通过回顾性分析2021年国际雪联系列测试活动(以下简称"相约北京")医疗保障工作,解决院前急救与院内急救缺乏实时衔接和协同救治的问题。依托5G+物联网技术,应用智慧医疗、移动医疗,以崇礼院区指挥中心为基础,建设院前院内紧...通过回顾性分析2021年国际雪联系列测试活动(以下简称"相约北京")医疗保障工作,解决院前急救与院内急救缺乏实时衔接和协同救治的问题。依托5G+物联网技术,应用智慧医疗、移动医疗,以崇礼院区指挥中心为基础,建设院前院内紧密衔接的冬奥会医疗保障指挥调度平台。通过指挥调度平台实现竞赛以及与竞赛直接相关延伸区域的场地(field of play,FOP)、固定医疗站、救护车转运途中与崇礼院区指挥中心音视频实时互联互通、生命体征和医学影像的传输,院内专家指导院前医生实施救治工作。指挥调度平台可为伤员从受伤时刻起到救治结束的全过程获得高质量、高效率的救治,提升冬奥会医疗保障水平,在后奥运时代发展前景良好。展开更多
Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of t...Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of the current study was to understand its epidemiology, clinical features and the cause of delay of its diagnosis in adolescents. Methods A retrospective analysis of nine adolescents with acute PE admitted to the Peking University Third Hospital over the past 16-year period was performed. The epidemiology, clinical features and risk factors of the adolescents were described and compared with those of adults and elderly patients. The time to diagnosis and misdiagnosed diseases were analyzed. Pretest probability of PE was assessed retrospectively by the Wells score and revised Geneva score. Results The incidence of PE was 43.6 per 100 000 hospitalized adolescents in our hospital. The incidence of PE in adolescents was much lower than that in adults and PE is diagnosed in about 1/50 of elderly people. The clinical features in adolescents were similar to those in adults. But fever and chest pain were more common in adolescents （P〈0.05）. The major risk factors included surgery, systemic lupus erythematosus （SLE）, thrombocytopenia, long-term oral glucocorticoids and trauma. The mean diagnostic time was （7.8±8.4） days. Six cases had a delayed diagnosis. The mean delay time from symptom onset to diagnosis was （11.0±8.8） days. The time of presentation to diagnosis in patients initially admitted to the emergency department was less than one day, and was much shorter than the time in outpatients, （9.4±7.5） days. Most of the patients were initially misdiagnosed with a respiratory tract infection. Most patients＇ values of Wells score or revised Geneva score were in the moderate or high clinical probability categories; 88% by Well score vs. 100% by revised Geneva score. Conclusions PE was seldom considered in the adolescent patients by physicians, especially outpatient physicians, so the diagnosis was often delayed. If adolescent patients complain of dyspnea or chest pain or syncope with/without fever, and they had risk factors such as surgery, thrombocytopenia and trauma, PE should be considered and included in the differential diagnosis.展开更多
To the editor： Antineutrophil cytoplasmic antibodies （ANCA） are a group of autoantibodies associated with various diseases andcan be detected in drug-induced vasculitides. Here, we report two patients of drug-induc...To the editor： Antineutrophil cytoplasmic antibodies （ANCA） are a group of autoantibodies associated with various diseases andcan be detected in drug-induced vasculitides. Here, we report two patients of drug-induced vasculitides combind with kidney damage （one is followed-up 10 years, the other is followed-up 3 years） and review the literature for the occurrence of this complication, share the common phenomenon with our peers.展开更多
Background Underlying diseases have a statistically significant positive correlation to sudden death. However, sudden unexplained death （SUD） is different from sudden death, as there is no clinical evidence to suppo...Background Underlying diseases have a statistically significant positive correlation to sudden death. However, sudden unexplained death （SUD） is different from sudden death, as there is no clinical evidence to support the sudden death due to the original underlying disease, nor a lethal pathological basis to be found during autopsy. In addition, SUD are more common in young, previously healthy individuals, usually without any signs of disease, with no positive lesions found after autopsy. Therefore, a causal relationship between SUD and the underlying disease needs to be further explored. This study aimed to explore the role that common underlying diseases play in patients with SUD and to reveal the correlation between them. Methods The medical records, history and case information of 208 patients with SUD were collected for the survey. All these SUD occurred in the emergency room of Peking University Third Hospital from January 2006 to December 2009. The patients were stratified by with and without common underlying diseases. To examine possible associations between the underlying diseases and the cause of unexplained sudden death, the chi-squared and Fisher＇s exact tests were used. Results Among the 208 patients, 65 were diagnosed with common underlying diseases while 143 were not. Within these two groups, there were 45 patients for whom the clear cause of death was determined. However, there were no statistically significant differences or strong associations （x2=1.238, P 〉0.05） between the 11 patients with （16.90%） and 34 without （23.78%） common underlying disease among these 45 patients. We also found that occurrence of the common underlying diseases, such as neurological system, cardiovascular and pulmonary system diseases, are not statistically significant （P 〉0.05） in the diagnosis of the SUD. Conclusion Common underlying diseases make no obvious contributions to SUD and are not useful in diagnosing the underlying reasons for death.展开更多
