Background: Severe trauma is a major cause of death and disability and requires rapid, coordinated management. Traditional emergency care is often fragmented across departments, which may delay critical interventions. This study evaluated the effectiveness of the Trauma Center emergency model, an integrated multidisciplinary system with standardized protocols, compared with conventional care in patients with severe trauma. Methods: This non-randomized time-series study included 100 patients with severe trauma admitted to Zigong Fourth People's Hospital from January to December 2025. Severe trauma was defined as a Shock Index >0.8. Patients were assigned chronologically to a control group receiving traditional emergency care and a study group managed under the Trauma Center model, with 50 patients in each group. Outcomes included time to intravenous access, emergency department processing time, complication rate, and rescue success rate. Results: Compared with the control group, the Trauma Center group had significantly shorter time to intravenous access (12.17 +/- 3.43 vs. 19.79 +/- 5.88 min; mean difference 7.62 min, 95% CI 5.71-9.53; p-value < 0.001) and shorter emergency department processing time (78.32 +/- 25.42 vs. 103.54 +/- 39.27 min; mean difference 25.22 min, 95% CI 11.89-38.55; P < 0.001). The complication rate was lower (14.0% vs. 40.0%; p-value = 0.004), while rescue success was higher (92.0% vs. 80.0%; p-value = 0.003). Conclusion: Implementation of the Trauma Center emergency model in severe trauma care significantly reduces critical time intervals, lowers complication rates, and improves rescue success.
Background: Chronic Obstructive Pulmonary Disease (COPD) seriously threatens the quality of life in middleaged and elderly populations. Respiratory function exercise is a core non-pharmacological treatment, yet patient adherence is often suboptimal. This study aimed to analyze the factors influencing adherence to respiratory function exercise among middle-aged and elderly COPD patients in primary care settings, providing a reference for clinical intervention. Methods: A cross sectional study that employs a total of 100 middle-aged and elderly COPD patients admitted to The People's Hospital of Gaoxian from February 2025 to January 2026 was selected. All participants were hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). General demographic data were collected, and assessments were conducted using anxiety, depression, and social support scales. Adherence to respiratory function exercise was also evaluated. SPSSAU software was used for statistical analysis. Univariate analysis employed the chi(2) test, and multivariate analysis employed logistic regression. Results: Among the 100 patients, 64 (64%) exhibited poor adherence, while 36 (36%) exhibited good adherence. Multivariate logistic regression analysis revealed that age <= 70 years (OR=0.145), educational level of junior high school or below, disease duration <5 years, drug dependence, and anxiety were all risk factors for poor adherence to respiratory function exercise. Conclusion: Adherence to respiratory function exercise in middle-aged and elderly COPD patients is associated with age, educational level, disease duration, drug dependence, and anxiety. Clinical practice should address these factors with targeted measures to improve adherence and prognosis.
The management of complex renal stones presents a persistent and significant challenge in urology. While percutaneous nephrolithotomy (PCNL) remains a standard, retrograde intrarenal surgery (RIRS) has gained prominence as a major minimally invasive alternative, valued for its rapid recovery and favorable safety profile. This narrative review explores how recent technological innovations are expanding the role and efficacy of RIRS for these difficult cases. Key developments include the integration of negative-pressure suction systems, which effectively mitigate stone migration and reduce residual fragment rates. Furthermore, the emergence of artificial intelligence (AI) leverages big data to facilitate personalized surgical planning and intraoperative guidance, enhancing both precision and safety. Concurrently, advancements in high-power, short-pulse laser technology have substantially improved the efficiency and safety of stone dusting. The introduction of novel digital flexible nephroscopes offers superior flexibility and high-definition imaging, proving particularly valuable for stones in challenging locations and for large stone burdens. Finally, combined strategies, such as RIRS with micro-percutaneous nephrolithotomy (MPCNL), represent an effective trend, achieving high stone-free rates while further minimizing overall surgical trauma. In conclusion, the ongoing evolution of RIRS, through its synergy with suction, AI, advanced lasers, and new instrumentation, is profoundly transforming the therapeutic landscape for complex renal stones. These integrated approaches position RIRS as a cornerstone of safer, more efficient, and highly personalized minimally invasive treatment.
Introduction: Prediabetes and T2DM can lead to structural changes in both white and gray matter of the brain, including lacunar infarction, white matter hyperintensity, and brain atrophy. These alterations are strongly associated with cognitive decline and may be linked to the effects of diabetes on brain structures. Therefore, this study aimed to explore the onset of abnormal glucose metabolism on brain gray and white matter microstructure and to examine how clinical features correlate with changes in generalized fractional anisotropy (GFA), fractional anisotropy (FA), and mean diffusivity (MD). Methods: The study included 23 patients with type 2 diabetes mellitus (T2DM), 20 individuals with prediabetes, and 22 with normal glucose metabolism (NGM). Microstructural indices (GFA, FA, MD) were obtained for gray and white matter. Pearson and Spearman correlation analyses assessed relationships between these indices and clinical features. Results: Patients with prediabetes and T2DM showed abnormal GFA, FA, and MD values across multiple gray matter regions, while no significant white matter differences were found (P > 0.05). Cognitive scores did not differ between prediabetes and NGM groups but were lower in the T2DM group. After adjusting for sex, correlation analyses indicated that different clinical features variably affected brain microstructure across glucose-metabolism stages. Conclusion: Abnormal gray matter microstructure may be a potential factor underlying diabetes-related cognitive impairment, particularly in T2DM. Early recognition and intervention of structural brain changes in prediabetes and T2DM are essential to help prevent cognitive decline.
Background Otorhinolaryngological diseases are highly prevalent and significantly impacts patients' quality of life. While adequate health literacy is crucial for effective self-management and optimal clinical outcomes, research focusing specifically on otorhinolaryngology outpatients remains scarce. This population faces unique barriers, as impairments in auditory and speech functions can directly hinder their ability to access and comprehend health information. Therefore, this study aims to investigate the health literacy status of patients with otorhinolaryngological diseases, analyze its influencing factors, and provide a basis for developing targeted intervention strategies. Methods: This cross-sectional study utilized a random sampling method and included 100 outpatients from the Otorhinolaryngology Department of Zigong Fourth People's Hospital, selected between October 1, 2025, and February 5, 2026. Data collection involved a general information questionnaire, the Brief Health Literacy Screen (BHLS), the Family Assessment Device, the Self-Rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI). To identify factors linked to health literacy, univariate analysis and multiple linear regression analysis were conducted. Results: The average BHLS score for the 100 patients was (7.3 +/- 2.6), suggesting a general need for improvement in health literacy. Univariate analysis showed significant differences (P < 0.05) in health literacy levels based on gender, age, education level, employment status, medical payment method, and family function. Further, multiple linear regression identified age >= 60 years as an independent negative predictor of health literacy (P<.001). Conversely, having a high school education or above (P < 0.001) and good family function (P < 0.001) were positive predictors. Conclusion: The health literacy level of patients with otorhinolaryngological diseases is jointly fluenced by age, education level, and family function. In clinical practice, focused attention should be given to elderly patients and those with lower educational attainment. Comprehensive intervention measures, including strengthening family support systems, should be implemented to improve their health literacy effectively
