emergency medical treatment; Information system; 5G technology","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1231-1236"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41558537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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