目的 探討H2受體拮抗劑和質子泵抑制劑（PPI）緩解急性胃黏膜損傷的時效性研究。 方法 對2008年1月－2010年1月在急診科就診的98例急性乙醇中毒后胃黏膜損傷患者，隨機分為對照組50例，治療組48例。常規給予休息、保暖，補液，維持水、電解質、酸堿平衡，維持循環功能等治療基礎上，對照組給予H2受體拮抗劑治療，治療組給予PPI治療。通過觀察急性胃黏膜損傷患者上消化道癥狀及體征，記錄不同飲酒及飲酒量，并根據患者就診時間及不同飲酒組治療后上消化道癥狀完全緩解時間進行比較。 結果 治療組上消化道癥狀緩解所需時間與對照組比較差異有統計學意義（P＜0.001），不同飲酒組上消化道癥狀緩解時間上差異有統計學意義（P=0.000）。 結論 PPI在緩解急性乙醇中毒所致胃黏膜損傷的時效上更明顯，具有臨床價值。
During the prevention and control of coronavirus disease 2019, West China Hospital of Sichuan University urgently set up 4 medical tents to conduct centralized screening of fever patients, effectively avoiding cross-infection, and at the same time alleviating the pressure on the Department of Emergency Medicine and improving the efficiency of medical treatment for patients with fever. Later, in order to actively respond to China’s severe acute respiratory syndrome coronavirus 2 nucleic acid detection policy, 5 tents were adjusted to carry out the severe acute respiratory syndrome coronavirus 2 nucleic acid detection. This article introduces the function setting, personnel arrangement and protective measures of medical tents in West China Hospital of Sichuan University during the prevention and control of coronavirus disease 2019. It aims to share the experience of urgently setting up medical tents in the prevention and control of coronavirus disease 2019, with a view to provide a reference for the construction of medical tents in other medical institutions.
目的 探討血清降鈣素原（PCT）、C反應蛋白（CRP）與急性生理及慢性健康評分標準Ⅱ（APACHE Ⅱ）評分在轉診肺炎合并膿毒癥患者診斷中的相關性，以尋找更為簡潔、快速判斷其病情嚴重程度的指標。 方法 2009年1月－2010年12月，選取178例轉診肺炎合并膿毒癥患者并進行膿毒癥分級，對其進行血清PCT和CRP測定，并與APACHE Ⅱ評分及預后進行相關性分析。 結果 嚴重膿毒癥組及膿毒性休克組患者血清PCT、CRP水平與APACHE Ⅱ評分較全身炎癥反應綜合征組及膿毒癥組高（P＜0.05）；30 d內死亡的患者其血清PCT、CRP水平及APACHEⅡ評分較存活組明顯增高（P＜0.05）；轉診肺炎合并膿毒癥患者血清PCT與APACHE Ⅱ評分呈正相關（r=0.683，P=0.023），與血清CRP水平呈較弱的正相關（r=0.272，P=0.037）。 結論 對轉院肺炎合并膿毒癥患者進行血清PCT和CRP測定，對病情評估具有一定臨床價值，特別是PCT可作為對轉診肺炎合并膿毒癥患者病情程度判斷的重要指標，為早期干預及治療提供依據，值得臨床推廣應用。
Objective To develop a novel prediction model based on cerebrospinal fluid (CSF) lactate for early identification of high-risk central nervous system (CNS) infection patients in the emergency setting. Methods Patients diagnosed with CNS infections admitted to the Department of Emergency Medicine of West China Hospital, Sichuan University between January 1, 2020 and December 31, 2023 were retrospectively selected. Patients were classified into a survival group and a death group according to their 28-day survival status, and clinical characteristics were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of 28-day mortality, which were subsequently used to construct a nomogram. Results A total of 173 patients were included, comprising 135 in the survival group and 38 in the death group. Multivariate analysis identified the Acute Physiology and Chronic Health Evaluation Ⅳ (APACHE Ⅳ) score [odds ratio (OR)=1.027, 95% confidence interval (CI) (1.002, 1.055), P=0.034], CSF lactate [OR=1.147, 95%CI (1.025, 1.286), P=0.018], and interleukin-6 [OR=1.002, 95%CI (1.001, 1.004), P=0.002] as independent predictors of 28-day mortality. The integrated model combining APACHE Ⅳ score, CSF lactate, and interleukin-6, demonstrated superior predictive performance compared with the APACHE Ⅳ score alone (P=0.020), and showed good calibration (Hosmer-Lemeshow P=0.50). Conclusions This tool may provide a useful instrument for emergency physicians to assess the 28-day mortality risk in patients with CNS infections, potentially facilitating early and targeted interventions for high-risk individuals. However, as the findings of this study are derived from a single-center retrospective dataset, the clinical applicability of this model requires further external validation through large-scale, prospective, multicenter studies to evaluate its generalizability.