To analyze the rescue process after a bus was rear-ended by a cement tanker in Tongzhou District, to review and analyze the start of emergency plan, dispatch and command, on-site emergency rescue, and to summarize rescue experience in order to improve pre-hospital medical rescue and agency's ability to rescue a bus fire in a public emergency.

A retrospective analysis was conducted on the rescue process of the fire incident after a bus was rear-ended by a cement truck on September 22 in Tongzhou District, Beijing, including information reception, ambulance dispatch, on-site triage, information reporting, triage hospital, four-station linkage, basic information of the wounded, the classification of the disease, degree of the wounded, time-consuming of each state of the ambulance and the number of the wounded transferred.

A total of 5 ambulances were sent to the rescue. The overall rescue work took a total of 77 minutes. All 18 patients were safely and timely transferred to the hospital and received further treatment, 4 patients with moderate degree of injuries were in stable condition after treatment in hospital, the overall deployment work was smooth, and the rescue was timely and effective.

To strengthen the construction of 120 emergency medical system, to advance the intelligence and informationization of dispatch system, and to strengthen the training and drilling of pre-hospital first aid team in dealing with public emergencies, it is of great significance to the pre-hospital first aid of batch of wounded in public emergency.

To clearly identify the clinical practice and outcome of 1-hour bundle of sepsis in emergency department.

A retrospective cohort analysis was carried out in this study. Patients with septic shock who had been admitted to the emergency department of Zhongda Hospital Affiliated to Southeast University between September 1, 2021 and August 31, 2023 were included. The diagnosis of sepsis or septic shock was according to the criteria of sepsis and septic shock from 2021 Surviving Sepsis Campaign Guidelines. The study subjects were divided into completed group and incompleted group according to that 1- hour bundle was performed or not. Pertinent clinical data including patients’ age, gender, basic diseases and clinical prognosis were collected. Furthermore, SOFA and APACHEⅡ scoring were performed in each patient. Statistical software SPSS 23.0 was used for analysis.

A total of 526 emergency patients were diagnosed with septic shock during the study period. 316 patients were included in the final analysis after screening. The median age of the whole population was 71.0 years and 52.8% were male. The most frequent primary sites of infection were pulmonary, the biliary system and the abdomen. In enrolled patients, the 1-hour bundle was performed in only 15.5% who were included in the completed group. Among the remaining patients, there was one and more treatments was not finished. Fluid resuscitation(74.37%, 235/267) ranked the first place. Secondly, blood culture was conducted before using antibiotics(46.84%, 148/267). Broad-spectrum antimicrobial agents using was the third common unfinished treatment. A total of 104 (32.8%) patients with septic shock died during hospitalization and the median length of hospital stay was 10 days. There were no significant statistical differences in ICU hospitalization, length of hospital stay and hospital mortality between the completed group and the incompleted group. Compared with only one therapy unfinished group, the hospital mortality of two or more unfinished group was increased(35.2% vs. 32.5%), but without statistical differences hospital mortality (P>0.05).

The compliance rate of sepsis 1- hour bundle therapyis still relatively low in emergency department. A poor prognosis may be associated with delays to the initiation of 1-hour bundle therapy. Improvements require further training and quality management for sepsis 1-hour bundle therapy.

To explore the application effect of emergency pre-screening triage standard in the triage of emergency trauma patients, to provide a reference of rapid and accurate triage for emergency trauma patients and to find out relevant factors to improve the ability of pre-screening triage nurses, and then make pre-screening triage management better.

A total of 600 trauma patients were selected from the Department of Emergency, Wuzhou Hospital affiliated to Youjiang Medical University For Nationalities and divided into different groups according to the time of arrival. 300 trauma patients who visited from April to September 2021 were set as the control group, including 211 males and 89 females, and the average age was(50.10±16.48 )(14-97) years; and 300 trauma patients who visited from October 2021 to March 2022 were set as the observation group, including 200 males and 100 females, and the average age was(50.27±17.71)(14-97) years. The control group used conventional triage methods, while the observation group used emergency pre-examination triage standards for triage, waiting, reception and disposal. The pre-examination triage time, waiting time for diagnosis and treatment, emergency response time and triage accuracy between two groups of emergency trauma patients were analyzed and compared.

The overall triage accuracy of the observation group was 96.3%, significantly higher than that of the control group (88.0%), the difference was statistically significant (P<0.01). The pre-treatment triage time for acute trauma in the observation group was gradeⅠ(3.18 minutes), gradeⅡ(3.22 minutes), gradeⅢ(3.35 minutes), and gradeⅣ(3.72 minutes); treatment waiting time was gradeⅠ(4.00 minutes), gradeⅡ(6.15 minutes), gradeⅢ(11.62 minutes), and gradeⅣ(12.76 minutes); emergency response time was gradeⅠ(2.09 minutes), gradeⅡ(3.59 minutes), gradeⅢ(10.38 minutes), and grade Ⅳ(12.28 minutes); all of which were less than the pre-treatment triage time in the control group, which was gradeⅠ(4.07 minutes), gradeⅡ(4.20 minutes), gradeⅢ(3.93 minutes), and gradeⅣ(3.80 minutes); treatment waiting time was gradeⅠ(4.79 minutes). The difference in emergency response time was statistically significant (P<0.05).

