Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.

The Chinese Journal of Emergency Medicine is the only national journal representing the development of emergency medicine in China. It is supervised by the China Association of Science and Technology, sponsored by the Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles related to all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China and establishes communication with emergency medicine circles in Hong Kong, Macao, Taiwan, and internationally.

《Chinese Journal of Emergency Medicine》是中国唯一代表急救医学发展的国家级期刊。该期刊由中国科学技术协会主管，由中国医学会赞助，并由浙江大学共同赞助。期刊发表与急救医学临床实践和研究相关的原创研究文章，栏目包括院前救护、急救护理、创伤、复苏、中毒、灾害医学、继续教育等。期刊在中国具有广泛的覆盖面，并与香港、澳门、台湾及国际急救医学界建立了沟通。

Chinese Journal of Emergency Medicine

Objective@#To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates.@*Method@#Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc.@*Results@#The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38oC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea.@*Conclusion@#People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control.

Wei Zhang

Sijia Tian

Ying Wang

Hui Chen

Jinjun Zhang

Zhonghua jizhen yixue zazhi

Analysis of family cluster infection with Novel Coronavirus Pneumonia/ 中华急诊医学杂志

新型冠状病毒肺炎家庭聚集性感染分析/ 中华急诊医学杂志

Objective:To externally validated the intra-aortic balloon pump (IABP) shockⅡ score and CardShock score for predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and compared them with the Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score.Methods:According to the inclusion and exclusion criteria, patients admitted to the cardiac care center (CCU) of our center from December 2010 to May 2019 were enrolled in this study. Patients’ baseline characteristics, in-hospital interventions, and outcomes were collected. The APACHEⅡ score was calculated during hospitalization by clinicians and collected by researchers. Two researchers independently calculated the IABP-ShockⅡ score and CardShock score; any disagreement was discussed with the third researcher. The performance of risk scores was evaluated by discrimination and calibration. The discriminative ability of risk scores was evaluated using the area under the receiver operating characteristic curve (AUC) and compared by the Delong method. The calibration of these risk scores was examined by the Hosmer-Lemeshow goodness-of-fit test. The calibration plot was also built.Results:A total of 150 patients enrolled in our study, and the in-hospital mortality was 60%. According to the IABP-ShockⅡ score, patients scored as low risk (0-2), moderate risk (3-4), and high risk (5-9) had in-hospital mortality of 29%, 68%, and 80%, respectively. According to the CardShock score, patients scored as low risk (0-3), moderate risk (4-5), and high risk (6-9)had in-hospital mortality of 21%, 57%, and 82%, respectively. According to the APACHEⅡ score, patients scored 30 had in-hospital mortality of 19%, 69%, and 93%, respectively. For predicting the in-hospital mortality, the APACHEⅡ score demonstrated excellent discrimination (AUC=0.90, 95%
 CI: 0.84-0.95). The IABP-ShockⅡ score and CardShock score showed good discrimination (AUC=0.76, 95%
 CI: 0.68-0.83 and AUC=0.79, 95%
 CI: 0.72-0.85). The discriminative ability did not significantly differ between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05), but both of which were significantly lower than the APACHEⅡ score (0.76 vs 0.90, P<0.05, and 0.79 vs 0.90, P<0.05). At the same time, it was not significantly different between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05). All of these three scores were adequately calibrated according to the Hosmer-Lemeshow goodness-of-fit test (
 P>0.05).The calibration plot showed accurate calibration of these three scores.
 Conclusions:Although less accurate than the APACHEⅡ score, the IABP-ShockⅡ score and CardShock score can show accurate prediction for in-hospital mortality of AMI-CS patients.

Feng Dejing

Liu Yu

Wang Lefeng

Yang Xinchun

Du Shengli

Li Chuang

Zhai Zhen

Li Yanyan

Validation and comparison of risk prediction models in patients with cardiogenic shock complicating acute myocardial infarction

