ObjectiveTo investigate the type,characteristics and development trend of prehospital medical care of sudden mass incident from 2001 to 2010 in Guangzhou.MethodsThe data of prehospital medical care of sudden mass incident in Guangzhou from 2001 to 2010 were come from the database of 120 Emergency Center.ResultsTotal 6 807 events of Sudden mass incident were recorded from 2001 to 2010,resulting in 26 749 injuries and 917 deaths.In all kinds of sudden mass incident,traffic accident was primary cause ( the number of cases,injuries and deaths accounted for 49.80％,55.29％ and 61.72％,respectively),followed by fighting,fire and poisoning.Over the past decade,the number of occurrence of traffic accidents and the number of injuries were increasing.The large sudden mass incident was 76.65％ in all levels of sudden mass incident happened from 2008 to 2010.Conclusions Traffic accident is an important cause of sudden mass incident in Guangzhou from 2001 to 2010.The number of the traffic accident cases and injuries were increasing.The large sudden mass incident was the main type in all levels of sudden mass incident.It is important to improve the emergency plan,strengthen the training of medical staff and organize the medical rescue drill of sudden mass incident regularly.

Objective To analyse the effect with or without short course radiotherapy before laparoscopc surgery for middle and low locally advanced rectal cancer.Methods Clinical and pathological data of 145 patients confirmed with stage T3 or T4 middle and low locally advanced rectal cancer by pathology were retrospectively analyzed.69 cases were in preoperative short course radiotherapy group and 76 cases went directly to laparoscopic surgery.Results There was no statistical difference in the operation time,(140 ± 17) min vs.(136 ± 17) min,t =-3.04,P =0.761,for blood loss,(65 ±38)ml vs.(76 ±33)ml,t =-1.72,P =0.086.Less abdominal perineal resection was performed in preoperative short term radiotherapy group than in upfront surgery group,though the difference was not statistically significant (P =0.600).Postoperative complications were 16％ and 16％ respectively,x2 =0.001,P =0.98.The 2 year local recurrence rate was 6％ and 17％ respectively,x2 =2.246,P =0.035.There was no significant difference in 2 year distant metastasis rate between the two groups,x2 =0.000,P =0.99,nor the difference in 2 year's survival rate,87％ vs.87％,x2 =0.000,P =0.986.Conclusions Preoperative short course radiotherapy can reduce the local recurrence rate of middle and low locally advanced rectal cancer,without increasing the difficulty of operation and postoperative complications,but long time survival fails to improve.

OBJECTIVE: To evaluate ultrasound-guided renal intracapsular injection of methylprednisolone for primary glomerulonephritis. METHODS: Thirty patients with primary glomerulonephritis were performed intra-renal adipose capsule injection therapy under ultrasound guidance. The 24 hour urinary protein, plasma total protein, plasma albumin, urine volume, and serum creatinine were measured before and after the treatment. RESULTS: The injection success rate was 96.3% (314/326) in patients whose width of perinephric adipose capsule was >or= 5 mm. The injection success rate was 77.4% (212/274) in patients whose width of perinephric adipose capsule was < 5 mm (P < 0.01). The complications included pain, perirenal hematoma, and so on. The 24 hour urinary protein after the treatment was lower than before the treatment (P < 0.05). The plasma total protein and plasma albumin were higher than before the treatment (P < 0.05). The urine volume and serum creatinine were unchanged (P > 0.05). CONCLUSION Intra-renal adipose capsule injection under ultrasound guidance has a high success rate and good effect, and is effective to treat primary glomerulonephritis with glucocorticoid.
Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents ; administration & dosage ; Female ; Glomerulonephritis ; drug therapy ; Humans ; Injections ; methods ; Kidney ; drug effects ; Male ; Methylprednisolone ; administration & dosage ; Middle Aged ; Ultrasonography, Interventional ; methods ; Young Adult

