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 the longitudinal relationship between sleep duration(SD)and positive youth development(PYD)among primary and secondary school students in Chengdu city using a cross-lagged model,and to provide scientific evidence for enhancing sleep management practices for students.Methods A total of 4061 students of grades 3 through 9 from the Chengdu Child Positive Development Cohort were included in this three-wave longitudinal study.There was a one-year interval between one survey and the following round of survey,and the time points for the baseline,12-month follow-up,and 24-month follow-up surveys were designated T0,T1,and T2.The PYD of the participants was assessed using the Chinese version of the Positive Youth Development Scale.The demographic data and the average daily SD over the past month were collected.Spearman correlation analysis was performed to examine the associations between SD and PYD,and a cross-lagged model was used to investigate the longitudinal relationship between them.Results The average daily SD for the 3 rounds of surveys conducted at T0,T1,and T2 was 9.00(8.04,10.00)hours,10.44(9.67,11.11)hours,and 10.39(9.83,11.00)hours,respectively,while the PYD scores were 5.30(4.73,5.71),5.27(4.73,5.73),and 5.39(4.89,5.77),respectively.Statistical significance was found in the differences of SD and PYD scores across the 3 rounds(P＜0.05).Spearman correlation analysis revealed synchronous correlations between SD and PYD at all three time points(r=0.10 at T0,r=0.18 at T1,and r=0.21 at T2,P＜0.05)and significant lagged correlations(e.g.,r=0.10 for T1-PYD and T2-SD,and likewise,significant correlation was found for the 3 other cross-lagged paths).The cross-lagged model demonstrated that PYD at T0 and T1 positively predicted SD at T1 and T2,respectively(β0-1=0.116[95％CI,0.083-0.150],β1-2=0.097(95％CI,0.067-0.127),P＜0.05),and that SD at T0 and T1 also positively predicted PYD at T1 and T2(β0-1=0.028[95％CI,0-0.056],β1-2=0.042[95％CI,0.010-0.074],P＜0.05).According to these findings,a bidirectional predictive relationship between SD and PYD across different time points was observed in primary and secondary school students.Furthermore,PYD demonstrated better performance for predicting SD than SD did for PYD.Subgroup analysis by sex confirmed the robustness of the predictive power of PYD for SD.Conclusion This study reveals a positive bidirectional predictive relationship between SD and PYD among primary and secondary school students,suggesting that higher levels of PYD may contribute to adequate sleep.These findings provide critical scientific evidence for schools and families to strengthen sleep management and promote the holistic development and well-being of adolescents.

BACKGROUND:The patient underwent multiple hypoproteinemia after total hip arthroplasty,which affected postoperative healing and rehabilitation.OBJECTIVE:To investigate and screen the risk factors for hypoproteinemia after total hip arthroplasty,and to establish a nomogram prediction model so as to provide guidance for judging whether hypoproteinemia occurs after total hip arthroplasty.METHODS:A total of 355 patients who underwent total hip arthroplasty were included,and according to whether hypoproteinemia occurred on the first day after surgery,they were divided into 238 cases in the hypoproteinemia group and 117 cases in the normal group,with a hypoproteinemia rate of 67％.Data were collected,including age,gender,diabetes mellitus,hypertension,hyperuricemia,hyperlipidemia,anesthesia method,preoperative leukocytes,preoperative erythrocytes,preoperative hemoglobin,preoperative platelets,preoperative plasma prothrombin time,preoperative activated partial prothrombin time,preoperative international normalized ratio,preoperative thrombin time,preoperative fibrinogen,preoperative erythrocyte sedimentation rate,preoperative C-reactive protein,preoperative D-dimer,preoperative mean corpuscular hemoglobin content,preoperative mean corpuscular volume,operation time,body mass index,preoperative procalcitonin,and preoperative hematocrit.SPSS 27.0 software was used for univariate analysis,followed by R language(4.3.1)to perform least absolute shrinkage and selection operator regression and 10-fold cross-validation of the observation indicators to obtain the intersection of the two risk factors.SPSS 27.0 software was used to perform multivariate binary logistic regression to obtain the final risk factors.The prediction model of hypoproteinemia after total hip arthroplasty was constructed by R language.The receiver operating characteristic curve,calibration curve,and clinical decision curve were constructed to assess the predictive model predictive ability.RESULTS AND CONCLUSION:(1)Univariate analysis,least absolute shrinkage and selection operator regression,and multivariate logistic regression were used to screen out significant differences in age(OR=1.024,P=0.023),preoperative platelets(OR=0.995,P=0.028),and preoperative erythrocyte sedimentation rate(OR=1.031,P=0.045)in judging whether hypoproteinemia would occur after surgery(P＜0.05).(2)The nomogram prediction model was constructed based on the final risk factors screened by multivariate Logistic regression,and the prediction ability of the model was evaluated by constructing the receiver operating characteristic curve,and the area under the calculated receiver operating characteristic curve reached 0.835(95％CI=0.779-0.891),C-index=0.835.A threshold of 0-0.83 could bring better clinical efficacy calculated by the decision curve analysis.The model has good sensitivity and accuracy,which can better identify the risk of postoperative hypoproteinemia for medical staff and patients before total hip arthroplasty.