急性心肌梗死并发心源性休克患者风险预测模型的验证与比较

新型冠状病毒肺炎家庭聚集性感染的分析/ 中华急诊医学杂志

Objective: To assess the value of the ROX index in evaluating the efficacy of highflow nasal cannula oxygen therapy (HFNC) in patients with coronavirus infected disease (COVID-19). Methods: This is a retrospective study. The included patients were diagnosed as COVID-19 in the intensive care unit (ICU) of the Cancer Center of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 15, 2020 to March 15, 2020. All the patients were treated by HFNC. According to whether the patient subsequently received non-invasive positive pressure ventilation or invasive positive pressure ventilation, patients were divided into the HFNC success group and the HFNC failure group. Parameters in the two groups such as basic characteristics, lactic acid, number of chest radiographs, APACHE II, lymphocyte count, baseline respiratory rate, baseline percutaneous oxygen saturation, baseline PaO2/FiO2, baseline ROX index, and ROX index after 2, 6 and 12 h HFNC treatment were analyzed with t test, Chi-square test or rank sum test. Results: A total of 57 cases were included in this study. There were no significant differences in sex, age, comorbidities, lactic acid, quadrants of chest radiograph lung infection, APACHE II, lymphocyte count, and baseline respiratory frequency, transcutaneous oxygen saturation, oxygenation index, and ROX index between the HFNC success group and the HFNC faliure group (P>0.05). Logistic regression analysis showed that ROX index after 2 h HFNC treatment (OR=0.069), ROX index after 6 h HFNC treatment (OR=0.194) and ROX index after 12 h HFNC treatment (OR=0.036) were all protective factors for the therapeutic effect of HFNC treatment in COVID-19 patients. ROC curve showed that there were significant differences in ROX index after 2 h HFNC treatment, ROX index after 6 h HFNC treatment, and ROX index after 12 h HFNC treatment (P<0.05). In the evaluation index, the area under the ROC curve of the ROX index after 2 h HFNC treatment was 0.838, the sensitivity was 64.5%, and the specificity was 100%. After 6 h HFNC treatment, the area under the ROX index ROC curve was 0.762, the sensitivity was 64.5%, and the specificity was 92.3%. After 12 h HFNC treatment, the ROX index ROC curve area was 0.866, the sensitivity was 67.7%, and the specificity was 100%. Conclusions: The ROX index can be used to evaluate the efficacy of HFNC in COVID-19 patients in a timely, simple and real-time manner. © 2021 Chinese Medical Association. All rights reserved.

D. Wei

H. Yuanyuan

W. Xiaobo

X. Aihui

L. Yonghuai

X. Xihai

Z. Hong

The value of ROX index in evaluating the efficacy of high-flow nasal cannula oxygen therapy in patients with COVID-19

ROX指数在评估COVID-19患者高流量鼻导管氧疗疗效中的价值

Objective To evaluate the prognostic value of extravascular lung water index (EVLWI), soluble intercellular adhesion molecule-1(sICAM-1) and Krebs yon den lungen-6 (KL-6) in severe pneumonia patients with Severe Acute Respiratory Syndrome (ARDS). Methods A prospective study was conducted in Respiratory Intensive Care Unit of the Affiliated Zhengzhou Central Hospital of Zhengzhou University from October 2017 to February 2020. The study included 65 severe pneumonia patients with ARDS, who was performed by measurement of pulse index continuous cardiac output and survived more than 3days after admission. The Extravascular Lung Water Index（EVLWI）, sICAM-1, KL-6 and Oxygenation Index(OI) on 1st, 3rd and 5th day were detected. APACHE Ⅱ score, patient survival events (days) and survival outcome were recorded. Correlation analysis between EVLWI, sICAM-1, KL-6 and OI was performed on the 1st，3rd and 5th day after admission. Independent risk factors of mortality in severe pneumonia patients with ARDS were analyzed by multiple logistic regression. Receiver operating characteristic curve was drawn，and the prognostic value of each parameter was assessed finally. Results The PCT, EVLWI, sICAM-1, KL-6 and APACHE Ⅱ score in the death group were significantly higher than those in the survival group (P 0.05）. These parameters including levels of EVLWI, sICAM-1, KL-6, Procalcitonin and APACHE Ⅱ score in the death group were significantly higher than those in the survival group on the 1st，3rd and 5th day (P<0.05), whereas the OI was significantly lower than that of the survival group on the 3rd and 5th day (P<0.05). Logistic regression analysis showed that EVLWI, sICAM-1, KL-6 level were significantly related with the mortality of these patients. The levels of sICAM-1, kl-6 and EVLWI on 1st，3rd and 5th day after RICU admission showed a significant negative correlation with OI (P<0.001). Whereas, The levels of sICAM-1, kL-6 on 1st，3rd and 5th day showed a significant positive correlation with EVLWI (P<0.001). The sensitivity and specificity of sICAM-1, KL-6 combined with EVLWI in prognosis evaluation on 1st，3rd and 5th day were 75.0%，84.4%, 85.0%，66.7%，80.0%，86.7%, respectively. The AUC was 0.864，0.881，0.892 on 1st，3rd and 5th day, respectively (P<0.001), which had a better prognostic value than each of them. Conclusions EVLWI, sICAM-1 and KL-6 were independent risk factors for the prognosis of severe pneumonia patients with ARDS. The combination of EVLWI, sICAM-1 and KL-6 might be important in early predicting the prognosis of the 28d mortality. © 2021 Chinese Medical Association. All rights reserved.

