To investigate the effect of integrated emergency nursing process on the rescue effect of patients with acute myocardial infarction (AMI).

Ninety AMI patients admitted to Xi'an International Medical Center Hospital from August 2023 to October 2024 were selected as the research subjects, including 48 males and 42 females; The age ranged from 41 to 70 years, with an average of (60.28±7.63) years. According to the random number method, they were divided into an observation group and a control group, with 45 cases in each group. The control group received routine emergency care procedures, while the observation group received integrated medical and nursing emergency care procedures. The time nodes related to emergency treatment, including onset to balloon dilation, first medical contact to balloon dilation, hospital gate to balloon dilation, and onset to hospital gate, pre- and post-emergency cardiac function indicators, including left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD), major adverse cardiovascular events (MACE) during hospitalization, and nursing satisfaction were compared between two groups of patients.

The time of onset-to-ballooning, first medical contact-to-ballooning, hospital gate-to-ballooning and onset-to-hospital gate in the observation group was shorter than that in the control group (P<0.05). Compared with the same group before first-aid, LVEF was significantly increased and LVEDD was significantly decreased in both groups after first-aid (P<0.05). After first-aid, LVEF in the observation group was significantly higher than that in the control group, and LVEDD was significantly lower in the control group (P<0.05). The incidence of major adverse cardiovascular events (MACE) during hospitalization in the observation group was lower than in the control group, and the nursing satisfaction was higher than the control group (P<0.05).

Integrated emergency nursing is helpful to improve the prognosis of AMI patients, shorten the emergency process, promote the recovery of cardiac function, reduce the incidence of MACE, and improve nursing satisfaction.

To explore the preventive effect of four-step rehabilitation program combined with motivational interview on acute attack after discharge in elderly patients with heart failure.

A prospective study was conducted on 126 elderly patients with HF admitted to the First Affiliated Hospital of Shihezi University from March 2023 to July 2024. They were divided into the control group and the study group according to the random number table method, with 63 cases in each group. The control group received routine rehabilitation guidance on the basis of routine management, and the study group received four-step rehabilitation program combined with motivational interview on the basis of routine management. Cardiac function [(Left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume (SV), 6-min walking distance (6MWD)], Chinese version of Heart Failure Self-care Scale, compliance score, Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) were compared between the two groups before intervention, at discharge and 3 months after discharge, and the acute attacks within 6 months after discharge were compared between the two groups.

Before intervention, there were no differences in cardiac function, Chinese version of Heart Failure Self-care Scale, compliance score and MLHFQ score between the two groups (P>0.05). At discharge and 3 months after discharge, the LVEF, CO, SV, 6MWD, SCHFI score and compliance score of the study group were higher or greater than those of the control group, and the MLHFQ score was lower than that of the control group (P<0.05). At the last follow-up, the acute attack rate of the study group was lower than that of the control group (P<0.05).

Four-step rehabilitation program combined with motivational interview can significantly improve the cardiac function of elderly HF patients and reduce the number of acute attacks after discharge.

To compare the effects of different emergency nursing methods in endoscopic treatment of patients with acute upper gastrointestinal bleeding.

A total of100 patients with acute upper gastrointestinal bleeding admitted to the Fifth Hospital of Huangshi City from January 2022 to December 2024 were selected; there were 55 males and 45 females, the age ranged from 27 to 65 years old, with an average of (46.03±10.23) years. They were randomly divided into an observation group and a control group, with 50 patients in each group, using a random number table. The control group received routine perioperative care, while the observation group received perioperative dual track emergency care, both of which continued until the patient was discharged. The hemostatic outcomes (immediate hemostasis success, rebleeding within 72 hours, and conversion to surgical intervention) were compared between the two groups, and the changes in self-rating depression scale (SDS), self-rating anxiety scale (SAS), hemoglobin (Hb), albumin (ALB), and prealbumin (PA) before endoscopic treatment and discharge, as well as the length of hospital stay, hospitalization costs, and nursing satisfaction were compared.

