Advanced Emergency Medicine

Immunoinflammatory mechanism of severe pneumonia and the application of inflammatory markers in clinical practice

Yanxin Xu — 2024-02-19

Pneumonia is a common disease and one of the leading causes of morbidity and mortality worldwide. [1] Severe pneumonia is a unique clinical disease that is highly life-threatening, characterized by severe sepsis, septic shock, or respiratory failure. Usually, treatment is required in the intensive care unit (ICU). Approximately 10% of community-acquired pneumonia (CAP) patients require hospitalization, with a mortality rate of 21% -47%. Most patients with severe community-acquired pneumonia have complications, including chronic obstructive pulmonary disease, diabetes and coronary heart disease. Streptococcus pneumoniae, Staphylococcus aureus, Mycoplasma pneumoniae, aaLe_x005fgionella, Klebsiella pneumoniae, Haemophilus influenzae, novel coronavirus, respiratory virus and Pseudomonas aeruginosa are important pathogenic microorganisms for severe CAP. [2] Host autoimmune factors, patient clinical manifestations, and laboratory and imaging examination results at admission can help identify high-risk populations for this disease. Early identification and timely empirical application of antibiotics are particularly important for the prognosis of patients.

Research progress of embryonic stem cells in treatment of spinal cord injury

Deqiang Gao — 2024-02-19

Spinal Cord Injury (SCI) refers to the structural and functional injury of the spinal cord under external forces. The spinal cord is an important part of the human nervous system, responsible for transmitting information between the brain and the rest of the body. Spinal cord injury may lead to varying degrees of neurological dysfunction, including impaired sensory, motor, autonomic, and vesical and intestinal functions [1]. Traditional treatments for patients often fail to fully restore their function, so it is particularly important to find a new treatment [2]. As a kind of cell with the ability of self-replication and multidirectional differentiation, stem cells have been widely used in the treatment of spinal cord injury, showing great potential in the treatment of spinal cord injury and achieving certain clinical effects [3]. This article reviews the research progress of embryonic stem cells in spinal cord injury, aiming to explore the application status, mechanism and prospect of stem cells in the treatment of spinal cord injury, and provide scientific basis for clinical treatment.

Application Analysis of Combining Scenario Simulation with the Problem-Based Learning (PBL) Model in Orthopedic Teaching

Xiangyu Tian — 2024-02-19

The development of medical expertise demands a meticulous and scientific approach, relying not solely on extensive theoretical foundations but also on ample practical experience to reinforce theoretical applications. This is particularly evident in orthopedic teaching, where an understanding of the skeletal system, analysis of pathogenesis, and treatment are essential. Practicality becomes crucial in this context. To augment teaching effectiveness, it is imperative to employ effective teaching methods and strategies. Integrating scenario simulation with the Problem-Based Learning (PBL) model allows for a more intuitive presentation of pathological knowledge to students. This method aids students in better absorbing theoretical content, fostering deeper communication and learning during scenario simulation, and ultimately achieving superior learning outcomes.

Reperfusion Combined with Neuroprotective Agents Treatment in Acute Ischemic Stroke: a Literature Review of Current Progress

Yukuan Wu — 2024-02-19

Acute ischemic stroke remains to be a heavy burden causing serious mortality and disability. Clinical studies of neuroprotective agents produced disappointing results in the treatment, and recanalization may be a precondition for it to be successful. By searching for relevant randomized controlled trials concerning combination therapy in the online databases and analyzing them, this literature review investigated the therapeutic effect of reperfusion combined with neuroprotective agents treatment in acute ischemic stroke. We found that reported trials specifically designed to investigate the efficacy of combination treatment are scarce. Overall, use of uric acid and nerinetide in the combination therapy exhibited positive results. These results indicate a high potential for clinical use with further confirmation. Future studies are still needed. They should focus on (1) designing clinical trials that investigate combination therapy specifically or include prespecified subgroup analyses for different types of recanalization, (2) reaffirming previous positive clinical trials with more patients of different characteristics or geographical locations, (3) employing multitarget neuroprotectant combinative therapy (cocktail therapy) to target multiple targets of ischemia-reperfusion injury instead of the currently prevalent single neuroprotectant with recanalization therapy.

