Contribution of the 5G Smart First-Aid Care Platform to Achieving High-Quality Prehospital Care.

China is gradually becoming an aging society, and the necessity for prehospital first-aid care is increasing. However, there is a long-term information blind spot in traditional prehospital first-aid care. Fifth-generation (5G) network has the advantages of enhanced broadband, multiple connections, and low latency. Combined with the current prehospital first-aid system, the 5G smart medical prehospital first-aid care model creates a new opportunity for the development of prehospital first-aid care. This paper aimed to describe the 5G smart first-aid care platform and offers practical insights into the construction and application of the 5G smart first-aid care platform in small- and medium-sized cities. We first introduced the working principle of the 5G smart first-aid care platform and then chose patients with prehospital chest pain as an example to describe the whole workflow in detail. The application of the 5G smart emergency-care platform is at the stage of pilot exploration in large- and medium-sized cities. Big data statistical analysis of the completed first-aid care tasks has not been performed yet. The 5G smart first-aid care platform realizes real-time interconnection of information between the ambulance and the hospital, performs remote consultation, shortens the treatment time, and enhances treatment efficiency. Future research should focus on quality control analysis of the 5G smart first-aid care platform.

Ruptured sinus of valsalva aneurysm presenting as syncope and hypotension: a case report.

BACKGROUND: Unruptured sinus of valsalva aneurysm (SOVA) are typically asymptomatic, and hence can be easily ignored. Ruptured sinus of valsalva aneurysm (RSOVA) usually protrude into the right atrium or ventricular. However, in this case, the RSOVA protruded into the space between the right atrium and the visceral pericardium leading to compression of the right proximal coronary artery. Very few such cases have been reported till date. CASE PRESENTATION: We describe a case of ruptured right SOVA in a 61-year-old man with syncope and persistent hypotension. At the beginning, considered the markedly elevated troponin, acute myocardial infarction was considered. However, emergency coronary angiography unexpectedly revealed a large external mass compressed right coronary artery (RCA) resulting in severe proximal stenosis. Then, aorta computed tomography angiography (CTA) and urgent surgery confirmed that the ruptured right SOVA led to external compression of the right proximal coronary artery. Finally, ruptured right SOVA repair and RCA reconstruction were successfully performed, and the patient was discharged with no residual symptoms. CONCLUSIONS: It is very important to be vigilant about the existence of SOVA. RSOVA should be suspected in a patient presenting with acute hemodynamic compromise, and echocardiography should be immediately performed. Moreover, it is very important to achieve dynamic monitoring by using cardiac color ultrasound. Definitive diagnosis often requires cardiac catheterization, and an aortogram should be performed unless endocarditis is suspected.

Prolonged treatment with macrolides in adult patients with non-cystic fibrosis bronchiectasis: meta-analysis of randomized controlled trials.

BACKGROUND: Infection, resulting in chronic airway inflammation, forms the basis of bronchiectasis pathogenesis. Macrolides possess antibacterial, anti-inflammatory and immunomodulatory properties, and are used to treat patients with non-cystic fibrosis bronchiectasis (NCFB). However, the efficacy and safety of long-term treatment with macrolides in patients with bronchiectasis have been controversial. We performed a meta-analysis to assess the efficacy and safety of macrolides in adults with NCFB. METHODS: We performed electronic search of several databases, including: Pubmed, EMBASE, EBSCO, SCI, and CENTRAL, and also searched references from identified articles for further consideration. Only randomized controlled trials (RCTs) comparing prolonged macrolide treatment with placebo for adult bronchiectasis were included. Data were extracted independently by two reviewers and combined using a fixed-effects model or random-effects with effect size expressed as OR or MD or SMD and 95% CIs for different situations. RESULTS: 834 studies were identified. Four RCTs met the inclusion criteria. Macrolide treatment significantly reduced pulmonary exacerbation (OR = 0.39, 95% CI 0.25-0.63) and improved lung function (SMD = 0.37, 95% CI 0.16-0.58) as compared to the placebo group. However, macrolide treatment did not significantly improve quality of life (MD = -1.90, 95% CI -7.01 to 3.20). With respect to the total numbers of participants who developed adverse events, there was no significant difference between the macrolides and placebo groups (OR = 0.83, 95% CI 0.50-1.39). Macrolides therapy could have increased the rate of macrolide resistance in adults with NCFB. CONCLUSIONS: Macrolide maintenance therapy was effective in reducing pulmonary exacerbations, and improving lung function in adults with NCFB. However, it did not improve quality of life, and could have led to macrolide resistance.