The observation group had a rebleeding rate within 72 hours of 2.00%, which was lower than the control group's 14.00% (P<0.05). At discharge, the SDS and SAS scores of the observation group were (36.04±3.51) points and (37.46±4.02) points, both of which were lower than those of the control group (40.27±3.92) points and (41.85±4.15) points (P<0.05). At discharge, the Hb, ALB, and PA levels in the observation group were (128.32±15.23) g/L, (40.11±3.52) g/L, and (225.69±15.32) mg/L, all higher than those in the control group (121.57±11.05) g/L, (36.87±3.20) g/L, and (213.25±13.07) mg/L (P<0.05). The hospitalization time and hospitalization expenses of the observation group were (6.35±1.83) days and (0.86±0.09) yuan, both of which were shorter/less than those of the control group (7.60±1.24) days and (0.92±0.13) yuan (P<0.05). The overall satisfactory rate of the observation group with nursing care was 94.00%, which was higher than the control group's 78.00% (P<0.05).

Perioperative dual track emergency nursing can help reduce the rebleeding rate of patients with acute upper gastrointestinal bleeding undergoing endoscopic treatment, alleviate negative emotions, and improve nutritional status. It is worthy of clinical promotion.

To analyze the infection status and preventive measures of multidrug resistant organism (MDRO) in patients with oral and maxillofacial trauma.

A retrospective analysis was conducted on the medical records of 71 hospitalized MDRO patients with oral and maxillofacial trauma received by Huangshi Hospital of Traditional Chinese Medicine from January 2023 to February 2025, including 41 males and 30 females, the age ranged from 22 to 71 years, with an average of (53.01±7.95) years. During the same period, 78 patients with oral and maxillofacial trauma admitted to our hospital who were hospitalized but did not have MDRO infection were selected as the control group, including 37 males and 41 females, the age ranged from 20 to 73 years, with an average of (55.30±8.42) years. The distribution and drug resistance of pathogenic bacteria in MDRO infected patients were detected, and the distribution of infection sites was analyzed., and the risk factors of MDRO infection in patients with oral and maxillofacial trauma were analyzed by univariate and multivariate logistic regression analysis.

A total of 78 strains of MDRO were detected in 71 patients with oral and maxillofacial trauma, mainly Escherichia coli, MRSA and Klebsiella pneumoniae. The resistance of Escherichia coli and Klebsiella pneumoniae to cephalosporins, quinolones and sulfonamides was high, and the resistance of methiclococcus aureus to penicillins, macrolides and lincoamides was high. Univariate analysis showed that the rates of open injury, use of antibiotics ≥3 kinds, use of antibiotics ≥7 days, stay ≥10 days in MDRO patients hospitalized with oral and maxillofacial trauma were higher than those in the control group (P<0.05). Multivariate logistic regression analysis showed that open injury, use of antibiotics ≥3 kinds, use of antibiotics ≥7 d, and hospital stay ≥10 d were the risk factors for oral and maxillofacial trauma inpatient MDRO infection (P<0.05).

The MDRO in patients with oral and maxillofacial trauma is mainly composed of gram-negative bacteria, which is mostly associated with wound and lower respiratory tract infection, and is related to multiple risk factors. Clinical preventive countermeasures should be strengthened.

To compare the effects of intravascular ultrasound (IUVS) and optical coherence tomography (OCT) guided emergency percutaneous coronary intervention (PCI) on acute myocardial infarction.

A total of 80 patients with acute myocardial infarction admitted to our hospital from May 2023 to November 2024 were divided into IUVS group and OCT group, with 40 cases in each group; there were 47 males and 33 females, the age ranged from 51 to 73 years, with an average of (63.51±6.59) years. Emergency PCI under IVUS guidance was performed in the IVUS group, while emergency PCI under OCT guidance was performed in the OCT group. The preoperative characteristics of lesions (plaque rupture, plaque erosion, lipid and fibrous plaques, and calcified nodules), preoperative coronary conditions [minimum lumen area (MLA), reference vessel diameter, minimum lumen diameter, lesion length, and bifurcation lesion], perioperative situation (number of stent placement, intraoperative dilation times, minimum stent area after stent placement, stent placement success rate, and length of hospital stay), detection rate of immediate stent implantation defects after PCI (stent mal-expansion, poor adhesion, immediate thrombosis, marginal dissection, and tissue prolapse), the incidence of major adverse cardiovascular events (MACE) 30 days after surgery (angina pectoris, recurrent myocardial infarction, and malignant arrhythmias) were compared between the two groups.

The plaque rupture and plaque erosion in OCT group were higher than that in the IVUS group (P<0.05); the MLA, reference vessel diameter, minimum lumen diameter, lesion length and bifurcation lesion were compared between the two groups, with statistically significant (P>0.05); the intraoperative dilation times in OCT group were more than that in IVUS group, and the hospital stay was shorter than that in IVUS group (P<0.05); the total detection rate of stent implantation defects immediately after PCI in OCT group was higher than that in IVUS group (P<0.05); there was no statistical significance in the total incidence of 30dMACE between the two groups (P>0.05).