The Impact of Energy Level Zoning Nursing Mode on the Emergency Response Effect of Critically Ill Patients

Yuanyuan Zhang — 2024-02-19

Objective: To improve the emergency response effect of critically ill patients, and to implement a level zoning nursing model in clinical practice to clarify its impact on critically ill patients. Methods: A total of 95 critically ill patients who received diagnosis and treatment in the hospital during the period of January 2023 to December 2023 were analyzed. They were divided into a control group (49 cases) and an observation group (46 cases) in order of diagnosis and treatment. Two groups of nursing interventions were implemented using conventional methods and level based nursing models, and the intervention situation was analyzed. In terms of the incidence of complications, the observation group had a lower total value (P<0.05) compared to the two groups. In terms of clinical indicators, the observation group had lower values (P<0.05) compared to the two groups. In terms of nursing quality, the observation group had higher values (P<0.05) compared to the two groups. Conclusion: Implementing a level zoning nursing model in clinical practice can have a positive impact on emergency treatment of critically ill patients, and can help control related complications, improve clinical indicators, and enhance nursing quality.

Study on the application of CBCT in the diagnosis of chronic periapical periodontitis with different depth of periodontal pocket

Zhao Lili — 2024-02-19

Objective To investigate the application of conical beam CT(CBCT) in the diagnosis of VRF with chronic periapical inflammation and different depth of periodontal exploration. Methods 40 teeth with chronic periapical inflammation suspected of VRF in 39 patients were examined by X-ray apical film, CBCT and periodontal examination respectively. Diagnosis and statistical analysis were performed for each affected tooth by two specialists, and subgroup analysis was performed according to the influence of the depth of the peridental pocket on the diagnosis results of CBCT. Results The sensitivity, missed diagnosis rate and consistency rate of CBCT in the diagnosis of VRF were 78.8%, 21.2% and 82.5%, respectively, which were significantly different from that of X-ray root tip film (54.8%, 45.2% and 60.0%) (P<0.05). The sensitivity and missed diagnosis rate of CBCT in the deep periodontal pocket group (probing depth ≥5mm) were significantly different from those in the non-deep periodontal pocket group (probing depth <5mm) (P<0.05). Conclusion CBCT is superior to X-ray apical film in the di_x005fagnosis of VRF. The presence of deep periodontal pocket has influence on sensitivity and missed diagnosis rate.

Research Progress on the effect of High altitude and hypoxia on Mitochondrial function in Obesity

Ying Liu — 2024-02-19

Obesity is one of the diseases that threaten human health at present, and it can lead to the increasing prevalence of related complications, such as Insulin resistance, Non-alcoholic fatty liver diseases NAFLD and Type 2 diabetes mellitus and so on. In the whole world, the prevalence rate of obesity is on the rise. Insulin resistance is one of the most common complications of obesity. More and more studies have shown that there is a close relationship between mitochondrial dysfunction and insulin resistance. Skeletal muscle is an important target organ of insulin. Skeletal muscle mitochondrial dysfunction can lead to abnormal glucose and lipid metabolism and further affect the signal pathway of energy metabolism. The new epidemiological survey shows that the prevalence of obesity in high altitude areas is significantly lower than that in plain areas, and the prevalence of overweight and obesity is negatively correlated with altitude. This paper discusses the relationship between high altitude hypoxia and mitochondrial metabolism.

The clinical effection of thoracoscopic subsegmentectomy in the treatment of peripheral lung cancer

Peirui Chen — 2024-02-19

Objective: To investigate the clinical effect of thoracoscopic subsegmentectomy in the treatment of patients with early lung cancer. Methods: A retrospective analysis was performed between January 2021 and December 2022 The clinical data of 121 patients with early lung cancer admitted to the hospital were collected. According to different surgical methods, they were divided into control group (n=59) and observation group (n=62). The observation group was given thoracoscopic subsegmentectomy, and the control group was given thoracoscopic segmentectomy. The perioperative indicators, inflammatory factors and complications were compared between the two groups. Results: The number of resected subsegments in the observation group was less than that in the control group.The levels of CRP and PCT in the observation group were lower than those in the control group. There was no significant difference in the incidence of complications, operation time, intraoperative blood loss, width of lesion margin, and length of hospital stay between the two groups. Conclusions: Thoracoscopic subsegmentectomy and thoracoscopic subsegmentectomy have the same surgical effect in the treatment of early stage lung cancer, but thoracoscopic subsegmentectomy can reduce the number of resected subsegments and reduce the inflammatory response after operation.

Analysis of therapeutic effect of extracorporeal shock wave on tennis elbow

Zhenguo Wu — 2024-02-19

Extracorporeal shock wave therapy plays an important role in the prevention and treatment of musculoskeletal diseases due to its advantages of convenient operation, safety, high efficiency and no drug intervention. In recent years, extracorporeal shock wave therapy has been widely used in the treatment of external humeral epicondylitis, such as through extracorporeal shock wave combined with ultrashort wave therapy and other physical factors. As people become more accepting of exercise, the frequency of some musculoskeletal disorders is also increasing. For such diseases, the effect of drug treatment is often reflected in the alleviation of symptoms, and the radical cure of the disease is not obvious. Under this premise, the advantages of the physical factor therapy approach appear. By performing extracorporeal shock wave therapy, the pain can be relieved in a short period of time, and the patient’s normal activities and symptoms can be significantly improved after the treatment cycle.

