To summarize the emergency nursing experience of 1 patient with neck suicide complicated with airway obstruction and hemorrhagic shock.Nursing points:to ensure airway safety and establish artificial airway;to optimize airway management and implement early sedation and wake-up;to control injury bleeding and limited fluid resuscitation;to establish a micro blood station in the emergency department and start a high-dose blood transfusion procedure;to carry out the refined target body temperature management to reduce complications;to optimize speech communication strategies and implement early psychological care.After 7 days of careful treatment and nursing,the patient's condition improved and recovered.After 2 months of follow-up,the patient recovered well.

Objective To explore the application effect of promoting excellence and reflective learning in the full-process situational simulation training of team collaboration in the emergency departments,and to provide a reference for cultivating clinical nursing talents.Methods Stratified random sampling combined with sequential substitution method was adopted to conduct situational simulation training for 56 nurses in the emergency department from October to December 2024.The method of promoting excellence and reflective learning was used for guiding feedback,including 5 steps:pre-feedback,response,description,analysis,and summary.The clinical reasoning and reflection ability,clinical practice ability and teamwork ability of nurses were compared before and after the training.Results After the training,nurses improved in all dimensions of clinical reasoning and self-assessment ability of reflection(P＜0.001).The theoretical examination and team operation assessment scores of nurses were improved compared with those before the training(P＜0.001).The leadership,teamwork ability,overall evaluation and total score of nurses were all improved compared with those before the training(P＜0.05).Conclusion The use of promoting excellence and reflective learning for training in the scenario simulation of team collaboration in the emergency departments is helpful to improve nurses' clinical reasoning and reflection ability,clinical practice ability and teamwork ability

Objective To explore the application effect of promoting excellence and reflective learning in the full-process situational simulation training of team collaboration in the emergency departments,and to provide a reference for cultivating clinical nursing talents.Methods Stratified random sampling combined with sequential substitution method was adopted to conduct situational simulation training for 56 nurses in the emergency department from October to December 2024.The method of promoting excellence and reflective learning was used for guiding feedback,including 5 steps:pre-feedback,response,description,analysis,and summary.The clinical reasoning and reflection ability,clinical practice ability and teamwork ability of nurses were compared before and after the training.Results After the training,nurses improved in all dimensions of clinical reasoning and self-assessment ability of reflection(P＜0.001).The theoretical examination and team operation assessment scores of nurses were improved compared with those before the training(P＜0.001).The leadership,teamwork ability,overall evaluation and total score of nurses were all improved compared with those before the training(P＜0.05).Conclusion The use of promoting excellence and reflective learning for training in the scenario simulation of team collaboration in the emergency departments is helpful to improve nurses' clinical reasoning and reflection ability,clinical practice ability and teamwork ability

To summarize the emergency nursing experience of 1 patient with neck suicide complicated with airway obstruction and hemorrhagic shock.Nursing points:to ensure airway safety and establish artificial airway;to optimize airway management and implement early sedation and wake-up;to control injury bleeding and limited fluid resuscitation;to establish a micro blood station in the emergency department and start a high-dose blood transfusion procedure;to carry out the refined target body temperature management to reduce complications;to optimize speech communication strategies and implement early psychological care.After 7 days of careful treatment and nursing,the patient's condition improved and recovered.After 2 months of follow-up,the patient recovered well.

Objective To exploring the correlation between the expression level of serum carbohydrate antigen 211(CA211)and the number of natural killer(NK)cells and prognosis in non-small cell lung cancer(NSCLC)pa-tients.Methods 132 NSCLC patients admitted to the Affiliated Hospital of Hangzhou Normal University from June 2019 to July 2022 were selected as the test group,and 132 patients with benign lung lesions during the same period were selected as the control group.Data were collected from the laboratory to analyze the relationship between serum CA211 expression and NK cell count in NSCLC with clinical prognosis,as well as the related factors affecting the prognosis of NSCLC patients.Results The neutrophil to lymphocyte ratio(NLR)and serum CA211 expression in the test group were higher than those in the control group(P＜0.05),while the count of NK cells was less than that in the control group(P＜0.05);The expression level of serum CA211 in the test group was negatively cor-related with the count of NK cells(r=-0.405,P＜0.001);There were significant differences in lymph node metastasis and TNM staging among patients with different levels of serum CA211 expression and NK cell count(P＜0.05);The one-year survival rate of patients with low expression of CA211 was significantly higher than that of patients with high expression of CA211(P＜0.05),and the one-year survival rate of patients with high count of NK cells was higher than that of patients with low count of NK cells(P＜0.05);Lymph node metasta-sis,TNM staging and CA211 level were all risk factors affecting the prognosis of NSCLC patients(P＜0.05),while counting of NK cells was protective factor for the prognosis of NSCLC patients(P＜0.05).Conclusions The level of serum CA211 and the number of NK cells in NSCLC patients are closely related to pathological characteristics and clinical prognosis.

