Objective To study the effects of classification-partition-distribution emergency nursing management for severe trauma patients. Method A total of 60 patients from June 2014 to May 2015 were set as control group receiving common nursing and other 62 patients from June 2015 to June 2016 as observation group treated with emergency hierarchical partition and triage nursing. Result The treatment success rate in the observation group were both significantly higher than that of the control group (P<0.05). Conclusion Classification-partition-distribution emergency nursing management for severe trauma patients can increase treatment success rate .

Objective To evaluate the analytical performance of a novel HBV DNA assay based on automated DNA extraction and real-time fluorescence quantitative PCR .Methods Analytic verification studies.Accuracy and lower limit of detection were assessed by determining a panel of HBV standard plasma of WHO.HBV standard plasma (genotype A, B, C and D) at 6 different concentrations were measured 18 times to evaluate precision and reproducibility .Pseudo-viral particles at high HBV DNA concentration were serially diluted to assess linear range .One hundred and forty-four clinical specimens were quantified for HBV DNA so as to evaluate the correlation between the new test and COBAS ? system. Results Quantification of HBV standard plasma showed acceptable accuracy , with each deviation between observed and expected values within ±0.35 lg IU/ml (-0.17-0.32 lg IU/ml).Intra-assay coefficients of variation ( CV) for genotype A , B, C and D were 3.87% -6.32%, 0.45% -14.68%, 0.16% -8.36% and 0.64%-13.01%respectively, and the inter-assay CV were 5.67%-9.69%, 1.28%-15.68%, 0.36%-9.05%and 1.69%-13.65%, separately.Linearity assessment exhibited an excellent dynamic range of linear quantification from 20 to 1.0 ×1010 IU/ml ( r =0.998, P <0.001 ) .And the satisfactory results obtained at 3 levels of HBV DNA concentration (10, 20, 50 IU/ml, respectively) confirmed the claimed lower limit of detection with 5/5 detectable rate at 20 IU/ml.Furthermore, good correspondence was observed between the new HBV DNA assay and the COBAS ? system with 100% ( 144/144 ) qualitative coincidence and significant correlation based on 104 positive data ( r=0.984, P<0.000 1).Conclusions The novel fully-automated real-time PCR assay displayed good analytical and clinical performance for highly sensitive detection of HBV DNA.It was well suited for monitoring antiviral responses as well as drug resistance according to current clinical practice guidelines for the management of chronic HBV infection .

Objective:This study aimed to investigate the changes of ventricular repolarization index on ECG and its relationship between prognosis in patients with acute cerebral trauma.Methods:From January 2014 to January 2018, data of 289 consecutive patients with emergency traumatic brain injuries were prospectively collected and ultimately 219 cases were selected into the study group. Meanwhile, 220 healthy persons matched by age and sex served as the control group. ECG indexes such as P wave dispersion (Pd), corrected QT(QTc), Tp-e and Tp-e/QT were all measured and calculated in the 1st and 72th hour. The independent sample t test and paired t test were used to compare the changes of the above indexes on the 1st day and the control group, the 1st day and the 3rd day, respectively, and the association between ECG indexes and the illness severity or adverse events (MACE) of the trauma group during hospitalization. Results:QTc, Tpec and Tp-e/QT of the acute cerebral trauma group increased on the 3rd day compared with the control group and on the first day, the differences were statistically significant ( P all <0.05). Tp-ec and Tp-e/QT in patients with moderate to severe brain injury in Glasgow Coma Scale (GCS) were increased, and the differences were statistically significant (150.48±16.58 vs 130.14±11.86, P=0.006). 0.29±0.04 vs 0.23±0.03, P=0.030). Tpec and Tp-e/QT were significantly increased in acute brain truma patients with MACE during hospitalization compared with those without MACE (149.76±12.52 vs 128.84±12.47, P <0.001). 0.30±0.04 vs 0.21±0.03,<0.001). Conclusion:Tp-e and Tp-e/QT in patients with acute cerebral trauma are correlated to the severity of the disease, which could be used as short-term prognostic indicators under certain conditions.

Objective:To determine whether the blood urea nitrogen to serum albumin (B/A) ratio was a useful prognostic factor of mortality in the patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB).Methods:Totally 1 120 patients with acute upper gastrointestinal bleeding (VUGIB) admitted to the Emergency Department from January 2019 to December 2021 were prospectively and continuously collected and 449 eligible patients with acute non-varicose upper gastrointestinal tract were finally enrolled. The clinical data, laboratory tests and endoscopic results of the patients were recorded, and the data from the 30-day survival group and the non-survival group were compared and analyzed.Results:Significant differences were observed in age, mean arterial pressure, pulse rate, albumin levels, total protein levels, blood urea nitrogen levels, glucose, Glasgow-Blatchford score (GBS), Rockall, and AIMS65 scores between the survival and non-survival groups (all P <0.05). The B/A ratio in the non-survival group was significantly higher than that in the survival group [(24.9 ± 16.4) vs. (9.0 ± 8.6) mg/g, P<0.001]. Receiver operating characteristic (ROC) curve showed that the best cutoff value of B/A ratio for predicting 30-day death was 32.08 mg/g, with a sensitivity of 0.776 and specificity of 0.823. There was a significant difference in the 30-day Kaplan-Meier survival curve between patients with B/A ratio ≥32.08 mg/g and those with B/A ratio <32.08 mg/g (Log Rank 32.229, P<0.001). Multivariate logistic regression analysis revealed that the B/A ratio (≥32.08 mg/g) was associated with 30-day mortality ( OR=4.87, 95% CI: 1.94-6.85, P<0.001). Area under the ROC curve (AUC) for B/A ratio, GBS, Rockall and AIMS65 scores for predicting 30-day mortality were 0.855 (95% CI: 0.807-0.902), 0.849 (95% CI: 0.796-0.901), 0.657 (95% CI: 0.576-0.737), and 0.828 (95% CI: 0.774-0.883), respectively. Conclusions:The B/A ratio is a simple but potentially useful prognostic factor of mortality in the ANVUGIB patients.