文摘通过回顾性分析2021年国际雪联系列测试活动(以下简称"相约北京")医疗保障工作,解决院前急救与院内急救缺乏实时衔接和协同救治的问题。依托5G+物联网技术,应用智慧医疗、移动医疗,以崇礼院区指挥中心为基础,建设院前院内紧密衔接的冬奥会医疗保障指挥调度平台。通过指挥调度平台实现竞赛以及与竞赛直接相关延伸区域的场地(field of play,FOP)、固定医疗站、救护车转运途中与崇礼院区指挥中心音视频实时互联互通、生命体征和医学影像的传输,院内专家指导院前医生实施救治工作。指挥调度平台可为伤员从受伤时刻起到救治结束的全过程获得高质量、高效率的救治,提升冬奥会医疗保障水平,在后奥运时代发展前景良好。
文摘Background Pulmonary embolism （PE） is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of the current study was to understand its epidemiology, clinical features and the cause of delay of its diagnosis in adolescents. Methods A retrospective analysis of nine adolescents with acute PE admitted to the Peking University Third Hospital over the past 16-year period was performed. The epidemiology, clinical features and risk factors of the adolescents were described and compared with those of adults and elderly patients. The time to diagnosis and misdiagnosed diseases were analyzed. Pretest probability of PE was assessed retrospectively by the Wells score and revised Geneva score. Results The incidence of PE was 43.6 per 100 000 hospitalized adolescents in our hospital. The incidence of PE in adolescents was much lower than that in adults and PE is diagnosed in about 1/50 of elderly people. The clinical features in adolescents were similar to those in adults. But fever and chest pain were more common in adolescents （P〈0.05）. The major risk factors included surgery, systemic lupus erythematosus （SLE）, thrombocytopenia, long-term oral glucocorticoids and trauma. The mean diagnostic time was （7.8±8.4） days. Six cases had a delayed diagnosis. The mean delay time from symptom onset to diagnosis was （11.0±8.8） days. The time of presentation to diagnosis in patients initially admitted to the emergency department was less than one day, and was much shorter than the time in outpatients, （9.4±7.5） days. Most of the patients were initially misdiagnosed with a respiratory tract infection. Most patients＇ values of Wells score or revised Geneva score were in the moderate or high clinical probability categories; 88% by Well score vs. 100% by revised Geneva score. Conclusions PE was seldom considered in the adolescent patients by physicians, especially outpatient physicians, so the diagnosis was often delayed. If adolescent patients complain of dyspnea or chest pain or syncope with/without fever, and they had risk factors such as surgery, thrombocytopenia and trauma, PE should be considered and included in the differential diagnosis.
文摘To the editor： Antineutrophil cytoplasmic antibodies （ANCA） are a group of autoantibodies associated with various diseases andcan be detected in drug-induced vasculitides. Here, we report two patients of drug-induced vasculitides combind with kidney damage （one is followed-up 10 years, the other is followed-up 3 years） and review the literature for the occurrence of this complication, share the common phenomenon with our peers.
基金This study was supported by a grant from National Natural Science Foundation of China （No. 81172745）.
文摘Background Underlying diseases have a statistically significant positive correlation to sudden death. However, sudden unexplained death （SUD） is different from sudden death, as there is no clinical evidence to support the sudden death due to the original underlying disease, nor a lethal pathological basis to be found during autopsy. In addition, SUD are more common in young, previously healthy individuals, usually without any signs of disease, with no positive lesions found after autopsy. Therefore, a causal relationship between SUD and the underlying disease needs to be further explored. This study aimed to explore the role that common underlying diseases play in patients with SUD and to reveal the correlation between them. Methods The medical records, history and case information of 208 patients with SUD were collected for the survey. All these SUD occurred in the emergency room of Peking University Third Hospital from January 2006 to December 2009. The patients were stratified by with and without common underlying diseases. To examine possible associations between the underlying diseases and the cause of unexplained sudden death, the chi-squared and Fisher＇s exact tests were used. Results Among the 208 patients, 65 were diagnosed with common underlying diseases while 143 were not. Within these two groups, there were 45 patients for whom the clear cause of death was determined. However, there were no statistically significant differences or strong associations （x2=1.238, P 〉0.05） between the 11 patients with （16.90%） and 34 without （23.78%） common underlying disease among these 45 patients. We also found that occurrence of the common underlying diseases, such as neurological system, cardiovascular and pulmonary system diseases, are not statistically significant （P 〉0.05） in the diagnosis of the SUD. Conclusion Common underlying diseases make no obvious contributions to SUD and are not useful in diagnosing the underlying reasons for death.
