With the gradual advancement of medical reform policy,"non-pre-hospital medical emergency"has also emerged.Whether it will cause the plunder of pre-hospital emergency resources to be seized has become the focus of discussion in emergency centers at all levels.For the implementation of the provincial party committee,the provincial government on promoting the reform of government service value-added decision deployment,focusing on the whole life cycle,through the whole service chain whole process,around outpatient,hospitalization,referral treatment key link,speed up the building from convenient service to value-added services comprehensive upgrade new ecological health services.Jiaxing positive response,relying on the overall urban and rural development advantage,multiple departments together,opened a unified line service platform of 96120,and through the integration of the city's medical pre-hospital emergency resources,innovation pre-hospital emergency work responsibilities,the implementation of first aid and first aid classification management,establish the whole domain,urban and rural integration"non-emergency transport"service system.Efforts should be made to solve four major problems,such as insufficient supply of"non-emergency transport"services,poor service channels of"non-emergency transport",difficult management of"black ambulance"and the overall efficient recycling of first aid resources.We will innovate and establish a joint service system for non-emergency transport services,an efficient and convenient service model,a comprehensive and homogeneous management standard,a universal guarantee mechanism,and a training mechanism for professionals.So as to realize the province took the lead to build covering the whole city,urban and rural undifferentiated"emergency transport"service system,complete the province's first"emergency transport"municipal standards and industry internal specification,form can copy can promote ambulance vehicles"flat"operation mechanism,as well as a variety of security support"emergency transport"the 4 goals of universal public service.

Objective:To investigate and evaluate the correct cognition and influencing factors of mpox expertise among relevant Chinese clinicians and to provide a reference for prevention and control.Methods:A cross-sectional survey was conducted among clinicians in relevant departments using a structured questionnaire compiled by ourselves through a non-random network recruitment method. The content includes demography, clinical specialties, and characteristics of medical institutions, and 37 questions to evaluate the professional cognition of mpox etiology, clinical characteristics, transmission, prevention, and control. Using the modified Bloom's cutoff point to determine the correct answer is greater than or equal to 26 entitled correct cognition. A logistic regression model was used to analyze the factors influencing the correct cognition rate.Results:A total of 4 332 clinicians in 23 provinces (autonomous regions, municipality) in China were investigated by online questionnaires and 4 276 effective questionnaires were collected, with an effective rate of 98.71%. The mean age of the respondents was (39.46±9.54) years old, 61.18% were female. The overall correct cognition rate of mpox expertise was 62.04% (95% CI: 60.59%-63.50%), the correct cognition rates of mpox etiology, clinical characteristics, transmission, prevention and control were 48.25% (95% CI: 46.68%-49.82%), 78.66% (95% CI: 77.38%-79.95%), 68.56% (95% CI: 67.10%-70.02%), respectively. Multivariate logistic regression analysis showed that the relevant factors affecting the overall correct cognition of mpox expertise among Chinese clinicians included gender (female: OR=1.54, 95% CI: 1.31-1.80), region (eastern region: OR=1.46, 95% CI: 1.18-1.79; midwestern region: OR=1.24, 95% CI: 1.04-1.49), professional title (deputy senior: OR=1.43, 95% CI:1.16-1.76; senior: OR=1.72, 95% CI:1.30-2.28), the clinical field (the clinical fields of dermatology and venereal diseases: OR=1.78, 95% CI: 1.42-2.23). Conclusions:The overall correct cognition rate of mpox expertise among relevant Chinese clinicians was low. It was essential to conduct mpox knowledge training for clinicians in males, northeast regions, junior professional title and the clinical fields other than dermatology and venereal diseases to improve their correct cognition rates and epidemic prevention and control ability.

