Objective:To investigate the application of time series models in forecasting pre-hospital emergency ambulance trips in Handan City and develop the LPro ensemble model for improved prediction accuracy to support emergency resource allocation.Methods:Pre-hospital emergency data from Handan Emergency Medical Command Center (2019-2023) were retrospectively analyzed. From 324 799 original records, 289 949 valid records were included after cleaning. The training set (2019-2022: 215 918 records) included 35 527 records in 2019, 52 015 in 2020, 61 836 in 2021, and 66 540 in 2022. The validation set (2023) contained 74 031 records. ARIMA, linear trend seasonal, exponential smoothing, and Prophet models were fitted to the training set. The LPro ensemble model was constructed using MAPE-based weighting (linear trend seasonal model: 0.38, Prophet: 0.62). Performance metrics included MAPE, RMSE, MAE, and R 2. Results:Data showed annual growth (compound annual growth rate 23.27%) and seasonal patterns (October peaks, February troughs). Ambulance dispatches increased annually with monthly cyclical patterns. For 2023 validation predictions: ARIMA (MAPE 8.76%, RMSE 619, MAE 491, R 2 0.4563), linear trend seasonal (MAPE 9.83%, RMSE 671, MAE 545, R 2 0.3608), Prophet (MAPE 8.43%, RMSE 562, MAE 503, R 2 0.5513), exponential smoothing (MAPE 8.08%, RMSE 643, MAE 410, R 2 0.4124). LPro model showed superior performance (MAPE 7.05%, RMSE 491, MAE 393, R 2 0.6570), with 16.37% lower MAPE, 12.63% lower RMSE, 21.87% lower MAE, and 19.17% higher R 2 versus Prophet. Conclusion:The LPro ensemble model substantially enhances prediction accuracy and reliability, offering scientific support for emergency resource optimization and dispatch scheduling in Handan City.

Objective To summarize the prenatal diagnosis and genetic counseling of Turner syndrome fetuses with 46,X,i(X)(q10).Methods Two gravidas admitted to the Obstetrics and Gynecology Hospital of Dalian were enrolled in this study.One gravida,who was admitted in October 2016,was classified as high risk of Down syndrome based on prenatal serologic screening and systematic ultrasonography,which found remarkably shorter humeri and femora than fetus of the same gestations.The other was suggested to be monosomy X after non-invasive prenatal testing and admitted in November 2017.Fluorescence in situ hybridization (FISH) and karyotyping were performed for prenatal diagnosis.Peripheral blood karyotyping was also offered to the two women and their partners.Results FISH test for amniotic fluid did not find numerical abnormality in 13,18,21,and sex chromosomes in these two fetuses.Karyotype analysis showed that the two fetuses were both 46,X,i(X) (q10),while their parents were normal.Both cases were terminated after genetic counseling.Conclusions Prenatal serological screening,systematic ultrasonography and non-invasive prenatal testing may help to identify Turner syndrome fetus of 46,X,i(X) (q10).Timely and accurate prenatal diagnosis may prevent the affected fetus from being born.

Objective To investigate the feasibility and safety of laparoscopic aortobifemoral bypass (LABF) for diffuse aortoiliac occlusive diseases.Methods Clinical data of 18 cases who underwent LABF were retrospectively analyzed.The intraoperative procedures and postoperative outcome were evaluated.Results LABF was performed successfully in 17 of 18 patients.The mean operation time was (280 ±57) minutes,with a mean aortic cross-clamp time of (117 ±32) minutes.Estimated blood loss was(524 ±45) ml.Mean ICU stay was ( 1.0 ± 1.2) days.The mean postoperative hospital stay was ( 10 ±5) days.Mean time to resume diet was (3 ± 3 ) days.Postoperative myocardial infarction developed in 1 case,lung infection in 2 cases.There was no perioperative mortality.Graft thrombosis developed in 1 case and embolectomy surgery was successfully performed.All patients were followed up from 3 to 27 months,with mean follow-up of (18 ± 8) months,grafts were all patent.Conclusions Laparoscopic aortic bypass is feasible and miniinvasive in patients with diffuse aortoiliac occlusive disease.Short-term outcomes are comparable to those with open conventional aortic bypass.

Objective To analyse the clinical significance of variable deceleration and extended deceleration in non-stress test. Methods Studied the clinical characteristics of variable deceleration and extended deceleration of 200 cases who underwent non-stress test from January 2005 to December 2007, and compared corresponding clinical significance and newborn prognosis. Results Variable deceleration and extended deceleration in non-stress test dued to cord entanglement, polyhydramnios and fetal growth restriction. The occurrence of fetal distress and severe asphyxia in nowbom were less in low-grade variable deceleration (8.3%, 1.0%) than those in high-grade variable deceleration (17.7%, 4.8%)and extended deceleration (23.8%, 7.1%). Condusion Variable deceleration and extended deceleration in non-stress test due to cord entanglement mostly, low-grade variable deceleration is not always clue to fetal distress and high-grade variable deceleration and extended deceleration is often clue to fetal distress.