Background: In recent years, the incidence of wasp sting has increased annually in China. Organ damage and high mortality due to mass wasp envenomation remain major challenges. Timely and appropriate medical intervention can improve survival. However, there are currently no normalized tools for early assessment of severity. Methods: The clinical data of wasp sting patients hospitalized from 2011 to 2019 were used as a training set. Logistic regression was used to explore major risk factors for the development of a severe case of wasp sting (SC). The Wasp Sting Severity Score (WSS) was determined considering these risk factors to identify SCs and was tested in a validation dataset that was prospectively collected in 2020. Results: The data of 1131 wasp sting patients from 2011 to 2019 were included in the training set. Logistic regression analysis showed that tea-colored urine, number of stings, and lactate dehydrogenase and total bilirubin levels were risk factors for developing an SC. The WSS was developed considering these four risk factors, and the total possible WSS was 20 points. The WSS was tested using the validation dataset, comprising the data of 153 patients, in 2020, and we found that a WSS ≥3 points was an important indication for blood purification, with a sensitivity of 71.9%, specificity of 92.6% and an area under the curve of 0.918 (95% confidence interval 0.873–0.962). Among patients with more than 30 stings, mortality in those who underwent plasma exchange (PE) within 24 h after admission was significantly lower than that in those who did not receive PE treatment (14.3% versus 46.9%, P = 0.003). However, continuous venovenous hemofiltration (CVVH) (P = 0.317) and hemoperfusion (HP) (P = 0.869) did not significantly reduce mortality. Conclusions: Patients with WSS scores ≥3 should be considered for blood purification as early as possible in addition to routine treatment. In addition, PE is better than CVVH and HP at reducing mortality in patients suffering from severe wasp stings.

In the early stages of the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, many cross-infections occurred due to the limited number of wards and insufficient medical staff, which could not cope with the large number of patients visiting the hospital. A series of new infection control measures were implemented in our institution and a Wuhan hospital supported by our medical team, mainly including temporarily transforming the general ward into a passage for the staff to enter the infectious ward and standardizing the procedure for the wearing and removal of personal protection equipment (PPE). These measures significantly improved the situation, and no member of our medical staff was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the middle and late stages of the disease epidemic. We hope that these experiences can provide references for medical institutions that may face an outbreak of COVID-19, especially those in underdeveloped countries and regions.

Background: Inflammatory biomarkers are associated with outcomes in sepsis, but prognostic association does not necessarily imply additional predictive information beyond clinical severity. We evaluated the incremental prognostic value of procalcitonin (PCT), the neutrophil-to-lymphocyte ratio (NLR), and the monocyte-to-lymphocyte ratio (MLR) at a 24-hour landmark. Methods: This single-center retrospective cohort included 248 adults admitted through the emergency department with sepsis between January 2024 and April 2026. The primary analysis included 243 patients alive 24 h after arrival and used 50 multiply imputed datasets. Fixed-horizon logistic models compared a clinical base model comprising sex, albumin, lactate, and APACHE II with models that added continuous PCT alone or PCT, NLR, and MLR together. Internal validation used ordinary bootstrap optimism correction with 1000 patient-level resamples and multiple imputation nested within resampling; within each resample, separate MICE runs completed the incomplete bootstrap sample and the original cohort used to evaluate the bootstrap-fitted models (five imputations each). A 0-3-point equal-weight inflammatory score based on within-cohort Youden cut-offs was examined as a secondary exploratory analysis. Results: Forty-six patients in the landmark cohort died by day 28. Exploratory pooled comparisons did not provide evidence that adding PCT improved the clinical base model ( P = 0.775) or that adding PCT, NLR, and MLR together improved it ( P = 0.428). The odds ratios per doubling were 0.943 (95% CI 0.817–1.089) for PCT, 1.350 (0.937–1.943) for NLR, and 0.866 (0.681–1.101) for MLR. Optimism-corrected AUCs were 0.749, 0.743, and 0.728 for M0, M1, and M2, respectively. The corrected AUC difference between M2 and M0 was −0.022 (95% CI −0.030 to 0.023). The apparent association of the fixed-cut-off score was no longer supported after repeating the complete cut-off search procedure (selection-adjusted P = 0.295). A first-laboratory sensitivity analysis retaining all 248 patients and 51 deaths yielded a similar pattern (exploratory pooled P = 0.951). Conclusions: PCT, NLR, and MLR did not provide evidence of incremental predictive value in this exploratory single-center cohort. The within-cohort equal-weight inflammatory score was subject to substantial cut-off selection uncertainty and remains exploratory. Neither the model nor the score should guide clinical decisions before independent evaluation.