admitted

摘要： Access block,known as exit block or boarding,is defined as a situation in which patients who are admitted or planned for admission remain in the emergency department(ED)as they are unable to be transferred to an inpatient unit within a reasonable time frame(no longer than 8 hours).[1,2]Access block often occurs due to insufficient hospital capacity and is a major issue in emergency medicine.[3]

摘要： CASE A man in his sixties with dilated cardiomyopathy was admitted to our hospital for the replacement of his cardiac resynchronization therapy (CRT) device. Although his condition had been initially improved after CRT implantation and he had taken an optimized medication regimen and undergone regular device follow-up, echocardiography showed progressive dyspnea and edema with decreased left ventricular ejection fraction (LVEF). During the procedure,his CRT was disconnected and tested using an analyzer module 2290 of the Medtronic 2090 programmer (Medtronic Inc., USA), and a temporary pacemaker (Model 5318;Medtronic Inc., USA) and high pacing thresholds (>5 V/0.5ms) were noted for both ventricles (Figures 1 A and B).

摘要： Dr.Chen Jiayong(Chia-Yung)was born on Feb.17,1922 in a prestigous intellectual clan at Jintang County,Sichuan Province,China.After receiving early education at the Chengdu County Middle School(now Chengdu 7th School),he was admitted as an undergraduate student to the Department of Chemical Engineering,the National Central University at the city of Chongqing from 1939 through 1943 during the Anti-Japanese War.After graduation,he continued to work as a teaching assistant for both the inorganic and organic chemistry courses.

摘要： A59-year-old female patient was admitted to our hospital on 9 March 2021,due to recurrent chest pain.She underwent percutaneous coronary intervention,with a focus on the proximal segment of the left anterior descending(LAD)artery,six months prior to admission.The patient had a long-term history of hyperlipidaemia and obstructive sleep apnoea syndrome(OSAS).She also had rheumatoid arthritis and ANCA-associated vasculitis that lasted for more than 10 years and a 9-year history of concomitant hypertension.She was on long-term oral leflunomide and intermittent oral prednisone.The patient underwent a computed tomography angiogram(CTA)six years ago(2015),which showed minor atherosclerotic plaque build-up in the LAD artery and the right coronary artery(RCA)(Figure 1).

摘要： OBJECTIVE To describe the duration of the pre-hospital delay time and identify factors associated with prolonged pre-hospital delay in patients with acute myocardial infarction(AMI)in China.METHODS Data were collected from November 2014 to December 2019 as part of the Improving Care for Cardiovascular Dis-ease in China-Acute Coronary Syndrome(CCC-ACS)project.A total of 33,386 patients with AMI admitted to the index hospitals were included in this study.Two-level logistic regression was conducted to explore the factors associated with the pre-hospital delay and the associations between different pre-hospital delay and in-hospital outcomes.RESULTS Of the 33,386 patients with AMI,70.7%of patients arrived at hospital≥2 h after symptom onset.Old age,female,ru-ral medical insurance,symptom onset at early dawn,and non-use of an ambulance predicted a prolonged pre-hospital delay(all P<0.05).Hypertension and heart failure at admission were only significant in predicting a longer delay in patients with ST-seg-ment elevation myocardial infarction(STEMI)(all P<0.05).A pre-hospital delay of≥2 h was associated with an increased risk of mortality[odds ratio(OR)=1.36,95%CI:1.09-1.69,P=0.006]and major adverse cardiovascular events(OR=1.22,95%CI:1.02-1.47,P=0.033)in patients with STEMI compared with a pre-hospital delay of<2 h.CONCLUSIONS Prolonged pre-hospital delay is associated with adverse in-hospital outcomes in patients with STEMI in China.Our study identifies that patient characteristics,symptom onset time,and type of transportation are associated with pre-hospital delay time,and provides focuses for quality improvement.