Objective:To investigate and evaluate the correct cognition and influencing factors of mpox expertise among relevant Chinese clinicians and to provide a reference for prevention and control.Methods:A cross-sectional survey was conducted among clinicians in relevant departments using a structured questionnaire compiled by ourselves through a non-random network recruitment method. The content includes demography, clinical specialties, and characteristics of medical institutions, and 37 questions to evaluate the professional cognition of mpox etiology, clinical characteristics, transmission, prevention, and control. Using the modified Bloom's cutoff point to determine the correct answer is greater than or equal to 26 entitled correct cognition. A logistic regression model was used to analyze the factors influencing the correct cognition rate.Results:A total of 4 332 clinicians in 23 provinces (autonomous regions, municipality) in China were investigated by online questionnaires and 4 276 effective questionnaires were collected, with an effective rate of 98.71%. The mean age of the respondents was (39.46±9.54) years old, 61.18% were female. The overall correct cognition rate of mpox expertise was 62.04% (95% CI: 60.59%-63.50%), the correct cognition rates of mpox etiology, clinical characteristics, transmission, prevention and control were 48.25% (95% CI: 46.68%-49.82%), 78.66% (95% CI: 77.38%-79.95%), 68.56% (95% CI: 67.10%-70.02%), respectively. Multivariate logistic regression analysis showed that the relevant factors affecting the overall correct cognition of mpox expertise among Chinese clinicians included gender (female: OR=1.54, 95% CI: 1.31-1.80), region (eastern region: OR=1.46, 95% CI: 1.18-1.79; midwestern region: OR=1.24, 95% CI: 1.04-1.49), professional title (deputy senior: OR=1.43, 95% CI:1.16-1.76; senior: OR=1.72, 95% CI:1.30-2.28), the clinical field (the clinical fields of dermatology and venereal diseases: OR=1.78, 95% CI: 1.42-2.23). Conclusions:The overall correct cognition rate of mpox expertise among relevant Chinese clinicians was low. It was essential to conduct mpox knowledge training for clinicians in males, northeast regions, junior professional title and the clinical fields other than dermatology and venereal diseases to improve their correct cognition rates and epidemic prevention and control ability.

With the gradual advancement of medical reform policy,"non-pre-hospital medical emergency"has also emerged.Whether it will cause the plunder of pre-hospital emergency resources to be seized has become the focus of discussion in emergency centers at all levels.For the implementation of the provincial party committee,the provincial government on promoting the reform of government service value-added decision deployment,focusing on the whole life cycle,through the whole service chain whole process,around outpatient,hospitalization,referral treatment key link,speed up the building from convenient service to value-added services comprehensive upgrade new ecological health services.Jiaxing positive response,relying on the overall urban and rural development advantage,multiple departments together,opened a unified line service platform of 96120,and through the integration of the city's medical pre-hospital emergency resources,innovation pre-hospital emergency work responsibilities,the implementation of first aid and first aid classification management,establish the whole domain,urban and rural integration"non-emergency transport"service system.Efforts should be made to solve four major problems,such as insufficient supply of"non-emergency transport"services,poor service channels of"non-emergency transport",difficult management of"black ambulance"and the overall efficient recycling of first aid resources.We will innovate and establish a joint service system for non-emergency transport services,an efficient and convenient service model,a comprehensive and homogeneous management standard,a universal guarantee mechanism,and a training mechanism for professionals.So as to realize the province took the lead to build covering the whole city,urban and rural undifferentiated"emergency transport"service system,complete the province's first"emergency transport"municipal standards and industry internal specification,form can copy can promote ambulance vehicles"flat"operation mechanism,as well as a variety of security support"emergency transport"the 4 goals of universal public service.