Rapid and accurate triage based on the standard of emergency pre-examination is crucial to ensure that acute trauma patients receive emergency treatment in time.

To explore the feasibility of transcranial color Doppler ultrasound (TCCD) to monitor the changes of cerebral blood flow in patients with different intraoperative blood pressure and carbon dioxide partial pressure.

Thirty patients with laparoscopic elective surgery were selected, including 16 males and 14 females, aged 25~70 years, with an average age of (57lective surgery were selectedtranscranial Doppler and TCCD were used to measure the middle cerebral artery blood flow spectrum of all the patients, and to monitor cerebral oxygen saturation (rcSO₂) throughout the process after anesthesia. At the same time, TCCD was used to measure and calculate cerebral blood flow after anesthesia induction at the time point of when the blood pressure was normal, P_ETCO₂ was ect mmHg (T1), 35 mmHg-45 mmHg (T2), and ti mmHg (T3), respectively; when the blood pressure decreased by more than 30%, P_ETCO₂ was ect mmHg (T4), 35 mmHg-45 mmHg (T5) and o45 mmHg (T6), respectively.

Compared with the normal blood pressure, the cerebral arterial blood flow decreased significantly when the blood pressure decreased by more than 30% (F=49.73, P<0.010). When the blood pressure was maintained, with the gradual increase of P_ETCO₂, the cerebral arterial blood flow also gradually increased (F=50.33, P<0.010), and blood pressure had an interaction with the influence of P_ETCO₂ (F=3.21, P<0.050). TCCD had a good correlation with TCD and rcSO₂.

TCCD can effectively monitor the changes of intraoperative cerebral blood flow in real time, and has a good correlation with TCD, rcSO₂, and therefore it has good clinical application value.

To investigate the effects of health management based on behavior change wheel (BCW) and health belief model on prevention and control of first-episode ischemic stroke (IS).

A total of 248 first-time IS patients who were hospitalized in the Department of Neurology at the First People's Hospital of Xuzhou from January 2019 to December 2021 were selected and randomly divided into a control group and an observation group using a random number table method, with 124 patients in each group. The control group received routine nursing care and follow-up in neurology, while the observation group received health management based on BCW and HBM models on this basis. Before and after intervention, the self-management ability of stroke patients was evaluated using the self management behavior scale, the cognitive level of IS was evaluated using a self-designed disease cognition survey questionnaire, the health behavior was evaluated using the Chinese version of the HPLP-II Health Promotion Lifestyle Scale, and the neurological deficits of patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS) score. A stroke patient treatment compliance survey scale was designed 6 months after discharge to investigate treatment compliance and stroke recurrence rate.

There was no statistically significant difference in the scores of the self-management behavior scale, stroke cognitive level, and health behavior score between the two groups before intervention (P>0.05). After intervention, the dimensions of the self-management behavior scale, stroke cognitive level, and health behavior score in the observation group were higher than those before intervention and the control group during the same period (P<0.05). The NIHSS score of the observation group after intervention was lower than that of the control group (P<0.05). The treatment compliance rate of the observation group was higher than that of the control group (P<0.05). The recurrence rate of stroke in the observation group was lower than that in the control group.

Health management based on BCW theory and HBM can improve the self-management ability and stroke cognition level of first-onset IS patients, regulate health behavior, improve treatment compliance, reduce stroke recurrence, and benefit patient health and disease control.

To investigate the expression characteristics and clinical significance of serum sPD-1/L1 and interferon-γ expression in patients with acute coronary syndrome.

This study retrospectively included 73 patients admitted to the emergency department of Beijing Electric Power Hospital from November 2020 to October 2022. All patients were divided into a control group and a coronary heart disease group (divided into chronic coronary disease group and acute coronary syndrome group). 32 patients in the acute coronary syndrome group, including 19 males and 13 females; Age range from 54 to 84 years old, with an average of (69.09±14.97) years old. There are 21 patients in the chronic coronary disease group, including 8 males and 13 females; Age range from 65 to 83 years old, with an average of (74.24±8.60) years old. 20 cases in the control group, including 13 males and 7 females; Age range from 58 to 73 years old, with an average of (65.70±7.39) years old. Enzyme linked immunosorbent assay (ELISA) was used to detect serum sPD-1, sPD-L1, and IFN in three groups of patients- γ Horizontal.

The comparative analysis of serum immune markers among the three groups showed that there were significant differences in the levels of IL-18, IFN-γThe comparative analysis of serum immune markers among the three groups showed that there were sigisease group were significantly higher than those in the control group (P<0.01), and the expression levels of IFN-an those in the control group ( showed that there were significant differences in the levels of IL-18, IFN-ol group (P<0.05). The expression of L1 in the ACS group and the chronic coronary disease group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that serum IFN-p was significantly higher thorrelated with sPD-1 (r=0.922, P<0.01) and L1 (r=0.922, P<0.01) in the ACS group.

There is a certain relationship between sPD-1/L1 and IFN-N-p was significantly higher than that in the control group, and the difference was statistically significssion of sPD-1/L1, which may play an important role in the immunoregulation of ACS.