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Nutritional status and prognostic factors for mortality in patients admitted to emergency department observation units:a national multi-center study in China

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World Journal of emergency Medicine 2023年第1期14卷 17-24页

作者： Hai-jiang Zhou Dong-jing Zuo Da Zhang Xin-hua He Shu-bin Guo Nutrition School of Education College of Chinese emergency Medicine Beijing Key Laboratory of Cardio-pulmonary Cerebral ResuscitationEmergency Medicine Clinical Research CenterBeijing Chao-yang HospitalCapital Medical UniversityBeijing 100020China

BACKGROUND:Nutritional risk is common among patients admitted to the emergency department and is associated with adverse clinical *** its large population,few comprehensive studies have been conducted in China concerning the nutritional status of patients admitted to emergency department observation units(EDOUs).METHODS:Patients admitted to EDOUs of 90 tertiary hospitals in China between June 2020 and December 2020 were *** information,laboratory parameters,nutritional support therapies,and 28-day mortality were *** factors for mortality were examined using multi-variateadjusted logistic regression *** operating characteristic(ROC)curves for each predictor of mortality were plotted,and the area under the ROC(AUROC)curves was ***:A total of 2,005 eligible patients were finally *** the 28-day follow-up,1,911 patients survived,and 94 *** group with a Nutritional Risk Screening 2002(NRS 2002)score of 3-4 points was the largest(52.01%).The number of patients receiving oral nutritional supplements,enteral nutrition(EN),parenteral nutrition(PN),and the combination of EN and PN was 425,314,853,and 413,*** the total,77.55%of patients had nutritional risk(NRS 2002≥3).The proportion of patients with high nutritional risk(NRS2002≥5)in the age group>80 years was significantly higher than that in the age group 66-80 years(29.00%vs.23.93%,P=0.032),but not significantly higher than that in the age group 18-65 years(29.00%vs.26.54%,P=0.449).Logistic regression analysis revealed that heart failure(odds ratio[OR]1.856,95%confidence interval[CI]1.087-3.167,P=0.023),consciousness(OR 2.967,95%CI 1.894-4.648,P<0.001),Acute Physiology and Chronic Health Evaluation II(APACHE II)score(OR 1.037,95%CI 1.017-1.058,P<0.001),NRS 2002 score(OR 1.286,95%CI 1.115-1.483,P=0.001),and Mini Nutritional Assessment-Short Form score(OR 0.946,95%CI 0.898-0.997,P=0.039)were all independent risk factors for 28-day m

关键词： Nutritional risk Malnutrition Nutritional Risk Screening 2002 Mini Nutritional Assessment-Short Form

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Experience and practice of the emergency Operations centerz Chinese center for Disease Control and Prevention:a case study of response to the H7N9 outbreak

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Infectious Diseases of Poverty 2021年第1期10卷 87-94页

作者： Fan Ding Qun Li Lian-Mei Jin Public Health emergency center Chinese Center for Disease Control and PreventionBeijingChina

Background:emergency Operations center(EOC)is a place to provide response to public health *** center for Disease Control and Prevention(China CDC)'s EOC was officially established in 2016,which has been the core department for the public health emergencies and risk *** recent years,we have been continuously improving the function of EOC through many *** the study,we hope to share the construction status,operation management experience of China CDC's EOC and the response process in the human avian influenza A(H7N9)*** text:The China CDC's EOC mainly focus on building the five core elements including sites/places and facilities,information and data,plans and procedures,training and exercises,and *** on summarizing previous emergency respons巳the China CDC's EOC established its own incident management and the standardized response *** event-specific data,context-specific data and event management data could be obtained through various *** logistics department of the EOC also provides comprehensive *** well-trained staff is another necessary conditions for its *** sharing the response process of H7N9 outbreak,it further explains the EOC's functions in the five phases of outbreak response,such as the formulation of the incident response framework,monitoring,personnel dispatch and resource ***:The EOC con tributes to faster and more efficient responses during emergencies which en able a greater reduction in morbidity and *** with the traditional incident response process,under the command and coordination of China CDC's EOC,each group involved in the response has a clearer goal,responsibilities and tasks at each ***,each group also gave full play to its own expertise and *** a whole,incident response tended to be more specialized and precise,which generally improves the efficiency of incident ***,different co