S. Li

Y. Gao

L. Zhou

X. Li

L. Zhang

R. Dong

R. Zhang

G. Zhang

M. Shang

The prognosis evaluation of sICAM-1, KL-6 combined with EVLWI in severe pneumonia patients with acute respiratory distress syndrome

sICAM-1、KL-6联合EVLWI对重症肺炎合并急性呼吸窘迫综合征患者的预后评估

目的对新型冠状病毒肺炎(COVID-19)康复者的ABO血型分布做出统计, 并进一步分析具有不同恢复期血浆抗严重急性呼吸系统综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)抗体效价的康复者的ABO血型分布。 方法抽取150份年龄18~60岁的COVID-19康复者血浆作为实验组, 患者达到出院标准后14 d采集血浆。另抽取武汉市180例健康人的血型作为健康对照组。分析年龄、性别与康复者ABO血型分布的关联性。同时分析康复者血浆中抗体的效价及其于ABO血型的关联。 结果和健康对照组相比, COVID-19康复者中B型血患者数量较多(36% vs 25.0%, χ2=4.714, P 结论COVID-19康复者中, 40岁以下、B型血患者数量较多; 部分血浆抗SARS-CoV-2抗体效价较低的康复者不具备捐赠血浆的条件; 而B型血康复者可能更适宜作为COVID-19恢复期血浆捐献对象。

Kai Duan Di Xiao Fen Hu Peng Wu Bende Liu

The relationship between ABO blood group distribution of COVID-19 convalescents and the plasma antibody titer against SARS-CoV-2

Objective:
To analyze application fields of 5G communication technology in Corona Virus Disease 2019 (COVID-19) epidemic prevention and control, and build a 5G intelligent medical service system for COVID-19 epidemic prevention and control in China.


Methods:
We collected and analyzed 5G technology application cases used in the fight against COVID-19 from December 2019 to February 2020: 5G + telemedicine application cases, 5G + negative pressure ambulance cases, 5G + remote monitoring cases, 5G + artificial intelligence cases, 5G + infrared thermography temperature detection cases, 5G + big data analysis cases for epidemic prevention and control.


Results:
Through the analysis of 5G application cases in COVID-19 epidemic prevention and control, we found out the key elements of 5G intelligent medical service system in COVID-19 epidemic prevention and control. By optimizing and upgrading the internal service mode of the hospital, breaking the internal and external barriers, integrating internal and external resources, and strengthening 5G intelligent medical security, we can form a 5G intelligent medical service system for COVID-19 epidemic prevention and control, including application layer, technical service layer, network support layer and security system layer.


Conclusion:
5G communication technology has the characteristics of faster speed, shorter time delay and denser capacity. In COVID-19 epidemic prevention and control work, it can further improve the efficiency of doctors' diagnosis, improve patients' medical experience, realize the remote sharing of high-quality medical resources and real-time information exchange, effectively block the spread of epidemic, alleviate the shortage of medical resources and medical staff, and make the epidemic prevention and control more efficient.


Key words: 
5G communication technology; Artificial intelligence; COVID-19; Epidemic prevention and control; Intelligent medical treatment

Dacan Li

Min Huang

Cailian Zhao

Yuanyuan Gong

Yan Zhang

Construction of 5G intelligent medical service system in novel coronavirus pneumonia prevention and control

新型冠状病毒肺炎防控中的5G智慧医疗服务体系构建

The prevention and control of 2019 novel coronavirus (2019-nCoV) is currently the primary task of all industries in China. People can be infected through respiratory droplets, airborne and close contact. Pediatric airway foreign body is a common otorhinolaryngology emergency, especially occurred in 1 to 3-year-old children. It usually causes complications like airway obstruction, suffocation and pneumonia, which may become an acute threat to life. The common practice in otorhinolaryngology emergency room is to perform direct laryngoscope, bronchoscope and foreign body removal. Medical staff need to be closely contacted with these children during surgical operation, who may produce massive droplets and aerosols during examination. With a combination of characteristics of surgical operation, this article intends to provide advices on diagnosis and treatment of airway foreign body removal for pediatric otorhinolaryngology colleagues during the prevention and control of 2019-nCoV. Adjustments could be made subsequently due to changes of the epidemic situation and the recognition of 2019-nCoV.

jia Liu

hangyan Zhao

jinjin Huang

sheng Ye

wei Wang

junfen Fu

fei Qiu

yong Fu

Pediatric Airway Foreign Body Retrieval During the Prevention and Control of 2019 Novel Coronavirus

2019新型冠状病毒防控期间儿童气道异物取出术

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Chinese Journal of Emergency Medicine

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Analysis of family cluster infection with Novel Coronavirus Pneumonia/ 中华急诊医学杂志

Validation and comparison of risk prediction models in patients with cardiogenic shock complicating acute myocardial infarction

Analysis of family cluster infection with Novel Coronavirus Pneumonia/ 中华急诊医学杂志

Validation and comparison of risk prediction models in patients with cardiogenic shock complicating acute myocardial infarction

Analysis of family cluster infection with Novel Coronavirus Pneumonia/ 中华急诊医学杂志

The value of ROX index in evaluating the efficacy of high-flow nasal cannula oxygen therapy in patients with COVID-19

The prognosis evaluation of sICAM-1, KL-6 combined with EVLWI in severe pneumonia patients with acute respiratory distress syndrome

The relationship between ABO blood group distribution of COVID-19 convalescents and the plasma antibody titer against SARS-CoV-2

Construction of 5G intelligent medical service system in novel coronavirus pneumonia prevention and control

Pediatric Airway Foreign Body Retrieval During the Prevention and Control of 2019 Novel Coronavirus

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xGGr6y	北大核心中国科学引文数据库中国科技核心期刊目录

ISSN	1671-0282
h-index	7