The value and application of project teaching method in high_x005fer vocational nursing teaching

Keyi Liu — 2024-02-19

Project teaching is of great value in higher vocational nursing teaching, which can improve students’ practical ability and compre_x005fhensive quality. The application of project teaching method can stimulate students’ interest in learning, cultivate students’ teamwork ability and problem-solving ability. In addition, project teaching can promote students’ independent learning and innovative thinking, so that students can better adapt to the actual work environment. Therefore, project teaching method should be actively applied in nursing teaching in higher vocational colleges to improve teaching effect.

Application of novel oral anticoagulants for the antithrombotic effect of cardiovascular system diseases

Runtian Xiao — 2024-02-19

Long-term oral anticoagulant is one of the methods for the treatment of cardiovascular system diseases, and the most widely used anticoagulant drug is warfarin, but its clinical application has been greatly limited due to its slow onset, easy to affect by various factors, and difficult dose control. In recent years, with the continuous in-depth research on cardiovascular system diseases, the emergence of new oral anticoagulants (NOAC) has greatly impacted the status of traditional anticoagulant warfarin because of its safety, stability and convenience of consumption. The purpose of this article is to review the classification and application of novel oral anticoagulants.

Visual Analysis of The Citespace-based COPD Research On The Stable Care Field

Yuanyuan Wang — 2024-02-19

Objective To explore the research hotspot and development frontier of stable care in COPD. Methods The CNKI database was searched, and the search year was set from January 1,2013 to March 31,2023. citespace software was used to visually analyze the distribution of publications, authors and institutions, keyword co-occurrence and clustering. Results A total of 511 articles were included, among which the number of articles showed a significant upward trend from 2013 to 2019;Xiaolei Shang Shang , Guifang Yu and other 21 authors; the school of Nursing of Nanjing Medical University has 3 articles; The research focus focus on quality of **life, extended nursing, compliance, TCM nursing, etc. The research frontier is mainly in exercise endurance. Conclusion Clinical medical staff should establish scientific evi_x005fdence-based intervention program and establish evidence-based patient care in stable COPD to improve patients’ exercise endurance.

Risk factors for ventilator-associated pneumonia in ICU me_x005fchanically ventilated patients: a meta-analysis

Qin Guan — 2024-02-19

Objective: This study aims to determine the risk factors for the development of ventilator-associated pneumonia (VAP) in ICU mechanically ventilated patients through meta-analysis. Method: Conduct a comprehensive search of multiple domestic and international databases, collect literature on the risk factors of VAP in ICU patients from November 2023, and conduct meta-analysis using RevMan5.4 software. Result: 31 high-quality studies were included, and it was found that age, COPD history, position, APACHE II score, antibiotic combination, repeated tracheal intubation, tracheostomy, indwelling gastric tube, mechanical ventilation time, and ICU hospitalization time were significantly associated with an increased risk of VAP; However, consciousness disorders and hypoalbuminemia do not show a signifi_x005fcant correlation with the risk of VAP. Conclusion: Specific patient characteristics and clinical procedures are associated with increased risk of VAP, and clinical attention should be paid to these risk factors in order to intervene early to prevent VAP and improve patient prognosis.

Mesenchymal stem cells secretions for treating neurological diseases and their mechanism of action

Peng Deng — 2024-02-19

Neurological diseases are a class of diseases that seriously affect human health, including stroke, Parkinson’s disease, Alzheimer’s disease and spinal cord injury. Traditional treatments have some limitations in the treatment of these diseases, such as drug side effects, surgical risks, etc. In recent years, secretions from mesenchymal stem cells (MSCs) have attracted much attention as a new method to treat neuro_x005flogical diseases. The secretions are composed of a variety of bioactive components, which can exert their therapeutic effects by regulating the inflammatory response, promoting the regeneration and repair of nerve cells, and resisting oxidative stress. This review aims to review the application of MSC secretions in the treatment of neurological diseases and explore the mechanism of action.

Anaphylactic shock causing cardiac arrhythmia: A case analysis of successful precordial thump intervention

Hongzhou Chen — 2024-02-19

This article presents a clinical case analysis of cardiac arrhythmia induced by anaphylactic shock, along with the diagnosis and treatment methods employed in the case. The article provides a detailed explanation of the causes and mechanisms of allergic reactions caused by neuromuscular blocking agents and the subsequent cardiac arrhythmias. It also discusses treatment methods such as precordial thump. This article can serve as a reference for clinicians dealing with similar cases.

