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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.
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Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions , using the Cochrane Library and the databases of Pubmed,EMbase,CINAHL,CBM,CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases,extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review,which contained three randomized controlled trials,three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59,95％CI0.39-0.91,P=0.02). Standard connector and negative- displacement mechanical valve had a higher occlusions rates than positive- displacement mechanical valve ,but the difference did not reach statistical significance after merging the studies( P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation.
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Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.