Objective:To translate the Triage Risk Screening Tool (TRST) into Chinese and to test its reliability and validity among older patients in the emergency department.Methods:The Brislin translation model was used to translate and back-translate the English version of the TRST. After cultural adaptation and pre-testing, and subsequently, the final Chinese version of the TRST (TRST-C) was formed. Using the convenience sampling method, a questionnaire survey was conducted on 174 elderly patients who visited the emergency department of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University to verify the reliability and validity of the scale.Results:The item-level content validity index and the scale-level average content validity index were 0.89-1.00 and 0.978, respectively. Exploratory factor analysis extracted 2 common factors, and the cumulative variance explanation rate was 63.095%. Using 2 points as the threshold for high risk of adverse outcomes. The sensitivity of TRST-C for 30-day death, emergency department readmission, rehospitalization and composite adverse outcomes were 94.4%, 81.8%, 84.6% and 84.9% respectively, and the negative predictive values were 98.3%, 86.4%, 86.4% and 76.3%, respectively. The Cronbach α coefficient and the Guttman split-half reliability of the TRST-C were 0.639 and 0.669, respectively. The Kappa coefficient was 0.911. Conclusions:The TRST-C has good reliability and validity, which can screen elderly patients of emergency department at risk of adverse outcomes.

Objective:To translate the Triage Risk Screening Tool (TRST) into Chinese and to test its reliability and validity among older patients in the emergency department.Methods:The Brislin translation model was used to translate and back-translate the English version of the TRST. After cultural adaptation and pre-testing, and subsequently, the final Chinese version of the TRST (TRST-C) was formed. Using the convenience sampling method, a questionnaire survey was conducted on 174 elderly patients who visited the emergency department of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University to verify the reliability and validity of the scale.Results:The item-level content validity index and the scale-level average content validity index were 0.89-1.00 and 0.978, respectively. Exploratory factor analysis extracted 2 common factors, and the cumulative variance explanation rate was 63.095%. Using 2 points as the threshold for high risk of adverse outcomes. The sensitivity of TRST-C for 30-day death, emergency department readmission, rehospitalization and composite adverse outcomes were 94.4%, 81.8%, 84.6% and 84.9% respectively, and the negative predictive values were 98.3%, 86.4%, 86.4% and 76.3%, respectively. The Cronbach α coefficient and the Guttman split-half reliability of the TRST-C were 0.639 and 0.669, respectively. The Kappa coefficient was 0.911. Conclusions:The TRST-C has good reliability and validity, which can screen elderly patients of emergency department at risk of adverse outcomes.

Objective:To systematically review the profile of lymph node dissection (LND) for patients with intrahepatic cholangiocarcinoma (ICC) in China.Methods:Using the key words "intrahepatic cholangiocarcinoma" "intrahepatic cholangiocellular carcinoma" "lymph node dissection" "lymphadenec-tomy" "lymph node metastasis", the databases including China Zhiwang, Wanfang, Weipu, Sinomed, PubMed, Embase, Web of Science, Scopus, Cochrane Library were systematically searched. Cohort studies or randomized controlled clinical trials with intraoperative LND documentation and with analysis on the clinicopathologic characteristics or prognostic influences on patients with ICC were included into this meta-analysis from the date of database creation to April 20, 2022. The risk of bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A meta-analysis of preoperative imaging lymph node enlargement rates, LND rates, and pathological lymph node metastasis rates were performed using R software.Results:Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective cohort studies. All these publications were of medium to high quality. Patients’ enrollment ranged from 1993 to 2020. Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278 patients. The meta-analysis indicated that the LND rate, preoperative imaging lymph node enlargement rate, pathological lymph node metastasis rate were 47.8%(95% CI: 41.3%-54.3%), 18.5%(95% CI: 7.5%-29.6%) and 51.2%(95% CI: 43.8%-58.6%), respectively. Subgroup analysis showed the LND rate was 36.0%(95% CI: 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI: 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI: 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of patient enrollment ( P=0.032). Conclusion:The meta-analysis indicated that the overall LND rate for ICC in China was not high but showed an increasing tendency.