Objective To evaluate the significant clinical value of an intelligent dispatching platform based on the 120 command system and provide the basis for improving emergency service efficiency. Methods Convenience sampling was used to choose 356 patients who received pre-hospital care in the Jiaxing Emergency Center from August 2023 to May 2024 as research objects. The 178 patients who made phone calls to the 120 center from August to December 2023 (namely before the establishment of intelligent dispatching platform) served as a control group,while another 178 cases who made phone calls to the 120 center from January to May 2024 (namely after the establishment of intelligent dispatching platform) served as an observation group. The optimal ambulance was chosen and sent to receive the patients by the dispatcher himself in the control group,while the intelligent dispatching platform designed by the research team and computer engineers was used in the observation group. The platform was made up of multimodal receipt of alarms,accurate location of phone call places,matching and dispatching of ambulance resources,and collaborative management functions within the region. At the same time,geographic information,hospital information,and emergency vehicle information were completed to achieve united dispatching and whole-process quality control all over the region. The emergency response time,2 minutes ambulance dispatching rate,coincidence rate of medical treatment principles,and success rate of cardiopulmonary resuscitation in cities and rural areas were compared between the control group (before the establishment of intelligent dispatching platform) and the observation group (after the establishment of intelligent dispatching platform). Results The emergency response time in the observation group after the establishment of intelligent dispatching platform was shorter than that in the control group in cities (minutes:8.64±0.99 vs. 10.57±1.00,P<0.05),while there was no statistical significance between the observation group and the control group in rural areas (minutes:11.66±1.49 vs. 11.94±1.70,P>0.05). The 2 minutes ambulance dispatching rate higher than those in the control group[99.44％ (177/178) vs. 98.31％ (175/178)],there was no statistical significance (P>0.05),the coincidence rate of medical treatment principles in the observation group were significantly higher than those in the control group[98.88％ (176/178) vs. 89.89％ (160/178),P<0.05],For the observation group,the success rate of cardiopulmonary resuscitation in the observation group was slightly higher than that in the control group[18.92％ (7/37) vs. 13.51％ (5/37)],but there was no statistical significance (P>0.05). Conclusion The construction of an intelligent dispatching platform with the function of united dispatching,collaborative management of resources,and whole-process quality control all over the region can improve emergency service efficiency and effectiveness,thus promoting the development of pre-hospital care course.

Objective To evaluate the significant clinical value of an intelligent dispatching platform based on the 120 command system and provide the basis for improving emergency service efficiency. Methods Convenience sampling was used to choose 356 patients who received pre-hospital care in the Jiaxing Emergency Center from August 2023 to May 2024 as research objects. The 178 patients who made phone calls to the 120 center from August to December 2023 (namely before the establishment of intelligent dispatching platform) served as a control group,while another 178 cases who made phone calls to the 120 center from January to May 2024 (namely after the establishment of intelligent dispatching platform) served as an observation group. The optimal ambulance was chosen and sent to receive the patients by the dispatcher himself in the control group,while the intelligent dispatching platform designed by the research team and computer engineers was used in the observation group. The platform was made up of multimodal receipt of alarms,accurate location of phone call places,matching and dispatching of ambulance resources,and collaborative management functions within the region. At the same time,geographic information,hospital information,and emergency vehicle information were completed to achieve united dispatching and whole-process quality control all over the region. The emergency response time,2 minutes ambulance dispatching rate,coincidence rate of medical treatment principles,and success rate of cardiopulmonary resuscitation in cities and rural areas were compared between the control group (before the establishment of intelligent dispatching platform) and the observation group (after the establishment of intelligent dispatching platform). Results The emergency response time in the observation group after the establishment of intelligent dispatching platform was shorter than that in the control group in cities (minutes:8.64±0.99 vs. 10.57±1.00,P<0.05),while there was no statistical significance between the observation group and the control group in rural areas (minutes:11.66±1.49 vs. 11.94±1.70,P>0.05). The 2 minutes ambulance dispatching rate higher than those in the control group[99.44％ (177/178) vs. 98.31％ (175/178)],there was no statistical significance (P>0.05),the coincidence rate of medical treatment principles in the observation group were significantly higher than those in the control group[98.88％ (176/178) vs. 89.89％ (160/178),P<0.05],For the observation group,the success rate of cardiopulmonary resuscitation in the observation group was slightly higher than that in the control group[18.92％ (7/37) vs. 13.51％ (5/37)],but there was no statistical significance (P>0.05). Conclusion The construction of an intelligent dispatching platform with the function of united dispatching,collaborative management of resources,and whole-process quality control all over the region can improve emergency service efficiency and effectiveness,thus promoting the development of pre-hospital care course.