The precise and rapid monitoring of multiple organ dysfunction is crucial in drug discovery. Traditional methods, such as pathological analysis, are often time-consuming and inefficient. Here, we developed a multiplexed near-infrared window two (NIR-II) fluorescent bioimaging method that allows for real-time, rapid, and quantitative assessment of multiple organ dysfunctions. Given that existing probes did not fully meet requirements, we synthesized a range of NIR-II hemicyanine dyes (HDs) with varying absorption and emission wavelengths. By modifying these dyes, we achieved high spatial and temporal resolution imaging of the liver, kidneys, stomach, and intestines. This method was further applied to investigate disorders induced by cisplatin, a drug known to cause gastric emptying issues along with liver and kidney injuries. By monitoring the metabolic rate of the dyes in these organs, we accurately quantified multi-organ dysfunction, which was also confirmed by gold-standard pathological analysis. Additionally, we evaluated the effects of five aristolochic acids (AAs) on multiple organ dysfunction. For the first time, we identified that AA-I and AA-II could cause gastric emptying disorders, which was further validated through transcriptomics analysis. Our study introduces a novel approach for the simultaneous monitoring of multi-organ dysfunction, which may significantly enhance the evaluation of drug side effects.

BACKGROUND:The patient underwent multiple hypoproteinemia after total hip arthroplasty,which affected postoperative healing and rehabilitation.OBJECTIVE:To investigate and screen the risk factors for hypoproteinemia after total hip arthroplasty,and to establish a nomogram prediction model so as to provide guidance for judging whether hypoproteinemia occurs after total hip arthroplasty.METHODS:A total of 355 patients who underwent total hip arthroplasty were included,and according to whether hypoproteinemia occurred on the first day after surgery,they were divided into 238 cases in the hypoproteinemia group and 117 cases in the normal group,with a hypoproteinemia rate of 67％.Data were collected,including age,gender,diabetes mellitus,hypertension,hyperuricemia,hyperlipidemia,anesthesia method,preoperative leukocytes,preoperative erythrocytes,preoperative hemoglobin,preoperative platelets,preoperative plasma prothrombin time,preoperative activated partial prothrombin time,preoperative international normalized ratio,preoperative thrombin time,preoperative fibrinogen,preoperative erythrocyte sedimentation rate,preoperative C-reactive protein,preoperative D-dimer,preoperative mean corpuscular hemoglobin content,preoperative mean corpuscular volume,operation time,body mass index,preoperative procalcitonin,and preoperative hematocrit.SPSS 27.0 software was used for univariate analysis,followed by R language(4.3.1)to perform least absolute shrinkage and selection operator regression and 10-fold cross-validation of the observation indicators to obtain the intersection of the two risk factors.SPSS 27.0 software was used to perform multivariate binary logistic regression to obtain the final risk factors.The prediction model of hypoproteinemia after total hip arthroplasty was constructed by R language.The receiver operating characteristic curve,calibration curve,and clinical decision curve were constructed to assess the predictive model predictive ability.RESULTS AND CONCLUSION:(1)Univariate analysis,least absolute shrinkage and selection operator regression,and multivariate logistic regression were used to screen out significant differences in age(OR=1.024,P=0.023),preoperative platelets(OR=0.995,P=0.028),and preoperative erythrocyte sedimentation rate(OR=1.031,P=0.045)in judging whether hypoproteinemia would occur after surgery(P＜0.05).(2)The nomogram prediction model was constructed based on the final risk factors screened by multivariate Logistic regression,and the prediction ability of the model was evaluated by constructing the receiver operating characteristic curve,and the area under the calculated receiver operating characteristic curve reached 0.835(95％CI=0.779-0.891),C-index=0.835.A threshold of 0-0.83 could bring better clinical efficacy calculated by the decision curve analysis.The model has good sensitivity and accuracy,which can better identify the risk of postoperative hypoproteinemia for medical staff and patients before total hip arthroplasty.