Objective:To analyze the tendency of incidence and mortality of mechanical injuries among Chinese residents from 1990 through 2019 and to estimate the age-period-cohort effect.Methods:Based on the Global Burden of Disease (GBD) 2019 database, the incidence and mortality data of mechanical injuries among Chinese residents from 1990 to 2019 were extracted. The trends of age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of mechanical injuries among Chinese residents by gender was analyzed using the joinpoint regression model, and the annual percent change (APC) and average annual percent change (AAPC) were calculated. The age-period-cohort model was used to quantitatively assess the effects of age, period, and cohort on ASIR and ASDR for mechanical injuries.Results:① Overall tendency: from 1990 to 2019, the ASIR of mechanical injuries showed an increasing trend (540.95/100 000 in 1990 vs. 815.34/100 000 in 2019), and the ASDR first increased slightly and then decreased (2.62/100 000 in 1990 vs. 2.87/100 000 in 2005 vs. 1.77/100 000 in 2019) among Chinese residents. During the observation period, ASIR and ASDR for mechanical injuries of male were higher than female. ② Joinpoint regression model analysis showed that the ASIR of mechanical injuries had a fluctuating trend of increasing first and then decreasing and then rising rapidly among Chinese residents from 1990 to 2019 (AAPC = 1.42%, t = 9.59, P < 0.001). The ASIR of the Chinese male showed a slight decrease and then continued to increase (AAPC = 1.47%, t = 8.72, P < 0.001), while the ASIR of the Chinese female showed a rapid rising at first, then rapidly declining and then rising again (AAPC = 1.31%, t = 12.11, P < 0.001). From 1990 to 2019, the ASDR of mechanical injuries showed a fluctuating downward trend of first decreasing, then increasing, and then rapidly decreasing among Chinese residents (AAPC = -1.39%, t = -6.72, P < 0.001). The decrease rate of ASDR among male was as same as that among all population (AAPC = -1.44%, t = -7.29, P < 0.001), but the decrease rate of ASDR in female was relatively slow (AAPC = -1.08%, t = -4.54, P < 0.001). ③ Age-period-cohort model analysis showed that, with the increase of age, the risk of mechanical injuries among the overall population, male and female in China increased, then decreased, and then increased rapidly. The first small peak was at the age of 45-49 years old in male and 65-69 years old in female. The overall death risk showed an increasing trend with age, with a slowly increasing trend before 75 years old, and a sudden increase after 75 years old. The peak age of death risk was between 90 and 94 years. In terms of period effect, the risk of mechanical injuries showed a gradually increasing trend with time among the overall population, male, and female in China, and the risk of death showed a trend of decreasing first and then rapidly increasing and then decreasing. In terms of cohort effect, the risk of mechanical injuries among the overall population, male, and female in China showed a gradual upward trend with the increase in the birth year, and the risk of death showed an M-shaped trend. Conclusions:From 1990 to 2019, the incidence of mechanical injuries showed an increasing trend, and the mortality increased first and then decreased. Although the disease burden has improved, it is still high. More attention needs to be paid to the prevention and control of mechanical injuries, especially in the young population.

Objective To evaluate the effect of anisodamine in the air reduction for child intussusception. Methods Repeating the air reduction method for child intussusception after 20-30 min, muscular injection of anisodamine 5 mg, in 550 failure patients with routine air reduction method. Results 468 cases of intussusception persisted after routine air reduction were undergone second air reduction after administation of anisodamine with all outcoming of successful reduction. Other 82 cases still remained with intussusception after repeating the same procedure with anisodamine injection including 2 perforation cases; all were then undertaken surgical operation. Conclusion Air reduction for child intessusception with anisodamine is an easy and effective method ought to be recommanded.