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Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.
ABSTRACT
BACKGROUND: The abnormal changes of hemorrheologic indexes are closely correlated with vascular injury, disorder of microcirculation, thrombosis and its development.OBJECTIVE: To investigate the changes of 25 indexes of hemorheology and whole hemocytes in patients with acute cerebral infarction.DESIGN: A controlled case study.SETTING: Department of Medical Laboratory, Xinxiang Medical College.PARTICIPANTS: Cerebral infarction group: Totally 127 patients with the first attack of acute cerebral infarction were selected from the Department of Neurology, the Second Affiliated Hospital of Xinxiang Medical College from January to December in 2002. The onsetof disease ranged from 4 to 12 hours, and the lesions were confirmed by cranial CT, the diagnostic standard accorded with the diagnostic guidelines for various cerebrovascular diseases formulated by the Fourth National Academic Conference for Cerebrovascular Diseases. Normal control group: Fifty-three healthy physical examinees with normal blood pressure and without diseases of heart,brain and kidney, as well as diabetes mellitus. There were no sigmficant differences in ages and male to femaleratios between the two groups.METHODS: ① Patients in the cerebral infarction group received fibrinogen reduction therapy, they were injected with two pieces of 10 u defibrin on the day of admission, and injected with one piece of 10 u defibrin again on the 3rd, 5th and 7th days respectively. ② Fasting venous blood (5 mL) was drawn with thromboliquine anticoagulated vacuum blood collecting tube,and 2 mL blood was coagulated with EDTA-K2. The whole blood viscosity,whole blood high-sheafing reduction viscosity, whole blood low-shearing reduction viscosity, whole blood high-sheafing relative index, whole blood lowsheafing relative index, equation K value of erythrocyte sedimentation, plasma viscosity, hematocrit, erythrocyte sedimentation, aggregation index of red blood cells (RBC), rigidity index of RBC, deformation index of RBC, counts of while blood cells (WBC) and RBC, mean volume of RBC, mean corpuscular volume (MCV), RBC distribution width (RDW), content of hemoglobin,mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) were detected when the shear rate was 200 s-1, 30 s-1, 5 s-1 and 1 s-1 respectively. ③ The above indexes of the patients with cerebral infarction were detected within 24 hours after attack (exacerbation) and at two weeks after treatment (recovery period) respectively.MAIN OUTCOME MEASURES: The hemorrheologic and whole hemocyte indexes were compared between the two groups.RESULTS: All of the 127 cases in the cerebral infarction group entered the analysis of results at exacerbation, and 5 of them were not reexamined because of discharge and 122 cases entered the analysis of results at recovery period. All the 53 cases in the normal control group were involved in the analysis of results. ① Except RDW and MCHC, all the other indexes in the patients with cerebral infarction at exacerbation were significantly different from those in the normal control group (P＜0.05, 0.01). As compared with the normal control group, the whole blood low-shearing viscosity, whole blood low-shearing reduction viscosity, whole blood high-sheafing relative index, whole blood low-shearing relative index, plasma viscosity,hematocrit, aggregation index of RBC, WBC count and MCH all returned to normal in the patients with cerebral infarction at recovery period (P＞0.05).② As compared with the exacerbation, the RBC count and MPV were obviously decreased in the patients with cerebral infarction at recovery period (P ＜ 0.05), while the other indexes were similar (P ＞ 0.05).CONCLUSION: Abnormalities of hemorrheologic indexes commonly exist in patients with acute cerebral infarction, which indicates that the abnormalities of hemorrheologic and whole hemocyte parameters may be related to the occurrence of acute cerebral infarction.