关键词： emergency Operations center Practice Response Plan Human avian influenza A(H7N9)

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Engineering atomic Rb-N configurations to tune radical pathways for highly selective photocatalytic H2O2 synthesis coupled with biomass valorization

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Journal of Energy Chemistry 2025年第1期100卷 215-225页

作者： Jiaye Li Shuang Pan Yihuang Chen Qiong Liu College of Chemistry and Materials Engineering Wenzhou University Guangdong Provincial Key Laboratory of Chemical Measurement and emergency Test Technology (China) Institute of Analysis Guangdong Academy of Sciences (China National Analytical CenterGuangzhou)

Photocatalytic oxygen reduction for hydrogen peroxide （H2O2） synthesis presents a green and costeffective production ***,achieving highly selective H2O2synthesis remains challenging,necessitating precise control over free radical reaction pathways and minimizing undesirable oxidative ***,we report for the visible light-driven simultaneous co-photocatalytic reduction of O2to H2O2and oxidation of biomass using the atomic rubidium-nitride modified carbon nitride（CNRb）.The optimized CNRb catalyst demonstrates a record photoreduction rate of 8.01 mM h-1for H2O2generation and photooxidation rate of 3.75 mM h-1for furfuryl alcohol to furoic acid,achieving a remarkable solar-to-chemical conversion （SCC） efficiency of up to 2.27%.Experimental characterizations and DFT calculation disclosed that the introducing atomic Rb–N configurations allows for the high-selective generation of superoxide radicals while suppressing hydroxyl free radical *** is because the Rb–N serves as the new alternative site to perceive a stronger connection position for O2adsorption and reinforce the capability to extract protons,thereby triggering a high selective redox product *** study holds great potential in precisely regulating reactive radical processes at the atomic level,thereby paving the way for efficient synthesis of H2O2coupled with biomass valorization.

关键词： Free radical reactions

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Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study

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World Journal of emergency Medicine 2020年第4期11卷 206-215页

作者： Hai-jiang Zhou Tian-fei Lan Shu-bin Guo emergency Medicine Clinical Research center Beijing Chao-yang HospitalCapital Medical University&Beijing Key Laboratory of Cardiopulmonary Cerebral ResuscitationBeijingChina Department of Allergy Beijing Shijitan HospitalCapital Medical UniversityBeijingChina

BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,Pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in emergency Department Sepsis[MEDS])and admission lactate ***:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were *** characteristics were *** primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation *** prediction value of parameters above was compared using receiver operating characteristics(ROC)*** regression analyses were carried out to determine the risk factors for the 28-day ***-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and ***:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical *** single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU ***:NEWS could be a valuable predictor in septic patients with CAP in emergency depa

关键词： Community-acquired pneumonia Sepsis National Early Warning Score(NEWS) Intensive care unit emergency departments

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The relative value of education of emergency physicians in patient outcome: A retrospective analysis at a single center in developing India

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World Journal of emergency Medicine 2018年第2期9卷 130-135页

作者： Shastri Vandana Singh Shubnum Kole Tamorish Department of emergency Medicine and Max Institute of Medical Excellence Max Super Specialty Hospital

