2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

Objective:To investigate the effects of two anastomosis methods on perioperative and pathological outcomes during totally laparoscopic right hemicolectomy (TLRH).Methods:In a national multicenter snapshot study, 1,854 patients who underwent laparoscopic right hemicolectomy were enrolled from 52 tertiary hospitals across China. The post-hoc analysis based on this study compared the data of 303 patients who underwent TLRH. Patients were divided into the antiperistaltic group (33 cases) and the isoperistaltic group (270 cases) according to type of anastomosis. Due to the significant difference in sample size between the two groups, propensity score matching (PSM) was performed to eliminate the influence of baseline characteristic discrepancies. The matching was based on the following known confounding factors: age, gender, body mass index (BMI), history of abdominal surgery, and history of diabetes, with a caliper value of 0.2. Perioperative and pathological outcomes were compared between the two groups.Results:After PSM, 33 patients were included in the antiperistaltic group and 65 patients in the isoperistaltic group. There were no statistically significant differences in baseline data between the two groups (all P>0.05). No significant differences were observed between the two groups in terms of operation time, blood loss, time to first defecation, time to first oral intake, or the incidence and grading of complications either (all P>0.05). However, length of postoperative hospital stay in the isoperistaltic group was significantly shorter than that in the antiperistaltic group, however (7.0 [6.0, 9.0] days vs. 8.0 [7.0, 10.5] days, P=0.049). In terms of pathological outcomes, there were also no statistically significant differences between the two groups in the number of harvested lymph nodes or the number of positive lymph nodes (all P>0.05). Conclusions:The two digestive tract reconstruction modalities, antiperistaltic and isoperistaltic anastomosis, have comparable perioperative safety and efficacy in TLRH. The isoperistaltic group had better outcomes in terms of postoperative hospital stay.

Objective:To investigate the effects of two anastomosis methods on perioperative and pathological outcomes during totally laparoscopic right hemicolectomy (TLRH).Methods:In a national multicenter snapshot study, 1,854 patients who underwent laparoscopic right hemicolectomy were enrolled from 52 tertiary hospitals across China. The post-hoc analysis based on this study compared the data of 303 patients who underwent TLRH. Patients were divided into the antiperistaltic group (33 cases) and the isoperistaltic group (270 cases) according to type of anastomosis. Due to the significant difference in sample size between the two groups, propensity score matching (PSM) was performed to eliminate the influence of baseline characteristic discrepancies. The matching was based on the following known confounding factors: age, gender, body mass index (BMI), history of abdominal surgery, and history of diabetes, with a caliper value of 0.2. Perioperative and pathological outcomes were compared between the two groups.Results:After PSM, 33 patients were included in the antiperistaltic group and 65 patients in the isoperistaltic group. There were no statistically significant differences in baseline data between the two groups (all P>0.05). No significant differences were observed between the two groups in terms of operation time, blood loss, time to first defecation, time to first oral intake, or the incidence and grading of complications either (all P>0.05). However, length of postoperative hospital stay in the isoperistaltic group was significantly shorter than that in the antiperistaltic group, however (7.0 [6.0, 9.0] days vs. 8.0 [7.0, 10.5] days, P=0.049). In terms of pathological outcomes, there were also no statistically significant differences between the two groups in the number of harvested lymph nodes or the number of positive lymph nodes (all P>0.05). Conclusions:The two digestive tract reconstruction modalities, antiperistaltic and isoperistaltic anastomosis, have comparable perioperative safety and efficacy in TLRH. The isoperistaltic group had better outcomes in terms of postoperative hospital stay.

Objective To investigate the role of quality control circle management guided by Party building philosophy in improving patient satisfaction in emergency services.Methods Quality control circle management guided by the Party building philosophy was implemented in May 2023.Two groups of 1 000 emergency patients each were selected,one from April to May 2023(pre-implementation)and the other from April to May 2024(post-implementation).The control group and the observation group were compared across several metrics in terms of satisfaction scores,satisfaction rates,120 emergency call response time,3-minute pre-hospital emergency dispatch rates,and average waiting times for emergency observation patients.Results The ob-servation group demonstrated higher satisfaction scores,satisfaction rates,and higher 3-minute pre-hospital emergency dispatch rates compared to the control group.Additionally,the observation group had shorter emergency call response time and average waiting time in the emergency department,with statistically significant differences(P＜0.05).Conclusion The integration of quality control circle management guided by Party construction philosophy in the management of emergency patients has been shown to address operational issues,optimize service processes,and significantly improve patient satisfaction and experience.This method is worthy of broader application and promotion in clinical practice.

