1.Retrospective cross-sectional study on 701 cases of acute poisoning patients in the Tongliao area
Baoquan GONG ; Jiriga ULIJI ; Yingchun SHAN
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2023;30(5):606-612
		                        		
		                        			
		                        			Objective To analyze the spectrum of poisoning diseases in the Tongliao area,and provide the scientific basis for standardized treatment of acute poisoning and formulation of toxin control strategies in this area.Methods A retrospective cross-sectional study method was conducted,clinical data of acute poisoning patients admitted to the emergency center(department of emergency)of Inner Mongolia University for Nationalities Affiliated Hospital from January 1,2018 to December 31,2022,were collected through the hospital information system(HIS),including gender,age,marital status,regional distribution,poisoning routes,cultural level,poisoning cause,seasonal distribution,occupation,past medical history,types of toxic drugs,and number of patients undergoing blood purification treatment.Analyze the disease spectrum characteristics of patients with different prognosis,gender,age,region,seasonal distribution and occupational poisoning,and observe the changes in treatment costs for acute poisoning patients of different types of poisoning.Pearson correlation analysis were used to analyze the correlation between gender,age,occupation,past medical history,poisoning routes,cause of poisoning,treatment methods(gastric lavage,blood purification),season,and total hospitalization expenses.Results A total of 701 patients with acute poisoning were enrolled,including 335 outpatients and 366 inpatients.The ratio of males to females was 1∶1.49,and the average age was(43.23±19.39)years old.①Gender characteristics:there was no significant difference in the growth rate of male and female cases of sexual poisoning over the past 5 years(P>0.05).There was a statistically significant difference in the acute poisoning spectrum between males and females(χ2 = 39.75,P = 0.000);②In terms of age:acute poisoning patients were concentrated in those over 30 years old,with an average age of(52.41±14.47)years.Among them,169 cases(24.11%)over 60 years old were the most common.There was statistical significance in the comparison of poisoning spectra among patients of different age groups(χ2 = 87.57,P = 0.000);③ Past medical history:previous medical history has a significant impact on acute poisoning.In this study,244 cases(34.81%)had a previous medical history,of which 85 cases(34.84%)had a history of mental illness.Among the 47 cases of poisoning caused by psychotropic drugs;④Regional distribution:Horqin District had the highest number of acute poisoning patients(340 cases),while Huolingol City had the lowest number(5 cases).There were statistically significant differences in the number of acute poisoning patients in different regions(χ2 = 74.820,P = 0.034);⑤Seasonal characteristics:poisoning months were concentrated in May,June,July,August,and September,pesticide poisoning was concentrated in May,July,and August,and therapeutic drug poisoning was concentrated in June,July,August,and October;food poisoning mainly occurs in August and September;⑥ Occupational characteristics:farmers and herdsmen had the highest incidence of acute poisoning(63.33%),while retirees had the lowest incidence of poisoning(1.71%).There were statistically significant differences in the spectrum of occupational poisoning among different professions(χ2 = 86.130,P = 0.000);⑦ Treatment cost:pesticide poisoning and food poisoning have the highest per capita cost;⑧ Correlation analysis:correlation analysis showed that the total cost of treatment was significantly positively correlated with toxic drugs and blood purification(r = 0.105,0.678,P = 0.044,0.000),and negatively correlated with seasons(r =-0.125,P = 0.017).It was not correlated with gender,age,occupation,history,poisoning routes,poisoning cause,and gastric lavage(r values were 0.077,0.078,-0.025,0.036,0.069,-0.073,0.004,all P>0.05);⑨Types and prognosis of toxins:therapeutic drugs(54.07%)and pesticides(37.95%)were the most common types of toxins.The main therapeutic drugs were sedatives and hypnotics(32.72%)and antipyretic analgesics(22.69%);pesticide poisoning was mainly caused by herbicides(31.20%),rodenticides(27.44%),and organophosphorus insecticides(24.81%).Poisoning routes mainly due to gastrointestinal intake(97.43%);545 cases(77.75%)were cured and improved,146 cases(20.83%)were not cured,and 10 cases(1.42%)died.There is no statistically significant difference in overall prognosis among different types of poisoning(χ2 = 10.380,P = 0.239).The blood purification treatment rate was 27.39%.Conclusion Acute poisoning in the Tongliao area has regional characteristics.The main causes were emergency stimuli such as arguments and alcohol consumption,as well as intentional poisoning caused by mental and neurological diseases such as anxiety,depression,sleep disorders,and cerebrovascular diseases.Reducing accessibility is crucial for the control of local toxins.
		                        		
