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.

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.

We report a case of a male patient who developed persistent fever and central nervous system symptoms after eating raw snails for 10 days. The patient was diagnosed with Angiostrongyliasis depended on the clinical presentation, epidemiological history, and etiological results. The patient recovered after receiving albendazole anthelmintic and dexamethasone anti-inflammatory therapy. This article incorporates literature review to sort out the diagnosis and treatment of this patient, in order to provide feasible reference for clinicians.

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.

We report a case of a male patient who developed persistent fever and central nervous system symptoms after eating raw snails for 10 days. The patient was diagnosed with Angiostrongyliasis depended on the clinical presentation, epidemiological history, and etiological results. The patient recovered after receiving albendazole anthelmintic and dexamethasone anti-inflammatory therapy. This article incorporates literature review to sort out the diagnosis and treatment of this patient, in order to provide feasible reference for clinicians.

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 investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblastic dif-ferentiation (GCED). Methods: A retrospective analysis of 337 patients with gastric adenocarcinoma diagnosed by the pathology de-partment of the First Affiliated Hospital of Zhejiang University in March 2013-2017 was conducted. Of them, 8 patients were diag-nosed with gastric carcinoma with intestinal blastocyte differentiation. All the patients were elderly, including 6 men and 2 women. The onset age was 68-83 years (mean 76.6 years). Two cases had serum AFP≥200 μg/L before treatment. According to the histopatho-logical morphology, the immunophenotype was analyzed by immunohistochemistry, the SALL4 gene was detected using reverse tran-scription-polymerase chain reaction (RT-PCR), and the relevant literature was reviewed. Results: Microscopically, all cases had primi-tive enteroid structures, consisting of cubic or columnar cells with clear cytoplasm, and immunohistochemical staining showed positivi-ty for either AFP and GPC3 or SALL4. The expression of SALL4 mRNA was significantly increased by RT-PCR. Follow-up from 1 to 5 years showed that 5 patients had liver and other organ metastases, 2 patients died, and 1 patient survived without a tumor. Conclusions:GCED is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma. The treatment of general intestinal adenocarcinoma has little effect. There are some characteristic changes in histology. It would be helpful for diag-nosis and differential diagnosis if clinicians are familiar with the tumor spectrum and genetic characteristics. Target therapy for an origi-nal marker, such as SALL4, has a bright future.