Objective To observe the clinical curative effect of unilateral biportal endoscopy(UBE)in the treatment of extreme lateral lumbar disc herniation(ELLDH).Methods From June 2019 to June 2022,25 patients with ELLDH were treated with UBE-guided discectomy,including 16 males and 9 females.The age ranged from 26 to 62 years with a mean of(53.67±17.45)years.History ranged from 3 d to 10 years.There were 9 cases of internal foraminal type(type Ⅰ),13 cases of external foraminal type(type Ⅱ)and 3 case of mixed type(type Ⅲ).There were 8 cases of L4/5 space and 17 cases of L5/S1 space.All the patients underwent anterior and lateral lumbar X-rays,CT and MRI scans before surgery.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)assessed lower limb and lower back pain and functional recovery before surgery and at 3 d and 3 months after surgery,respectively.Macnab criteria evaluated the immediate surgical outcome.Results The UBE technique was used to treat ELLDH.The operative time was(79.79±23.97)min,the intraoperative bleeding volume was 40～80 mL,with an average of(55.80±10.74)mL.Follow-up time was(7.02±4.26)months.Preoperative VAS of lower limb was(7.04±0.92),lower back VAS was(3.49±1.52),ODI was(35.03±2.97)%.Compared with the preoperative results,the lower limb VAS was(2.17±0.61),lower back VAS was(1.48±0.43),and ODI was(18.77±3.15)%on day 3 after surgery,lower limb VAS was(1.38±0.65),lower back VAS was(1.03±0.48)and ODI was(6.05±1.80)%on the 3 months after surgery were improved(P＜0.05).The excellent and good rate was 96.0%(excellent 20,good 4,fair 1),and no obvious complications were observed during the follow-up.Conclusion UBE is effective,with little trauma,clear intraoperative visual field,good intraoperative experience,and less traumatic and safe in the treatment of ELLDH.

In clinical application, a microneedle system that continuously delivers drugs is of great value for the delivery of some vaccines and hormone drugs. In this study, a controlled-release chitosan-based microneedle array (PVA/CS-MN) was designed, combining microneedle patches with drugs for controlled-release of drugs. Here we report the optimization of the preparation process of PVA/CS-MN. The appearance, morphology, mechanical properties, dissolution and swelling properties, and in vitro penetration properties of the MN arrays were characterized. The PVA/CS-MN prepared by the optimal process showed good morphology and mechanical properties. PVA/CS-MN can smoothly open microchannels on the skin and achieve controllable dissolution and swelling functions. Ascorbic acid (l-ascorbic acid) was used as a model drug to prepare a Vc-PVA/CS-MN. In vitro transdermal diffusion experiments showed that the Vc-PVA/CS-MN released about 57% of the drug within 1 h. About 66.7% of the drug was slowly released within 12 h, and a total of 92% of the drug was released after 7 days. The controllable sustained-release properties and excellent drug delivery efficiency of PVA/CS-MN provide a new option for sustained transdermal drug delivery.
Ascorbic Acid ; Chitosan ; Delayed-Action Preparations ; Drug Delivery Systems ; Hormones ; Vaccines

Objective:To understand the status quo of nutrition knowledge, attitude and behavior of nurses in class A tertiary hospital and its influencing factors, and to provide reference for the development of reasonable and standard nutrition training courses.Methods:The knowledge, attitude and behavior of nutrition of 207 nurses in 28 class A tertiary hospitals from 17 provinces cities on October 25-26, 2019 were investigated Questionnaire on Nutritional Knowledge, Attitude and Behavior Cognition of Nurses.Results:The scores of nurses′ nutritional knowledge, attitude and behavior were (69.70 ± 2.92), (82.76 ± 4.97) and (64.90 ± 4.77) respectively. There were significant differences in nurses′ nutritional knowledge, attitude and behavior at different ages, nursing ages, whether they had children, the highest educational background, department rotation, technical titles, administrative positions, employment methods, article publication, whether they had participated in nutrition training courses and in different regions ( F values were 6.80-60.95, t values were 2.94-7.08, all P<0.05). The main factors affecting nutrition knowledge were region, nursing age, the highest educational background, department rotation and whether they had participated in nutrition training courses ( t values were -6.88-6.73, all P<0.05). The main factors affecting nutritional attitude were region, nursing age and the highest educational background ( t=-2.22, 6.84, 3.21, all P<0.05). The main factor affecting nutritional behavior was nursing age ( t=5.45, P<0.05). Conclusions:Nurses′ nutritional attitude level is excellent, but their mastery of nutritional knowledge and nutritional nursing behavior level need to be improved. Reasonable, scientific and feasible nutritional training courses should be formulated according to the influencing factors of their nutritional knowledge, attitude and behavior, so as to improve nurses′ nutritional knowledge, belief and behavior level and improve the nutritional status and prognosis of hospitalized patients.

Humans ; Hydrocarbons, Brominated ; toxicity ; Occupational Exposure ; standards