Compared with IVUS, OCT-guided emergency PCI is better in the treatment of patients with acute myocardial infarction, which can effectively identify the nature of preoperative lesions and improve the detection rate of poor stents, shorten hospital stay, and is worthy of clinical promotion.

基孔肯雅热是由基孔肯雅病毒（CHIKV），引起的蚊媒传染病，主要通过埃及伊蚊和白纹伊蚊叮咬传播。典型症状包括突发高热（39℃以上）、剧烈关节痛（可持续数月）、皮疹，与登革热相比关节症状更突出，但出血风险较低。预防是关键，防蚊灭蚊要注意以下几点：（1）个人防护：①使用含避蚊胺（DEET）的驱蚊剂，穿浅色长袖衣裤。②家中安装纱窗、蚊帐，及时清理积水（花盆、轮胎等）。（2）旅行注意：①前往东南亚、非洲等流行区前查询疫情，携带驱蚊用品。②回国后14 d内发热伴关节痛，立即就医并告知旅居史。（3）社区防控：①政府通过病例监测、灭蚊行动和公众教育降低传播风险。误区澄清：（1）不会人传人，但感染者被蚊叮咬可导致二次传播。（2）大蒜/维生素B防蚊无效，认准正规驱蚊产品。紧急提示：若出现疑似症状，尽早就医并拨打疾控热线12320咨询。科学防蚊，远离疾病！

To explore the role of forsythoside A (FA) in regulating neutrophil extracellular traps (NETs) and alleviating sepsis-related ARDS, as well as its possible mechanism.

A total of 80 mice were randomly divided into sham, model (CLP), FA, and FA+PPAR-γ groups. A sepsis-induced lung injury mice model was established using the classic cecal ligation and puncture (CLP) procedure. The sham group underwent only laparotomy. siPPAR-γ (10 nmol/20g) was administered via tail vein injection (twice a week for 2 weeks), while FA was administered via intraperitoneal injection (80 mg/kg, once daily for 3 days). After successful model establishment, Kaplan-Meier survival curves were used to analyze the cumulative 7-day survival rate of 10 mice per group. For the remaining mice, six per group were randomly selected to collect lung tissue. Inflammatory factors (TNF-α, IL-6, IL-1β) and NET markers (NE-DNA, MPO-NDA) were detected using ELISA kits. SOD, MDA, and ROS levels were measured by spectrophotometry. The lung wet/dry weight (W/D) ratio was calculated. Pathological changes were observed under light microscope after H&E staining, and lung injury histopathological scoring was conducted. Immunofluorescence was used to detect H3-cit protein expression in lung tissue. Western blotting was performed to measure the relative expression levels of PPAR-γ, H3-cit, MPO, and NE proteins.

Kaplan-Meier survival curve analysis revealed that the 7-day cumulative survival rate in the FA group was significantly higher than in the CLP and FA+PPAR-γ groups (P<0.05). The CLP group showed partial alveolar destruction, thickened alveolar septa, extensive inflammatory cell infiltration, alveolar and partial alveolar hyaline membrane formation, and alveolar collapse. In the FA group, H&E staining showed significant reduction in inflammatory cell infiltration, thinner alveolar septa, and less alveolar collapse. Compared to the sham group, the CLP group exhibited higher lung injury histopathological scores and W/D ratios (P<0.05), increased levels of inflammation factors (TNF-α, IL-6, IL-1β, P<0.05), elevated NE-DNA and MPO-NDA expressions (P<0.05), increased MDA and ROS levels (P<0.05), and decreased SOD levels (P<0.05). PPAR-γ protein expression was reduced (P<0.05), while H3-cit, MPO, and NE protein expressions were elevated (P<0.05). Compared to the CLP group, the FA group showed lower lung injury histopathological scores and W/D ratios (P<0.05), decreased levels of inflammatory factors (TNF-α, IL-6, IL-1β, P<0.05), reduced NE-DNA and MPO-NDA expression (P<0.05), lower MDA and ROS levels (P<0.05), higher SOD levels (P<0.05), and increased PPAR-γ protein expression (P<0.05). H3-cit, MPO, and NE proteins were reduced (P<0.05).

Forsythoside A alleviates sepsis-related ARDS by activating PPAR-γ to inhibit the formation of neutrophil extracellular traps.