BACKGROUND: There is a considerable paucity with regards to the research available on the quality and quantity of clinical teaching in the national emergency department(ED) setups. With the onset of the age of modern medicine, the outlook towards to the time worn tradition of triage and detailed medical evaluation must be revoked. Despite the variety of programs being conducted in the country, a comparable entity common to all is patients' clinical outcomes which can be measured using simple parameters which can be easily acquired compiling hospital registry ***: A retrospective observational study was conducted in the emergency department of Max Hospital, Saket, New Delhi. A period of 22 months prior to the start of the program and like-wise 22 months after initiation of the program was collected from the hospital registry. The emergency Medicine program in consideration was the Masters in emergency Medicine(MEM) Program affiliated with George Washington University, NY, USA. Patients of all age groups and gender registering in the emergency Department and so were all the doctors working in the ED before and after initiation of the ***: An improvement was noted in terms of total admissions through the ED per month, average length of stay of admitted as well as discharged patients; return to ED within 24 hours; leave against medical advice and patient complaints. A reduction was noted in number of discharges from the ED. Despite a numerical worsening on the patient's death in ED a graphical improvement can be noted considering the month wise representation of ***: We can make a coherent conclusion that there is an improvement in the outcome of the entire patient related aspects in the emergency Department considering the all two time frames included in the study. The difference can be very well attributed to the integration of the structural Academic Program in the development of the emergency Physicians. This leads us to make a co

关键词： Education emergency physicians

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gpidemiology and characteristics of acute poisoning treated at an emergency center

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World Journal of emergency Medicine 2010年第2期1卷 154-156页

作者： Feng Chen Jun-ping Wen Xiao-ping Wang Qing-ming Lin Cai-jing Lin emergency center Fujian Provincial Hospital Fujian Medical University Fuzhou 350001 China

BACKGROUND： Acute poisoning is frequently encountered at emergency department. This study was to investigate the epidemiology and characteristics of patients with acute poisoning who were treated at the emergency center, Fujian Provincial Hospital, ***： We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these ***： Altogether 2867 patients with acute poisoning were treated from January 2004 to December 2009. The ratio of male to female was 1：1.04, and their average age was 33.8 years. Of the 2867 patients, 76.39% were between 18 and 40 years old. The incidence of acute poisoning was as high as 11.33% in January each year. The incidence of poisoning was in a descending order： alcohol poisoning （54.55%）, medication poisoning （25.95%）, pesticide poisoning （5.65%）, and drug poisoning （4.88%）. Most （56.44%） of the patients with drug poisoning were under 25 years and their mean age was significantly lower than that of patients with medication poisoning or alcohol poisoning （P 〈 0.01）. Approximately 69.54% of the patients were followed up after emergency treatment, 30.39% were hospitalized, and four patients ***： Acute poisoning is largely alcohol poisoning and medication poisoning in a city. The emergency green channel ＂pre-hospital emergency care-emergency department-hospital treatment＂ can significantly improve the survival rate of patients with acute poisoning.

关键词： Hospital-affiliated emergency center Management model Green channel Acutepoisoning Epidemiology emergency care

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Presepsin as a biomarker for risk stratification for acute cholangitis in emergency department: A single-center study

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World Journal of Clinical Cases 2021年第32期9卷 9857-9868页

作者： Han-Yu Zhang Zhao-Qing Lu Guo-Xing Wang Miao-Rong Xie Chun-Sheng Li Department of emergency Medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Acute cholangitis is caused by bacterial infection and has high morbidity and mortality *** grade of cholangitis can guide clinical treatment from single antibiotic treatment to biliary *** the introduction of white blood cell(WBC)count,C-reactive protein(CRP),and total bilirubin(T-Bil)into the diagnostic criteria and severity grading for acute cholangitis,the diagnosis rate and grading have significantly ***,early risk stratification assessments are challenging in the emergency ***,we hope to find an ideal predictive biomarker for cholangitis *** is a promising biomarker for the early diagnosis,severity,and prognosis of acute bacterial *** To assess the grading value of presepsin in patients with acute *** This clinical study was conducted at the Beijing Friendship Hospital,a 2000-bed teaching hospital with approximately 200000 emergency admissions per *** this prospective observational study,336 patients with acute cholangitis meeting the Tokyo Guidelines 2018 diagnostic criteria in the emergency department from May 2019 to December 2020 were *** count,CRP,procalcitonin(PCT),presepsin,T-Bil,and blood culture results were *** values were compared using the Pearsonχ2 test,Fisher’s exact test,or Mann-Whitney U *** area under the receiver operating characteristic curve(AUC)of the value was examined using the Delong *** correlations among the key research indicators were determined using Pearson *** In total,336 patients were examined,which included 107,106,and 123 patients classified as having mild,moderate,and severe cholangitis,*** count,CRP,PCT,presepsin,T-Bil,direct bilirubin,and sequential organ failure assessment scores of moderate and severe cholangitis patients were higher than those of mild cholangitis patients(P=0.000).The AUC of presepsin in predicting moderate acute cholangitis was 0.728,which was high