		                        		
		                        		
		                        	
2.Impact of dispatcher-assisted cardiopulmonary resuscitation on survival after out-of-hospital cardiac arrest: A Meta-analysis
Pengcheng ZHAO ; Qingyun GONG ; Di WANG ; Baoquan LI ; Rui XU ; Chunyu LI ; Chao BI ; Yanbin DONG ; Jinsong ZHANG ; Yan CHEN
Chinese Journal of Emergency Medicine 2022;31(4):487-496
		                        		
		                        			
		                        			Objective:To evaluate the outcome of the patients receiving dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) delivered by first-responders who witnessed the out-of-hospital cardiac arrest (OHCA) before the Emergency Medical Service (EMS) arrived.Methods:We performed a search of the relevant literature exploring major scientific databases. We assessed the quality of the included cohort study according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Meta-analysis was performed on three outcome indicators (recovery of spontaneous circulation survival to hospital discharge and survival with favourable neurologic outcome) using the Revman5.3 software.Results:A total of 21 studies with 349 822 patients were selected for the meta-analysis, including 182 125 patients in the DA-CPR group and 167 697 in the CPR-only group. The meta-analysis showed no significant difference between the DA-CPR and CPR-only groups in ROSC [ RR=1.10, 95% confidence interval ( CI): 0.94-1.29, P=0.24], survival to hospital discharge ( RR=1.10, 95% CI: 0.90-1.34, P=0.34) and survival with favourable neurologic outcome ( RR=1.01, 95% CI: 0.79-1.28, P=0.97) of the patients in America, Japan and Korea. However, there was a significant difference between the DA-CPR and the CPR-only groups in ROSC ( RR=2.61, 95% CI:1.53-4.46, P=0.0005), survival to hospital discharge( RR=6.08, 95% CI: 1.84-20.04, P=0.003), and survival with favourable neurologic outcome( RR=9.76, 95% CI: 1.87-51.02, P=0.007) of the patients in China. Conclusions:The overall effect of DA-CPR is significantly different for each country. In detail, DA-CPR offers a survival advantage (Return of spontaneous circulation, survival to hospital discharge and survival with favourable neurologic outcome) over CPR alone in China but no advantage in developed countries.
		                        		
		                        		
		                        		
		                        	
3.Comparison of the effect of PFNA and ALP in the treatment of elder patients with femoral intertrochanteric fracture
Chinese Journal of Primary Medicine and Pharmacy 2018;25(14):1863-1865
		                        		
		                        			
		                        			Objective To compare the clinical effects of PFNA and ALP in the treatment of elder patients with femoral intertrochanteric fracture.Methods The clinical data of 52 elder patients with femoral intertrochanteric fracture in the Second People's Hospital of Huoqiu County from March 2011to November 2017 were retrospectively analyzed.According to the different operation method,the patients were divided into PFNA group(treated with PFNA) and ALP group(treated with ALP),with 26cases in each group.The operation time,the amount of bleeding,healing time of fracture,postoperative complications,the function of hip joint and incidence of adverse reactions were com-pared between the two groups.Results The operative Time[(80.1±6.3)min],intraoperative bleeding[(156.2 ± 4.7)mL],bed time[(20.3 ±2.9)d]and fracture healing time[(77.3 ±3.2)d]in the PFNA group were significantly lower than those in the ALP group,the differences were statistically significant(all P<0.05).The Harris Assessment scores of the PFNA group was (87.30 ±6.18)points,the excellent rate of the PFNA group was 92.3%,while the Harris Assessment scores of the ALP group was (76.77 ±4.59 )points,the excellent rate of the ALP group was 80.77%,the difference was statistically significant in the excellent rate(χ2=0.019,P<0.05).The incidence of adverse reactions of the PFNA group was 0.00%,which was lower than 7.69%of the ALP group (P<0.05 ). Conclusion The proximal femoral intramedullary nail (PFNA)is effective in the treatment of intertrochanteric fracture of the elderly,with better fixation strength,smaller operative trauma,faster fracture healing and lower adverse reaction rate.
		                        		
		                        		
		                        		
		                        	
            
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