Objective To evaluate laparoscopic π-shaped esophageal jejunostomy vs.laparoscopic assisted end-to-side esophageal jejunostomy in]D2 radical total gastrectomy for middle third gastric cancer.Methods From July 2015 to July 2017,154 patients undergoing laparoscopic D2 radical total gastrectomy were divided into group of laparoscopic assisted end-to-side esophageal jejunostomy (92 cases) and the group of totally laparoscopic π-shaped esophageal jejunostomy (62 cases).Results The group of totally laparoscopic π-shaped esophageal jejunostomy was not statistically different in tumor pathology and postoperative complications with laparoscopic assisted group,but was better than the later in anastomotic reconstruction surgery time (21 ± 3) min vs.(30 ± 3) min,t =17.56,P =0.000,incision length (6.7 ±1.1) cm vs.(10.5 ± 1.7) cm,t =15.72,P =0.000 and anastomotic complications (3％ vs.13％,x2 =4.320,P =0.038).Conclusions Totally laparoscopic π-shape esophageal jejunostomy is safe,feasible,better than hand assisted procedures.

Objective:To screen biomarkers related to the prognosis of gastric cancer and the efficacy of 5-fluorouracil based on the bioinformatics method.Methods:Gastric cancer datasets like GSE54129, GSE79973 and GSE51725 based on GPL570 platform were downloaded from Gene Expression Omnibus (GEO) database. Genes related to the overall survival (OS) of the top 500 gastric cancer patients were downloaded from GEPIA2 online gene expression profile.GEO2R was used to identify the differentially expressed genes (DEG) between gastric cancer tissues and adjacent normal tissues, STRING database was used to build protein-protein interaction networks (PPI) and to identify the key genes, the enrichment analysis of gene ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) was made by using OmicShare. Kaplan-Meier Plotter was used to calculate the value of key genes in predicting the OS of gastric cancer patients. All patients were divided into the high expression group and low expression group according to the optimal cut-off value of gene expression level.Results:A total of 59 DEG were screened, including 39 up-regulated genes and 20 down-regulated genes. The key up-regulated genes including homeodomain transcription factors 2(PITX2), hepatocyte growth factor (HGF), fibroblast growth factor 1 (FGF1), transforming growth factor β 2 (TGFB2), thromobospondin 1 (THBS1) were analyzed by using PPI. Survival analysis results showed that the OS of gastric cancer patients with low expression of FGF1, HGF, PITX2 and TGFB2 genes was better (all P < 0.01); the OS of gastric cancer patients with low expression of THBS1 gene was poor, while the difference was not statistically significant ( P > 0.05). The patients with low expression of RIEG1 gene who received 5-fluorouracil-based chemotherapy regimen had the better OS ( P < 0.01),while those with THBS1 and HGF low expression had the worse OS ( P < 0.05). It was found that key genes might promote the development of gastric cancer by participating in the regulation of TGF- β signaling pathway, Rap1 signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway, Hippo signaling pathway, Ras signaling pathway and focal adhesion pathway. Conclusions:Bioinformatics analysis shows that the expressions of FGF1, HGF, PITX2 and TGFB2 genes are related to the prognosis of gastric cancer, and the expressions of RIEG1, THBS1 and HGF are related to the efficacy of 5-fluorouracil, which may be used as a predictive marker of fluorouracil chemosensitivity in patients with gastric cancer.

Objective:To investigate the correlation between perioperative new onset atrial fibrillation and the prognosis of colorectal cancer.Methods:This study involved 180 colorectal cancer patients undgoing radical resection at the Department of Gastrointestinal Surgery, Longyan First Hospital from Jan 2014 to Jan 2015. Among them, 47cases suffered from perioperative new onset atrial fibrillation.Results:The perioperative new onset atrial fibrillation group had a higher mean age and a higher mean postoperative C-reactive protein level than the control group ( t=-3.080, P=0.002; t=-2.184, P=0.030). Hence these patients had a longer hospital stay ( t=-5.072, P=0.001; t=-2.577, P=0.011). Multivariate analysis showed that postoperative new onset atrial fibrillation, high postoperative mean C-reactive protein level, poor tumor differenciation and late tumor stage were independent risk factors for the prognosis of colorectal cancer ( HR=1.835, P=0.018; HR=1.008 P=0.017; HR=1.950 P=0.046; HR=1.300, P=0.047). The median survival time of perioperative new onset atrial fibrillation group and control group were 59.05 months and 63.23 months, respectively ( P=0.005). Conclusions:Colorectal cancer patients suffering from perioperative new onset atrial fibrillation were more common among advanced age and high postoperative mean C-reactive protein level with higher all-cause mortality.

