Background： The aim of the research was to evaluate the association between CRP （C-reactive protein）, troponin I, d-dimer, creatinine, glucose, GFR （glomerular filtration rate） and LDL-C （low-density lipoprotei...Background： The aim of the research was to evaluate the association between CRP （C-reactive protein）, troponin I, d-dimer, creatinine, glucose, GFR （glomerular filtration rate） and LDL-C （low-density lipoprotein cholesterol） levels at the admission and the results of thrombolytic therapy. Materials and methods： 113 patients who underwent thrombolytic therapy for acute ischemic stroke in Pauls Stradins Clinical University Hospital from 01.01.2015 to 01.01.2016 were studied retrospectively. Blood samples were collected in the emergency department. The neurological status was estimated using the NIHSS （National Institute of Health Stroke Scale）. The efficacy of thrombolytic therapy was assessed by comparing NIHSS score at the admission and after treatment. Afterward all patients were divided into three groups-the major improvement （NIHSS 〉 4）, minor improvement （NIHSS ≤ 4） and without any clinical effect. Results： Only the median levels of GFR were significantly （p = 0.015） lower in patients who did not have any clinical improvements after thrombolytic therapy as compared to patients with the major or minor improvements （60.0, IQR （interquartile range） 42.4-72.3 mL/min/1.73m2; 83.2, IQR 65.3-98.3 mL/min/1.73m2 and 75.9, IQR 59.2-94.6 mL/min/1.73m2）. Based on the ROC （receiver operating characteristic） curve, the optimal cut-off value of GFR level as an indicator for prediction of worsen clinical outcome after thrombolytic therapy was projected to be 61.65 mL/min/1.73m2, which yielded a sensitivity of 71.4% and a specificity of 24.5%, the area under the curve was 0.788 （95% CI （confidence interval）, 0.648-0.928）. According Spearman rank correlation test was founded statistically significant indirect correlation between GFR level and NIHSS score after treatment （r = -0.410, p = 0.020） in patients with severe stroke （NIHSS 〉 14）. Conclusions： GFR level lower than 61.65 mL/min/1.73m2 at the admission could predict as a worse outcome, especially in patients with severe stroke.展开更多
To the Editor One of the most significant demographic changes in our cotmtry is the increase in the elderly population. In China Mainland, the population aged 60 and older was 194 million in 2012, accounting for 14.3%...To the Editor One of the most significant demographic changes in our cotmtry is the increase in the elderly population. In China Mainland, the population aged 60 and older was 194 million in 2012, accounting for 14.3% of the total population. However, by 2053, it is estimated that the number of elderly will reach 487 million, representing 34.8% of the total population. Elderly patients represent an everncreasing populace in emergency medicine who often present with atypical signs and symptoms as well as eomorbidities that can complicate diagnoses and treatment.Ell The geographic factors and the developmental status of the country can influence the spectrum of common geriatric emergencies. Thus, this study presents a retrospective analysis of common causes of geriatric emergencies involving 9,628 elderly patients from Jan. 2008 to Dec. 2013 in an emergency department in Beijing, China.展开更多
Trauma is a life-threatening ＂modern disease＂. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in add...Trauma is a life-threatening ＂modern disease＂. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support （ATLS）. Currently, the pre-hospital emergency medical services （EMS） has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training （CTCT） with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training.展开更多
文摘Background： The aim of the research was to evaluate the association between CRP （C-reactive protein）, troponin I, d-dimer, creatinine, glucose, GFR （glomerular filtration rate） and LDL-C （low-density lipoprotein cholesterol） levels at the admission and the results of thrombolytic therapy. Materials and methods： 113 patients who underwent thrombolytic therapy for acute ischemic stroke in Pauls Stradins Clinical University Hospital from 01.01.2015 to 01.01.2016 were studied retrospectively. Blood samples were collected in the emergency department. The neurological status was estimated using the NIHSS （National Institute of Health Stroke Scale）. The efficacy of thrombolytic therapy was assessed by comparing NIHSS score at the admission and after treatment. Afterward all patients were divided into three groups-the major improvement （NIHSS 〉 4）, minor improvement （NIHSS ≤ 4） and without any clinical effect. Results： Only the median levels of GFR were significantly （p = 0.015） lower in patients who did not have any clinical improvements after thrombolytic therapy as compared to patients with the major or minor improvements （60.0, IQR （interquartile range） 42.4-72.3 mL/min/1.73m2; 83.2, IQR 65.3-98.3 mL/min/1.73m2 and 75.9, IQR 59.2-94.6 mL/min/1.73m2）. Based on the ROC （receiver operating characteristic） curve, the optimal cut-off value of GFR level as an indicator for prediction of worsen clinical outcome after thrombolytic therapy was projected to be 61.65 mL/min/1.73m2, which yielded a sensitivity of 71.4% and a specificity of 24.5%, the area under the curve was 0.788 （95% CI （confidence interval）, 0.648-0.928）. According Spearman rank correlation test was founded statistically significant indirect correlation between GFR level and NIHSS score after treatment （r = -0.410, p = 0.020） in patients with severe stroke （NIHSS 〉 14）. Conclusions： GFR level lower than 61.65 mL/min/1.73m2 at the admission could predict as a worse outcome, especially in patients with severe stroke.
文摘To the Editor One of the most significant demographic changes in our cotmtry is the increase in the elderly population. In China Mainland, the population aged 60 and older was 194 million in 2012, accounting for 14.3% of the total population. However, by 2053, it is estimated that the number of elderly will reach 487 million, representing 34.8% of the total population. Elderly patients represent an everncreasing populace in emergency medicine who often present with atypical signs and symptoms as well as eomorbidities that can complicate diagnoses and treatment.Ell The geographic factors and the developmental status of the country can influence the spectrum of common geriatric emergencies. Thus, this study presents a retrospective analysis of common causes of geriatric emergencies involving 9,628 elderly patients from Jan. 2008 to Dec. 2013 in an emergency department in Beijing, China.
文摘Trauma is a life-threatening ＂modern disease＂. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support （ATLS）. Currently, the pre-hospital emergency medical services （EMS） has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training （CTCT） with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training.