To understand the first-aid knowledge, attitude and behavior level of employees in township enterprises, as well as the safety management status of enterprises, aimed to provide guidance for improving the health emergency response ability of enterprises.

From June to December 2024, the convenient sampling method was used to select employees of township enterprises in Kunshan City as the research object. The first-aid knowledge, attitude and behavior questionnaires were used for investigation; the persons in charge of enterprise safety management were Interviewed and a questionnaire was made based on the type of emergency equipment in the operating environment, quantity, usage, and the willingness of employees to receive first aid knowledge training.

A total of 3,388 employees participated in the pre-hospital first aid knowledge questionnaire, with a first-aid knowledge score of (15.23±2.14), a first-aid attitude score of (38.45±5.67), and a first-aid behavior score of (28.20±4.95); Different training experiences had statistical significance for the differences in first-aid knowledge and behavior scores. The P values were 0.001 and 0.002, respectively. There was no statistical significance for the difference in first-aid attitude score, with a (P>0.05); Questionnaires on the safety management status of 39 enterprises were prepared. Enterprises set up 100% of security personnel, and 58.97% of security personnel received first-aid training. The proportion of AED for first-aid equipment in enterprises was 25.64%, and the AED training rate of enterprise employees was 90.00%.

The first-aid knowledge of employees in township enterprises is at a medium and low level, and their first-aid attitude and behavior are at a medium level. The number and type of first-aid equipment configured by enterprises and the training of employees on the use of first aid equipment are insufficient. Safety management positions meet the requirements of fixed personnel, fixed number, fixed post, fixed responsibility and regular training. It is necessary for enterprises to strengthen the transformation of safety personnel training achievements and formulate reasonable first-aid training and drills for all personnel to improve their ability to cope with accidental injuries.

To investigate the relationship between dynamic changes in neutrophil-to-lymphocyte ratio (NLR) and the occurrence of disseminated intravascular coagulation (DIC) in patients with severe pneumonia.

A total of 340 patients with severe pneumonia hospitalized in Changzhou Second People's Hospital from January 2019 to December 2023 were retrospectively analyzed, and the cohort comprised 264 males and 76 females, aged 28 to 101 years, with a mean age of 73.56±13.65 years. These patients were divided into non-DIC (n=271) and DIC (n=69) groups based on complications. The generalized estimation equation was used to analyze the time-alone effect and the intergroup main effect of NLR in two groups; Logistic regression was used to analyze the effect of NLR on DIC at different time points, and the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of dynamic NLR in the development of DIC in patients with severe pneumonia.

The results of the generalized estimation equation showed that there was no statistical difference in NLR between DIC patients and non-DIC patients when they entered the emergency room, but the NLR of DIC patients gradually increased with time, while the NLR of non-DIC patients gradually decreased (P<0.001). Multivariate Logistic regression analysis showed that NLR 24 hours, 48 hours and 72 hours after admission were all risk factors for severe pneumonia complicated with DIC (P<0.05). ROC curve analysis showed that NLR (AUC=0.75) at 72 hours after admission was higher than that at 24 hours (AUC=0.60) and 48 hours (AUC=0.63).

Persistent hyperinflammatory response leads to DIC in patients with severe pneumonia. Dynamic changes in NLR can help in early identification of the risk of DIC in severe pneumonia.

创伤性凝血病世界性的治疗难题，全球每年因创伤死亡的患者人数现已超过800万。创伤后早期死亡与无法控制的出血及创伤失血后凝血障碍有关。尽管近几年来创伤凝血病急救医学得到发展，但是国内外的专家们还没有找到一种简便、有效的创伤凝血病治疗方案，死亡率仍居高不下。国际常规治疗包括尽早检测凝血功能、使用止血药、补充钙剂、成分输血等。

目前南京医科大学第三附属医院岳茂兴首席专家工作站科技团队独创了具有我国自主知识产权的"维生素B6联用20AA复方氨基酸创新疗法"，为创伤凝血病及急危疑难病患者的治疗开辟了简便、廉价、实用、有效的新途径。本团队从动物实验到临床救治对创伤凝血病的发生机理、防治进行创新性研究与转化。基础研究与临床救治证实：维生素B6联用20AA复方氨基酸新疗法具有抗休克、抗中毒、抗肺水肿、抗脑水肿、抗MODS（五抗）及止血与改善凝血功能的作用，获美、欧、中多国专利。