Objective:To establish a prognostic Nomogram model for predicting the risk of early death in polytrauma patients.Methods:Data extracted from a polytrauma study on Dryad, an open access database, was selected for secondary analysis. Patients from 18 to 65 years old with polytrauma in the original data were included. All patients with missing variables, such as blood lactic acid (Lac), Glasgow coma score (GCS) and injury severity score (ISS) at admission, were excluded. The differences of gender, age, Lac, ISS and GCS scores between the patients who died within 72 hours and those who survived were analyzed. The risk factors for 72-hour death were analyzed by Logistic regression, and the Nomogram prediction model was established using R software. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the model, and the Bootstrap method was used for internal verification by repeating sample for 1 000 times. Decision curve (DCA) was applied to analyze the clinical practical value of the model.Results:A total of 2 315 polytrauma patients were included. Logistic regression analysis showed that Lac, GCS score and age > 55 years old were the risk factors for early death in polytrauma patients [Lac: odds ratio ( OR) = 1.36, 95% confidence interval (95% CI) was 1.29-1.42, P < 0.001; GCS score: OR = 0.76, 95% CI was 0.73-0.79, P < 0.001; age > 55 years old: OR = 1.92, 95% CI was 1.37-2.66, P < 0.001]. The prediction model was established by using the above risk factors and displayed by Nomogram. ROC curve analysis showed that the area under the ROC curve (AUC) of Nomogram model to predict the risk of death within 72 hours was 0.858, and the predictive ability of Nomogram model was significantly higher than that of Lac (AUC = 0.743), GCS score (AUC = 0.774) and ISS score (AUC = 0.699), all P < 0.05. The model calibration chart showed that the predicting probability was consistent with the actual occurrence probability, and the DCA showed that Nomogram model presented excellent clinical value in predicting the 72-hour death risk for polytrauma patients. Conclusions:The prognostic Nomogram model presents significantly predictive value for the risk of death within 72 hours in polytrauma patients. Prognostic Nomogram model could offer individualized, visualized and graphical prediction pattern, and provide physicians with practical diagnostic tool for triage system and management of polytrauma according to precision medicine.

Objective To evaluate and analyze the feasibility and application effect of ^“DOTS + WeChat^” in the treatment and management of tuberculosis patients. Methods From 2018 to 2019, a total of 2 420 active pulmonary tuberculosis patients were registered in Zibo City, and 1 988 patients meeting the inclusion criteria were selected as the research subjects. 836 patients were randomly enrolled under the ^“DOTS + WeChat^” integrated management mode, while the other 1152 cases were treated with single DOTS management mode. The regular medication status, treatment and outcome, and core knowledge awareness of the two groups were analyzed by SPSS16.0 software, χ²- test and t- test methods. Result The ^“DOTS + WeChat^” comprehensive management group had higher a regular medication rate (98.80%), coincidence rate of sputum test times (95.81%), and success rate of treatment (98.68%) than the single DOTS management group (92.10%, 90.19%, and 96.53%) (P=0.000, 0.000, 0.003). The rate of medical staff participating in supervision and management in the comprehensive management group (100%) was higher than that in the single management group (75.87%) (P=0.000). The complete follow-up rate in the consolidation period (100%) and the complete whole course follow-up rate (99.76%) were both higher than those in the single management group (P=0.000, 0.001). The awareness level of core knowledge in the comprehensive management group (78.58±4.32) was higher than that in the single management group (70.70±8.02) (P=0.000). Conclusion The application of WeChat management mode has a positive effect on the treatment and management of tuberculosis patients in Zibo City. It is a feasible and effective supplement and improvement to the current tuberculosis control and management measures, which is worthy of further promotion and exploration.