Objective:To study the value of autoregressive integrated moving average (ARIMA) and autoregressive (AR) models in predicting the daily number of ambulances in prehospital emergency medical services demand in Guangzhou.Methods:Matlab simulation software was used to analyze the emergency dispatching departure records in Guangzhou from January 1, 2021 to December 31, 2021. A time series for the number of ambulances per day was calculated. After identifying the time series prediction model, ARIMA(1,1,1), AR(4) and AR(7) models were obtained. These models were used to predict the number of ambulances per day. ARIMA(1,1,1) model divided the time series into the training set and test set. Prony method was used for parameter calculation, and the demands of number of ambulances of the next few months were forecasted. AR(4) and AR(7) models used uniformity coefficient to forecast the demands of number of ambulances on that very day.Results:ARIMA(1,1,1), AR(4) and AR(7) can effectively predict the number of ambulances per day. The prediction fitting error of ARIMA (1,1,1) decreased with the extension of prediction time. The mean absolute percentage error (MAPE) of forecast results of daily vehicle output of emergency dispatching within two months was less than 6% and the predicted results were almost within the 95% confidence interval. The residual analysis of the model verified that the model was significantly effective.Conclusions:ARIMA model can make a long-term within two months and effective prediction fitting of the daily vehicle output of emergency dispatching, and AR model can make a short-term and effective prediction of the daily vehicle output of emergency dispatching.

Objective:To investigate the risk factors affecting the completion of postoperative adjuvant chemotherapy in elderly patients with progressive gastric cancer.Methods:Clinicopathological data of patients diagnosed with gastric adenocarcinoma and treated with radical surgery at our hospital between January 2017 and December 2018 were retrospectively collected, and 96 patients were finally included in the study according to the inclusion and exclusion criteria.Patients were divided into a completed chemotherapy group and an uncompleted chemotherapy group depending on whether they had completed 6 cycles of adjuvant chemotherapy after surgery.The optimal cut-off value was derived from the receiver operating characteristic(ROC)curve, and the Youden Index was calculated.Relevant factors that might affect the completion of postoperative adjuvant chemotherapy in elderly patients with progressive gastric cancer were included in univariate and multivariate Logistic regression analyses to identify independent risk factors affecting the completion of postoperative adjuvant chemotherapy in gastric cancer patients.The Kaplan-Meier(K-M)method was used to plot the survival curves for the groups, and the log-rank test was used to compare the survival rates between the groups.Results:A total of 96 patients, aged 60-89 years, with a mean age of(70.3±7.0)years, were included.Sixteen patients completed postoperative adjuvant chemotherapy, while 80 patients did not.The following analysis was performed on clinicopathological data of patients in the two groups.Univariate Logistic regression analysis showed that patient age ≥70 years( OR=8.135, 95% CI: 1.735-38.153, P=0.008)or a preoperative prognostic nutritional index(PNI)score <49.5( OR=4.765, 95% CI: 1.549-14.656, P=0.006)affected the completion of postoperative adjuvant chemotherapy.The risk factors that might affect the completion of postoperative adjuvant chemotherapy in elderly gastric cancer patients were analyzed using multivariate Logistic regression and the results showed that age ≥70 years( OR=9.815, 95% CI: 1.947-49.485, P=0.006)and a preoperative PNI score <49.5( OR=5.895, 95% CI: 1.711-20.305, P=0.005)were independent risk factors hindering the completion of postoperative adjuvant chemotherapy. Conclusions:Age ≥70 years and PNI<49.5 are independent risk factors for the completion of postoperative adjuvant chemotherapy.Failure to complete postoperative adjuvant chemotherapy is associated with a poor prognosis.PNI is a valid predictor for whether postoperative adjuvant chemotherapy will be completed and helps to screen chemotherapy patients who need nutritional intervention.

