China’s “15th Five-Year Plan” explicitly proposes the implementation of a health-prioritized development strategy, aiming to comprehensively enhance emergency medical care and response capabilities. In this context, the development of emergency medicine will face new opportunities and challenges. In order to provide theoretical and practical references for the high-quality development of emergency medicine, this paper analyzes the shortcomings in the identification and early warning of critical illnesses, the timeliness of emergency care, and emergency response capabilities in the development of emergency medicine in China. It reviews current practices with cutting-edge technologies in innovating diagnostic and monitoring techniques and equipment, optimizing and integrating resources, promoting interdisciplinary collaboration, and leveraging the complementary advantages of traditional Chinese and Western medicine. Furthermore, it outlines future development directions.
The effect of parasitic ions on the results of ultraviolet A (UVA) cross-linking in iontophoresis was still not clear. In this work, the porcine sclera was cross-linked by riboflavin lactate Ringer’s solution (group A) and riboflavin normal saline (group B) in vitro, respectively. The concentration of parasitic ions in the solution was calculated. In addition, the average fluorescence intensity, penetration depth and concentration after the introduction of riboflavin and the mechanical properties of cross-linked sclera tissue were measured. The ranges of diffusion coefficient of the two solutions were also calculated, respectively. The results showed that more kinds of parasitic ions were detected in group A compared with group B, while the average fluorescence intensity, penetration depth and concentration of riboflavin and scleral elastic modulus in group B were significantly higher than those in group A when the penetration time was 10 minutes. Besides, the diffusion coefficient of riboflavin in group B was about 1.5 times larger than that in group A. The results suggested that the species of parasitic ions has a great impact on the permeability of riboflavin, and affects the mechanical properties of cross-linked sclera. The above results could provide a reference for improving the efficiency of riboflavin introduction and optimizing the formula of riboflavin in iontophoresis scleral cross-linking.
ObjectiveTo systematically review the accuracy of the mini-mental state examination scale (MMSE) in the screening of poststroke cognitive impairment (PSCI), and the diagnostic value of different cut-off values of the scale, so as to provide references for the selection of the threshold of the MMSE scale. MethodsDatabases including PubMed, EMbase, Cochrane Library, Web of Science, CINAHL, CBM, VIP, CNKI, and WanFang data were searched for diagnostic tests about MMSE for PSCI from inception to November 2022. Two researchers independently screened the literatures, extracted data and assessed the risk of bias of the included studies. Then, meta-analysis was performed by Stata 16.0 software. ResultsA total of 23 studies involving 1 525 patients were included. The results of meta-analysis showed that after the analysis of bivariate mixed effect model, the optimal cutoff value of MMSE scale was 23/24 (the pooled sensitivity=0.75, 95%CI 0.52 to 0.89; the pooled Specificity=0.90, 95%CI 0.81 to 0.95; DOR=28, 95%CI 12 to 65; AUC=0.92, 95%CI 0.89 to 0.94). The results of hierarchical summary receiver-operating characteristic (HSROC) curve model showed that the pooled sensitivity=0.77, 95%CI 0.70 to 0.83; the pooled specificity=0.76, 95%CI 0.69 to 0.83, Beta=0.1, 95%CI ?0.13 to 0.33, Z=0.82, P=0.41, Lambda=2.38, 95%CI 2.12 to 2.64, and the area under the SROC curve was 0.84. Fagan pre-test probability was 38%, positive likelihood ratio was 3.3, positive post-test probability was 67%, negative likelihood ratio was 0.3,negative post-test probability was 16%. ConclusionThe current evidence shows that MMSE has a certain diagnostic value as a screening tool for PSCI, the overall diagnostic efficacy is moderate, and the diagnostic value is highest when the cut-off value is 23/24. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.