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 design an intelligent and healthy light environment scheme in intensive care unit(ICU)from the experience perspective of nurses,and evaluate its effect on improving nurses'visual perception and work efficiency.Methods According to the Standard for Lighting Design of Buildings(GB50034-2013),reconstruction was performed from the 3 aspects of basic layout,intelligent lighting,and simulated natural light.Then,the usage experience of nurses was investigated via semi-structured interview.By combining the interview results with illuminance and color temperature,the changing curve of light effect was described to finally determine the optimal strategy and form the healthy light environment.Thirty nurses in emergency ICU(EICU)of The First Hospital of Jiaxing before the application of intelligent and healthy light environment from July to October 2023 were selected as the control group,and 30 nurses after the application of intelligent and healthy light environment from January to March 2024 were selected as the observation group.The visual fatigue score of nurses,the completion time of single venipuncture,the occurrence rate of risk events,and the difference in satisfaction of light environment in ICU were compared before and after the establishment of intelligent and healthy light environment.Results After being on duty,the visual fatigue score of nurses in both groups obviously increased,but the scores in the observation group was significantly lower compared to the control group(14.77±2.99 vs.38.43±4.67,P<0.05).Additionly,the completion time of single venipuncture in the observation group was evidently shorter than that in the control group(minutes:4.93±1.82 vs.14.87±2.50,P<0.05),the occurrence rate of risk events in the observation group was remarkably lower than that in the control group[3.33%(1/30)vs.20.00%(6/30),P<0.05],and the satisfaction of light environment in the observation group was distinctly higher than that in the control group[93.33%(28/30)vs.66.67%(20/30),P<0.05].Conclusions Aiming at the special work scenario in ICU,this paper designed intelligent scene lighting and created a bright,comfortable,safe,and healthy light environment,which could effectively relieve nurses'visual fatigue,improve the efficiency and quality of nursing work,and enhance their clinical work experience.Additionally,it provided data support and design strategies for the sound environmental development of ICU.

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 design an intelligent and healthy light environment scheme in intensive care unit(ICU)from the experience perspective of nurses,and evaluate its effect on improving nurses'visual perception and work efficiency.Methods According to the Standard for Lighting Design of Buildings(GB50034-2013),reconstruction was performed from the 3 aspects of basic layout,intelligent lighting,and simulated natural light.Then,the usage experience of nurses was investigated via semi-structured interview.By combining the interview results with illuminance and color temperature,the changing curve of light effect was described to finally determine the optimal strategy and form the healthy light environment.Thirty nurses in emergency ICU(EICU)of The First Hospital of Jiaxing before the application of intelligent and healthy light environment from July to October 2023 were selected as the control group,and 30 nurses after the application of intelligent and healthy light environment from January to March 2024 were selected as the observation group.The visual fatigue score of nurses,the completion time of single venipuncture,the occurrence rate of risk events,and the difference in satisfaction of light environment in ICU were compared before and after the establishment of intelligent and healthy light environment.Results After being on duty,the visual fatigue score of nurses in both groups obviously increased,but the scores in the observation group was significantly lower compared to the control group(14.77±2.99 vs.38.43±4.67,P<0.05).Additionly,the completion time of single venipuncture in the observation group was evidently shorter than that in the control group(minutes:4.93±1.82 vs.14.87±2.50,P<0.05),the occurrence rate of risk events in the observation group was remarkably lower than that in the control group[3.33%(1/30)vs.20.00%(6/30),P<0.05],and the satisfaction of light environment in the observation group was distinctly higher than that in the control group[93.33%(28/30)vs.66.67%(20/30),P<0.05].Conclusions Aiming at the special work scenario in ICU,this paper designed intelligent scene lighting and created a bright,comfortable,safe,and healthy light environment,which could effectively relieve nurses'visual fatigue,improve the efficiency and quality of nursing work,and enhance their clinical work experience.Additionally,it provided data support and design strategies for the sound environmental development of ICU.