Objective In order to improve the"high-dose blood transfusion procedure",shorten the preparation time for blood transfusion in patients with clinical traumatic hemorrhagic shock,and improve the outcome of patients.Methods Patients with emergency traumatic hemorrhagic shock from January to December 2021 were selected as the study subjects.Patients who received improved high-dose transfusion procedures from July to December were selected as the experimental group,and patients who received conventional transfusion procedures from January to June were selected as the control group.The timeliness indexes and outcome indexes of the 2 groups were compared.Results The delivery time for blood type and routine examination was shortened from 15 min to 8 min(U=143.50,P=0.024);transfusion preparation time was shortened from 31 min to 19 min(U=126.50,P=0.026);the time for decision-making blood preparation was shortened from 44 min to 18 min(U=152.50,P=0.007);emergency stay time was shortened from 135 min to 114 min(U=91.50,P=0.036);the outcome distribution of patients(x2=10.64,P=0.031)was improved.Conclusion The improved high-dose blood transfusion procedure can significantly shorten the blood transfusion preparation time for patients with traumatic hemorrhagic shock and improve the treatment rate of patients.

Objective: To investigate the diagnosis value of myocardial work (MW) in evaluating left ventricular global systolic function among acute myocardial infarction (AMI) patients with preserved ejection fraction (LVEF). Methods: This study was a diagnostic trial in a prospective case-control design. AMI patients with preserved LVEF were enrolled as AMI(LVEF>50%) group and age and sex-matched healthy individuals undergoing healthy checkup in our hospital were collected as control group. Two-dimensional dynamic images, including standard apical two-chamber, long-axis and four-chamber views in 3 consecutive cardiac cycles were acquired. General clinical data, routine echocardiography and myocardial work parameters were obtained from all subjects. The indices were compared between the two groups. Intra-observer and inter-observer repeatability of myocardial work parameters were evaluated by intra-group correlation coefficient (ICC). Receiver operator characteristic (ROC) curve was used to determine the diagnostic value of global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global work index (GWI) on the reduction of left ventricular global systolic function in AMI(LVEF>50%) group. Results: There were 30 patients in AMI(LVEF>50%) group, the age was (67.3±9.7)years, and 14 cases were female(46.7%). Thirty participants were included in the control group, the age was (68.1±8.6)years, and 12 cases were female (40.0%). Compared with the control group, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septum thickness (IVSD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak early diastolic velocity of mitral orifice/tissue Doppler velocity of posterior mitral annulus (E/e), left ventricular mass (LVM), left ventricular mass index (LVMI) were significantly higher, while E and e values were significantly lower in AMI (LVEF>50%) group (all P<0.05). Compared with the control group, GCW ((1 145.9±440.1)mmHg% (1 mmHg=0.133 kPa) vs. (1 425.7±355.4)mmHg%), GWE ((80.9±9.5)% vs. (87.3±5.5)%), GWI ((1 001.3±416.2)mmHg% vs. (1 247.6±341.7)mmHg%) and the absolute value of long axis integral strain (GLS) ((8.5±3.4)% vs. (11.4±3.7)%) were significantly lower, while peak strain dispersion(PSD)((101.3±66.4)ms vs. (74.7±31.9)ms) was significantly higher in AMI(LVEF>50%) group (P all<0 05). There was no significant difference in GWW((177.2±71.1)mmHg% vs. (155.7±64.6)mmHg%) between the two groups (P>0.05). The reproducibility of GCW, GWW, GWE and GWI within and between observers were satisfactory (all ICC>0.75). ROC curve analysis showed that all four parameters, GCW, GWW, GWE, and GWI, could be used for the diagnosis of reduced left ventricular systolic function in patients with AMI (LVEF>50%), and their areas under the ROC curve were 0.896,0.929,0.808,0.862. Conclusion: Myocardial work assessment is valuable on diagnosing left ventricular global systolic function reduction in AMI patients with preserved LVEF.
Female ; Humans ; Myocardial Infarction/diagnostic imaging* ; Reproducibility of Results ; Stroke Volume ; Systole ; Ventricular Function, Left