关键词： C-reactive protein Procalcitonin Presepsin Acute cholangitis Risk stratification

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Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

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World Journal of emergency Medicine 2020年第2期11卷 120-121页

作者： Ryne Jenkins Nicholas A.Morris Bryce Haac Richard Van Besien Deborah MStein Neeraj Badjatia Amir Medic Gaurika Mester Quincy K.Tran Program in Trauma The R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreMDUSA Section of Neurocritical Care and emergency Neurology Department of NeurologyUniversity of Maryland School of MedicineBaltimoreMDUSA University of Maryland School of Medicine BaltimoreMDUSA University of Maryland at College Park College ParkMDUSA Department of emergency Medicine University of Maryland School of MedicineBaltimoreMDUSA

Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventilator.[1]The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of *** predictors for tracheostomy,i.e.,clinical factors when patients first present to an emergency Department after trauma or when patient fi rst arrive at a regional trauma center,can help clinicians’medical decision-making process.

关键词： patients admitted trauma

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The mortality of patients in a pediatric emergency department at a tertiary medical center in China: An observational study

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World Journal of emergency Medicine 2015年第3期6卷 212-216页

作者： Cui-ping Zhu Xiao-hui Wu Yu-ting Liang Wen-cheng Ma Lu Ren Division of emergency Medicine Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University

BACKGROUND: The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department(PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the ***: The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive ***: Altogether 466 919 patients visited the PED during the period and 43 925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years(median, 5 months). The time from admission to death ranged from 0 to 216 hours(median, 1.5 hours). There were 92(40%) patients who died within 24 hours after admission and 104(45.2%) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth ***: In our center, 40% of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.

关键词： Pediatric emergency department Mortality Developing counties

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Use of anticoagulation reversal therapy in the emergency department:a single-center real-life retrospective study

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World Journal of emergency Medicine 2023年第1期14卷 56-58页

作者： Jacopo Davide Giamello Andrea Pisano Fabrizio Corsini Remo Melchio Luca Bertolaccini Enrico Lupia Giuseppe Lauria School of emergency Medicine University of TurinTurin 10100Italy Department of emergency Medicine Santa Croce e Carle HospitalCuneo 12100Italy Department of Internal Medicine Santa Croce e Carle HospitalCuneo 12100Italy Department of Thoracic Surgery IEOEuropean Institute of Oncology IRCCSMilan 20141Italy Department of emergency Medicine Cittàdella Salute e della Scienza HospitalTurin 10126Italy Department of Medical Sciences University of TurinTurin 10100Italy

The incidence of atrial fibrillation(AF)and deep vein thrombosis/pulmonary embolism(DVT/PE)has increased in the last decades as a consequence of global aging and th refinement of diagnostic techniques;thus,the consumption o anticoagulant drugs has increased significantly.[1,2]Prescription of direct oral anticoagulants(DOACs)have overtaken thos of vitamin K antagonists(VKA)since the mid-2010s.[3]Consequently,the incidence of these drugs’side effects has also increased;the most relevant side effect in terms of morbidity and mortality is *** addition to critically ill bleeding patients,another indication of anticoagulant reversal therapy is the need for emergency surgery or for a procedure with high risk of bleeding.

关键词： drugs vitamin mortality

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