Contributions of Integration of Traditional Chinese and West_x005fern Medicine to the Prevention and Treatment of Respiratory Diseases

Hongsheng Yin — 2024-02-19

Respiratory disease is a relatively common disease currently recognized in society, which brings a burden to individuals and society that beyond measure. The Integration of traditional Chinese medicine (TCM) and Western medicine(WM) to prevent and treat respiratory diseases is a new method of comprehensive application of TCM and WM for prevention and treatment. Its advantage point in the treatment of respiratory diseases have become increasingly prominent, becoming one of the important measures in the field of disease control Nowadays. Integration of TCM and WM(ITCWM) brings a more effective and sustainable approach to the prevention and treatment of respiratory diseases and alleviates the pain and suffering of patients during treatment. The contribution of ITCWM to the prevention and treatment of respiratory diseases is not only reflected in treatment, but also in prevention, health-care and health education. This article will explore the particular contribution of ITCWM in the prevention and treatment of respiratory diseases in the disease control and human well-being.

Study On The Mechanism Of Jiedu Sanjie Recipe In The Treatment Of Liver Cancer Based On Network Pharmacology

Zhen Zhang — 2024-02-19

Objective: to study the mechanism of action of Jiedu Sanjie Recipe in the treatment of Liver Cancer through network pharmacology. Method: Collect and screen the active ingredients of Jiedu Sanjie Recipe through the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), and search for the human target protein corresponding to the active ingredients in the database; screen out the target set of liver cancer-related diseases through GeneCards and OMIM database; construct a Venn diagram to obtain the key target of Jiedu Sanjie Recipe for treating liver cancer; use Cytoscape 3.8.0 software to construct drug-component-target-pathway network; use Cytoscape software and BisoGenet plug-in to construct protein interaction network, use CytoNCA plug-in and R language to perform network topology analysis, gene ontology functional annotation (GO) and KEGG rich Collect pathway analysis to understand the possible biological processes and pathways of Jiedu Sanjie Decoction in treating liver cancer. Results: A total of 89 active ingredients of Jiedu Sanjie Prescription, 170 targets and 1885 liver cancer targets were obtained; After mapping, 114 potential targets of Jiedu Sanjie Recipe for liver cancer are obtained, and the core active ingredients are quercetin, luteolin, kaempferol, wogonin, baicalein, etc. The core targets NTRK1, TP53, CUL3, ESR1, MCM2, etc., involving lipids and atherosclerosis, chemical carcinogenesis-receptor activation signaling pathways, Ka_x005fposi’s sarcoma-associated herpes virus infection, fluid shear stress and atherosclerosis Cirrhosis, hepatitis C, AGE-RAGE signaling pathway, hepatitis B, human cytomegalovirus infection, cancer proteoglycan, TNF signaling pathway, IL-17 signaling pathway, etc.Conclusion: This study reveals the mechanism of the multi-component, multi-target, and multi-channel treatment of liver cancer by “Knowing Du Sanjie Decoction”, and provides a basis for the clinical application of Chinese medicine prescriptions for liver cancer.

Pulmonary Artery CTA and CT Abdominal Plain Enhancement One-Stop Scanning Methods and Application Value

Sheng Duan — 2024-02-19

Objective: To investigate the feasibility and application value of one-stop scanning method of CTA angiography of pulmonary artery and plain abdominal enhancement. Methods: In the following study, a total of two patients were selected from our hospital to undergo CTPA and plain abdominal enhancement scanning, and the feasibility of one-stop scanning was investigated by analyzing the examination parameters of the two patients. Results: The one-stop scanning method of pulmonary artery CTA and CT abdominal plain enhancement can provide accurate clinical information, shorten the examination time and reduce the use of contrast agents after parametric and clinical evaluation.

Severe Myelosuppression Induced by Piperacillin/Tazobactam: A Case Report

Aiyun Huang — 2024-02-19

This case report presents an elderly patient who developed severe bone marrow suppression following the administration of Piperacillin/Tazobactam. The patient exhibited a declining trend in platelet and white blood cell counts during Piperacillin/Tazobactam treatment. Subsequently, upon discontinuation of Piperacillin/Tazobactam, platelet and white blood cell counts gradually increased. Negative drug allergy test results and the absence of evidence for bone marrow suppression caused by platelet antibodies or other drugs led to the consideration of the possibility of immune-mediated bone marrow suppression induced by Piperacillin/Tazobactam. This report emphasizes the importance of close monitoring of hematological parameters to mitigate the risk of bone marrow suppression during the clinical use of Piperacillin/Tazobactam.