Objective: To analyze the using of pre-hospital emergency resources and treatment characteristics of acute alcoholism patients in Guangzhou. Methods: The pre-hospital emergency data of the emergency department of the Second Affiliated Hospital of Guangzhou Medical University from January 1st in 2009 to December 31st in 2018 were obtained from the database of the Guangzhou Emergency Medical Command Center. The related data of patients with acute alcoholism were collected, including gender, age, poisoning severity, treatment results, caller type, number of empty vehicles (empty vehicle was defined as the empty vehicle return caused by the ambulance who did not receive or refused to come to the hospital after the ambulance leaved), departure time (from the ambulance to the completion time), on-site time (from the ambulance to the patient boarding time) and the distribution of pre-hospital emergency time in 24 hours on weekdays and weekends. The relationship between acute alcoholism patients and the peak of in-hospital emergency treatment was analyzed. Results: A total of 2 408 acute alcoholism patients were recorded, among whom 2 109 patients (87.58%) with acute alcoholism, 126 (5.23%) with drug poisoning, 67 (2.78%) with chemical poisoning, 3 (0.13%) with pesticide poisoning, and 103 (4.28%) with other poisoning. Acute alcoholism patients were mainly male, with a total of 1 862 cases (88.29%), and the ratio between males and females was 7.54∶1. In 2 109 patients with acute alcoholism, 93.41% were in the age range of 18-59 years old. The number of mild patients was 1 717 (81.41%), 1 178 (55.86%) needed further treatment, and no patient died. For the occupation of pre-hospital emergency resources, 43.24% (912/2 109) of acute alcoholism called 120 through 110 with empty vehicles of 36.79% (776/2 109), which were significantly higher than the acute cerebrovascular disease [3.83% (362/9 461), 5.80% (549/9 461), both P < 0.01], acute trauma [24.29% (1 708/7 033), 7.96% (560/7 033), both P < 0.01], acute circulation system disease [2.44% (90/3 694), 2.87% (106/3 694), both P < 0.01], and acute respiratory system disease [0.86% (31/3 606), 1.58% (57/3 606), both P < 0.01]. Furthermore, empty vehicles were more likely to happen through 110 with empty vehicles rate of 51.75% (472/912), which was significantly higher than that through the witness [40.82% (60/147), P < 0.01] and relatives and friends [23.24% (244/1 050), P < 0.01]. The driving time and on-site time of acute alcoholism were significantly shorter than those of acute cerebrovascular disease, acute circulation system disease, and acute respiratory system disease [driving time (minutes): 26 (20, 34) vs. 34 (26, 45), 38 (29, 49), 38 (29, 50); on-site time (minutes): 6 (4, 10) vs. 10 (7, 14), 10 (7, 15), 10 (8, 15), all P < 0.01], but there was no statistical difference as compared with acute trauma [driving time (minutes): 26 (20, 34) vs. 29 (20, 42), on-site time (minutes): 6 (4, 10) vs. 7 (4, 11), both P > 0.05]. The regularity of variation in number of critically acute alcoholism patients was distinctive, which peaked in the period of 21:00-00:00 and bottomed out in the period of 09:00-13:00, which overlapped with the peak flow in the hospital emergency department (17:00-22:00). Conclusions Acute alcoholism patients occupy excessive pre-hospital emergency resources, and overlap with the hospital emergency treatment peak. It is necessary to strengthen the public propaganda and education on the rational usage of 120 emergency resources and reduce waste.