OBJECTIVE: To investigate the effect of EBV-DNA copy number on the prognosis of patients with EBV positive lymphoma. METHODS: Clinical data of 109 patients diagnosed as EBV positive lymphoma in Tianjin Medical University Cancer Institute and Hospital from January 2010 to January 2020 were enrolled and analyzed retrospectively. Kaplan-Meier analysis was used for survival analysis, Log-rank was used to compare the clinical characteristics between the patients in different groups, and Cox regression was used for multivariate analysis. RESULTS: Among the 109 patients with EBV-positive lymphoma, the medium age were 56 (range 15 to 83) years old. 29 patients at Ann Arbor stage I-II while 80 patients at stage III-IV. The average value of EBV-DNA was 1 023 510 IU/ml, 7 patients were higher than the average value, while 102 patients were lower. KM survival analysis showed that OS and PFS in patients with EBV-DNA above average level were shorter than those in patients with EBV-DNA below average level (OS: P=0.048, PFS: P=0.001), EBV-DNA copy number was a factor affecting the prognosis of patients. In addition, LDH level showed positive correlation with EBV-DNA copy number (r=0.650), which was also one of the factors affecting OS (P=0.053). CONCLUSION EBV-DNA copy number and LDH level can influence the prognosis of EBV positive lymphoma patients. Therefore, detection of EBV-DNA copy number in peripheral blood is important for evaluate the prognosis the patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; DNA Copy Number Variations ; DNA, Viral ; Herpesvirus 4, Human ; Humans ; Lymphoma ; Middle Aged ; Retrospective Studies ; Young Adult

Objective: To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus. Methods: The clinical data of 117 patients with type 2 diabetes mellitus from January 2016 to June 2017 in Anhui No.2 Provincial People′s Hospital were analyzed retrospectively. According to the eGFR level, the patients were divided into 3 groups: eGFR ≥ 90 ml/(min·1.73 m²) in 68 cases (DM0 group), eGFR 60 to 89 ml/(min·1.73 m²) in 33 cases (DM1 group), and eGFR<60 ml/(min·1.73 m²) in 16 cases (DM2 group). In addition, 30 healthy people in the same period were selected as control group (NC group), eGFR ≥ 90 ml/(min·1.73 m²). The systolic blood pressure, diastolic blood pressure, blood routine, glycosylated hemoglobin (HbA₁c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), urea nitrogen, creatinine and uric acid were recorded; and the NLR was calculated. The influencing factors of eGFR in patients with type 2 diabetic mellitus were analyzed, and the relationship between NLR and eGFR was evaluated. Results: Compared with that in NC group and DM0 group, the eGFR in DM1 group and DM2 group was significantly lower: (75.12 ± 8.14) and (46.31 ± 13.25) ml/(min·1.73 m²) vs. (114.17 ± 12.21) and (113.21 ± 12.04) ml/(min·1.73 m²), the NLR was significantly higher: 2.50 ± 1.16 and 2.75 ± 1.39 vs. 1.53 ± 0.22 and 1.83 ± 0.65, and there were statistical differences (P<0.05). Compared with that in DM1 group, the eGFR in DM2 group was significantly lower, the NLR was significantly higher, and there were statistical differences (P<0.05). There were no statistical differences in NLR and eGFR between DM0 group and NC group (P>0.05). Correlation analysis result showed that NLR, age, course of disease, systolic blood pressure, TC, HDL-C, urea nitrogen, creatinine and uric acid were negatively correlated with eGFR (r=-0.415, -0.555, -0.491, -0.432, -0.259, -0.237, -0.584, -0.840 and -0.261; P < 0.05); gender, diastolic pressure, HbA₁c, TG and LDL-C were not correlated with eGFR (P > 0.05). Multiple linear regression analysis result showed that NLR, age, TC, creatinine and systolic blood pressure were independent risk factors of eGFR in patients with type 2 diabetes mellitus (P<0.01 or < 0.05). Conclusions There is a close relationship between the increase of NLR and the decrease of eGFR in patients with type 2 diabetes mellitus. Monitoring NLR is helpful to understand the changes of eGFR in patients with type 2 diabetes mellitus.

Congenital infiltrating lipomatosis of the face is a rare disorder resulting from overgrowth of adipose tissues. This condition presents gradually with swelling along with age, hypertrophy of adjacent bones, and tooth abnormalities. This study reports a case of congenital infiltrating lipomatosis of face with seizures and reviews relevant literature on the etiology, clinical symptom, diagnosis, and treatment of this condition.
Adipose Tissue ; Face ; Humans ; Lipomatosis ; complications ; Seizures ; complications