Validation of a seven-question tool (PRISMA-7) in predicting prognosis of older adults in the emergency department: A prospective study.

OBJECTIVES: Older patients arrive at the emergency department (ED) with complex medical challenges, and the current ED triage models frequently undertriage the severity of illness in older adults. There is increasing awareness regarding the importance of identifying frailty in older patients in the context of urgent care. Therefore, this study aimed to assess the predictive accuracy of the seven-question tool of the Program on Research for Integrating Services of the Maintenance of Autonomy (PRISMA-7) in the ED for 28-day mortality among older adults. DESIGN: A prospective polycentric observational study. SETTING: West China Hospital of Sichuan University, Shangjinnanfu of West China Hospital, and People's Hospital of Henan Province. PARTICIPANTS: ED patients aged ≥65 years from the three tertiary care centers over an 8-week period. PRIMARY AND SECONDARY OUTCOMES: The primary outcome, 28-day all-cause mortality, was investigated using a Cox proportional hazards regression model to assess the predictive validity. The secondary endpoints, intensive care unit (ICU) transfer was investigated using multivariable logistic regression, compared with trained study assistants. RESULTS: The final study population comprised 1043 consecutive patients aged ≥65 years. The area under the receiver operating characteristic (ROC) curve (AUC) for 28-day mortality was 0.80 (95% confidence interval [CI]: 0.76-0.84), 0.73 (95% CI: 0.68-0.77), and 0.78 (95% CI: 0.73-0.83) for PRISMA-7, Emergency Severity Index (ESI), and quick Sepsis Related Organ Failure Assessment (qSOFA), respectively.There was no difference in the AUC between PRISMA-7 and qSOFA(p = 0.374).The AUC for ICU admission was 0.78 (95% CI: 0.75-0.80), 0.62 (95% CI: 0.59-0.66), and 0.68 (95% CI: 0.64-0.72) for PRISMA-7, ESI, and qSOFA, respectively.The AUC for ICU admission between PRISMA-7 and ESI(p<0.001), PRISMA-7 and qSOFA(p<0.001), qSOFA and ESI(p = 0.005) was statistically significant. CONCLUSION: Our findings reveal that PRISMA-7 improves the prediction of ICU admission, but there is no significant difference when it comes to all-cause mortality. PRISMA-7 appears to be a reliable and valid instrument for identifying frailty in the ED. TRIAL REGISTRATION NUMBER: ChiCTR2100046545.

[Follow-up study on autogenous osteochondral transplantation for cartilage defect of knee joint].

OBJECTIVE: To evaluate clinical effect of autologous osteochondral transplantation in treating localized knee cartilage defects. METHODS: Fifteen patients with knee cartilage defects were treated by autologous osteochondral transplantation from January 2007 to January 2008, including 8 females and 7 males, aged from 23 to 45 years old. Preoperative and postoperative KSS score at 10 years were compared. RESULTS: All patients were followed up for 10.0 to 10.7 years, with an average of(10.2±0.3) years. Clinical score of KSS was improved from 38.86±4.09 to 85.07±2.19 at 10 years after operation(P<0.05), functional score increased from 3.33±4.88 to 82.67±4.58 at 10 years after operation(P<0.05), KSS score was improved form 42.20±7.84 befor operation to 167.73±6.29 at 10 years after operation, and had statistical differences before and after operation. While there was no statistical difference in stability of knee joint(P>0.05). All patients had no other complications. CONCLUSIONS: Through long-term follow-up of patients with cartilage defect in knee treated by autologous bone cartilage transplantation showed that this method could effectively improve function of knee joint and alleviate pain. So it is an effective method for repair of osteochondral defect.

[HPLC fingerprint of Phlomis younghusbandii].

OBJECTIVE: To establish the characteristic fingerpint from Phlomis younghustbandii. METHODS: The different collecting time and county samples of Phlomis younghusbandii were determined by HPLC. RESULTS: The HPLC-FPC of Phlomis younghusbandii was set up by establishing 14 common peaks. Accuracy, stability and repeatability of the method were good. CONCLUSION: The peaks in the spectrum were all separated perfectly, which met the regulation of HPLC-FPC.

[Studies on the chemical constituents of Phlomis younghusbandii].

OBJECTIVE: To study the chemical constituents of Phlomis younghusbandii. METHODS: Compounds were isolated from the ethanolic extract by silica gel column chromatography, and their structures were identified by physical and chemical evidences and spectral methods. RESULTS: Eight compounds were isolated and identified respectively as 8-acetylshanzhiside methyl ester (1), shanzhiside methyl ester (2), phlomiol (3), 2-butoxy-2-(hydroxymthyl) tetrahydro-2H-3,4,5-pyrantriol (4), sesamoside (5), pulchelloside-I (6), luteolin-7-O-beta-D-glucopyranoside (7) and daucosterol (8). CONCLUSION: All the compounds were isolated from the plant for the first time.