Emamectin·chlorfenapyr is insecticide compounded by emamectin benzoate and chlorfenapyr. There is no special antidote after poisoning, and the mortality rate of patients is very high. We admitted a case of toxic encephalopathy caused by oral administration of emamectin·chlorfenapyr. The clinical manifestations of patient were gastrointestinal symptoms, profuse sweating, high fever, changes in consciousness. After admitted to the hospital, despite active comprehensive treatment, the patient died of ineffective rescue eventually.

Emamectin·chlorfenapyr is insecticide compounded by emamectin benzoate and chlorfenapyr. There is no special antidote after poisoning, and the mortality rate of patients is very high. We admitted a case of toxic encephalopathy caused by oral administration of emamectin·chlorfenapyr. The clinical manifestations of patient were gastrointestinal symptoms, profuse sweating, high fever, changes in consciousness. After admitted to the hospital, despite active comprehensive treatment, the patient died of ineffective rescue eventually.

Objective:To explore the application effect of the tutorial system combined with one minute preceptor (OMP) in the standardized residency training of emergency medicine.Methods:A total of 48 residents who trained in the Department of Emergency, Zaozhuang Municipal Hospital Affiliated to Jining Medical College from January 2017 to December 2019 for ≥ 3 months were assigned randomly into control group ( n=24) and observation group ( n=24). The control group were given the traditional teaching mode only; while the observation group were given the tutorial system combined with OMP teaching mode, that was, a tutor was assigned to each training resident, and the teaching and training was carried out according to the teaching plan. After the rotation, the graduation examination was conducted, and the differences between the two groups were compared. SPSS 22.0 software was used for t test. Results:The clinical skills examination scores of the control and observation group were (47.50±3.91) points and (43.80±6.52) points respectively, with significant differences between the two groups ( t=2.42, P=0.020). The clinical operation technology examination scores of the control and observation group were (80.00±6.51) points and (75.10±6.19) points respectively, with significant differences between the two groups ( t=2.68, P=0.010). The clinical skills score and operation techniques score of the residents in the observation group were significantly better than those in the control group, and both were better than before training. Conclusion:The new training method of tutorial system combined with OMP can improve the clinical skills and operation techniques of the emergency residents significantly, which is worth being popularized and applied in clinical teaching.

A 69-year-old male patient was given pituitrin 24 U dissolved in 0.9% sodium injection for continuous intravenous pump once per 12 hours for alcoholic cirrhosis complicated by upper gastrointestinal hemorrhage. At the same time, omeprazole, octreotide, hemocoagulase, plasma, and symptomatic and supportive treatments were given conventionally. On the second day, the patient developed tongue swelling. Considering that it might be related to therapeutic drugs, intravenous injection of dexamethasone 5 mg and intramuscular injection of promethazine 25 mg were given. Due to the improvement of bleeding symptoms, pituitrin was stopped and other drugs continued to be used. Eight days later, black stool recurred in the patient and pituitrin was given again. The next day, the patient had tongue swelling again, which was improved after the same treatments. The patient′s tongue swelling was considered as angioedema caused by pituitrin.

A 69-year-old male patient was given pituitrin 24 U dissolved in 0.9% sodium injection for continuous intravenous pump once per 12 hours for alcoholic cirrhosis complicated by upper gastrointestinal hemorrhage. At the same time, omeprazole, octreotide, hemocoagulase, plasma, and symptomatic and supportive treatments were given conventionally. On the second day, the patient developed tongue swelling. Considering that it might be related to therapeutic drugs, intravenous injection of dexamethasone 5 mg and intramuscular injection of promethazine 25 mg were given. Due to the improvement of bleeding symptoms, pituitrin was stopped and other drugs continued to be used. Eight days later, black stool recurred in the patient and pituitrin was given again. The next day, the patient had tongue swelling again, which was improved after the same treatments. The patient′s tongue swelling was considered as angioedema caused by pituitrin.