摘要： BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospitals in China remain unreported.METHODS This study used the Chinese national database(Hospital Quality Monitoring System)from 2013 to 2016,which is a mandatory database that collects the front page of patients’medical records for hospital accreditation,to describe the clinical cha-racteristics of patients with AF as an overall cohort and as subgroups divided by catheter ablation and sex.RESULTS Of 597,919 AF patients first admitted,57,983 patients underwent catheter ablation[56,384 cases(97.2%)of radiofre-quency ablation and 1599 cases(2.8%)of cryoablation]at 746 tertiary hospitals.Nearly 10%of patients hospitalized with AF at ter-tiary hospitals in China underwent catheter ablation,and the percentage of patients undergoing catheter ablation was on the rise bet-ween 2013 and 2016,and the number of cases increased by 2.5 times.Compared with AF patients who did not undergo catheter ablation,those who did were younger,more frequently male,and had fewer baseline comorbidities.Although the overall CHA_(2)DS_(2)-VASc score revealed over half of the patients were high-risk,patients who underwent catheter ablation were mostly low-risk(71.2%of males and 59.1%of females).Considering in-hospital adverse events,the overall pericardial tamponade and all-cause death incidences were 0.2%(0.6%in the ablation group)and 1.2%(0.1%in the ablation group),respectively;both of which were higher in females than males.CONCLUSIONS In this study,AF patients who underwent catheter ablation were relatively young,had a low thrombosis risk,and had few comorbidities and adverse events.Females were older and experienced more complications than males.

摘要： A blind college student hopes he could repay the kindness he has received from the society.CERING was born into a rural family in Sagya County, Xigaze City in southern Tibet Autonomous Region. Due to illness,he lost vision in both eyes at an early age,and was admitted to the Lhasa School for the Blind at the age of six. Later he transferred to a public school for blind children in Xigaze (230 km from regional capital Lhasa), where he learned braille and finished primary education. Schooling opened a door to the world for him that he could not see.

摘要： IN 1951,20-year-old Xu Zhongqing traveled three days from Wenzhou to Hangzhou,Zhejiang Province,to take part in China’s National College Entrance Examination.He passed the test,and was admitted into Zhejiang University where he majored in electrical power engineering.After graduating in 1955,Xu was assigned to work at the East China Electric Power Design Institute(the Institute)in Shanghai.With long exploration and arduous efforts,Xu and his coworkers built China’s first nuclear power plant.

摘要： OBJECTIVE To establish a prediction model of coronary heart disease(CHD)in elderly patients with diabetes mellitus(DM)based on machine learning(ML)algorithms.METHODS Based on the Medical Big Data Research Centre of Chinese PLA General Hospital in Beijing,China,we identified a cohort of elderly inpatients(≥60 years),including 10,533 patients with DM complicated with CHD and 12,634 patients with DM without CHD,from January 2008 to December 2017.We collected demographic characteristics and clinical data.After selecting the important features,we established five ML models,including extreme gradient boosting(XGBoost),random forest(RF),decision tree(DT),adaptive boosting(Adaboost)and logistic regression(LR).We compared the receiver operating characteristic curves,area under the curve(AUC)and other relevant parameters of different models and determined the optimal classification model.The model was then applied to 7447 elderly patients with DM admitted from January 2018 to December 2019 to further validate the performance of the model.RESULTS Fifteen features were selected and included in the ML model.The classification precision in the test set of the XGBoost,RF,DT,Adaboost and LR models was 0.778,0.789,0.753,0.750 and 0.689,respectively;and the AUCs of the subjects were 0.851,0.845,0.823,0.833 and 0.731,respectively.Applying the XGBoost model with optimal performance to a newly recruited dataset for validation,the diagnostic sensitivity,specificity,precision,and AUC were 0.792,0.808,0.748 and 0.880,respectively.CONCLUSIONS The XGBoost model established in the present study had certain predictive value for elderly patients with DM complicated with CHD.

摘要： Traumatic injuries range from simple to complicated multiple injuries.The identification of patients with critical injuries and disrupted organ perfusion is essential to prevent tissue hypoxia.A study estimated that a fast and accurate response to thoracic trauma should reduce the mortality by 30%.[1]The tissue perfusion value is an essential indicator of mortality and morbidity for patients admitted to the hospital with thoracic trauma.Thus,this study aimed to show the role of the perfusion index(PI)in predicting the prognosis of patients admitted to the emergency department for thoracic trauma.