Objective: We aimed to evaluate door-to-puncture time (DPT) and door-to-recanalization time (DRT) without directing healthcare by neuro-interventionalist support in the emergency department (ED) by workflow optimization and improving patients’ outcomes. Methods: Records of 98 consecutive ischemic stroke patients who had undergone endovascular therapy (EVT) between 2018 to 2021 were retrospectively reviewed in a single-center study. Patients were divided into three groups: pre-intervention (2018–2019), interim-intervention (2020), and post-intervention (January 1^st 2021 to August 16^th, 2021). We compared door-to-puncture time, door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), last known normal time to-puncture time (LKNPT), and patient outcomes (measured by 3 months modified Rankin Scale) between three groups using descriptive statistics. Results: Our findings indicate that process optimization measures could shorten DPT, DRT, PRT, and LKNPT. Median LKNPT was shortened by 70 min from 325 to 255 min(P < 0.05), and DPT was shortened by 119 min from 237 to 118 min. DRT shortened by 132 min from 338 to 206 min, and PRT shortened by 33 min from 92 to 59 min from the pre-intervention to post-intervention groups (all P < 0.05). Only 21.4% of patients had a favorable outcome in the pre-intervention group as compared to 55.6% in the interventional group (P= 0.026). Conclusion: This study demonstrated that multidisciplinary cooperation was associated with shortened DPT, DRT, PRT, and LKNPT despite challenges posed to the healthcare system such as the COVID-19 pandemic. These practice paradigms may be transported to other stroke centers and healthcare providers to improve endovascular time metrics and patient outcomes.

Objective: Medical staff, especially nurses, suffered great anxiety and stress from the COVID-19 pandemic, which negatively affected their sleep quality. In this study, we aimed to analyze the sleep quality of nursing staff after terminating the Zero-COVID-19 policy in China. Methods: 506 participants were involved in our study. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep status of the participants. Binary regression was performed to evaluate the impact factors related to sleep difficulty. Results: The majority of participants (96.44%) suffered from sleep disturbances. There were significant differences in age, education level and front-line activity between participants with good sleep quality and sleep difficulty. Younger age (16–25 years old) was independently associated with less sleep difficulty, while front-line activity was independently associated with severe sleep difficulty. Conclusion: Sleep disorder was very common among nurses after ending the Zero-COVID-19 policy in China. More front-line nurses suffered severe sleep difficulty in particular, which should be worthy of attention.

Objective To assess the protective effect of COVID-19 vaccines in patients with varying immune states by analyzing lactate dehydrogenase (LDH), C-reactive protein (CRP), and D-dimer (D-Di) levels in COVID-19-infected individuals under different vaccination scenarios and immune statuses. Methods This is a single-center retrospective study involving 338 SARS-CoV-2-infected patients treated at a tertiary medical center in Foshan, China, between November 2022 and January 2023. The primary outcome was the vaccine's protective effect on LDH, CRP, and D-Di levels. Results Vaccinated patients had shorter hospital stays and less severe lung involvement (P < 0.05), particularly in immunocompromised individuals. In immunocompromised patients, LDH and CRP levels were elevated, but in the vaccine group, fewer patients developed abnormally high CRP, D-Di, and coagulation-related complications. Vaccination reduced LDH and CRP levels in immunocompetent patients and lowered CRP levels regardless of immune status. In addition, people who are both immunocompromised and vaccinated have a higher risk of developing microthrombosis. Conclusions COVID-19 vaccination generally improves LDH, CRP, and D-Di levels, particularly in immunocompromised patients, supporting vaccination efforts. However, a subset of immunocompromised and vaccinated patients exhibited higher D-Di levels upon hospital admission, suggesting a complex interplay between vaccination, immune status, and the risk of microthrombosis. This finding emphasizes the need for further investigation into the role of immune function in disease severity and vaccine response.