Current trauma care system and trauma care training in China / 中华创伤杂志(英文版)

Trauma is a life-threatening "modern disease". The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support (ATLS). Currently, the pre-hospital emergency medical services (EMS) has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training (CTCT) with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training.

Effect of retension sutures on abdominal pressure after abdominal surgery / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients.</p><p><b>METHODS</b>This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the "U" type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure (IVP) was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded.</p><p><b>RESULTS</b>During the operation, the IVP decreased and then increased; it was at its lowest 1 h after the start of the operation (5.3 mmHg ± 3.2 mmHg) and peaked after tension-reducing (8.8 mmHg ± 4.0 mmHg). The IVP values in the "U" type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation (p < 0.005). The Visual Analogue Scale (VAS) pain scores were 3.9 ± 2.2, 3.8 ± 2.0, and 3.0 ± 1.0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the "U" type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group (p < 0.005).</p><p><b>CONCLUSION</b>Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.</p>

Chronic caffeine exposure attenuates blast-induced memory deficit in mice / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of three different ways of chronic caffeine administration on blast- induced memory dysfunction and to explore the underlying mechanisms.</p><p><b>METHODS</b>Adult male C57BL/6 mice were used and randomly divided into five groups: control: without blast exposure, con-water: administrated with water continuously before and after blast-induced traumatic brain injury (bTBI), con-caffeine: administrated with caffeine continuously for 1 month before and after bTBI, pre-caffeine: chronically administrated with caffeine for 1 month before bTBI and withdrawal after bTBI, post-caffeine: chronically administrated with caffeine after bTBI. After being subjected to moderate intensity of blast injury, mice were recorded for learning and memory performance using Morris water maze (MWM) paradigms at 1, 4, and 8 weeks post-blast injury. Neurological deficit scoring, glutamate concentration, proinflammatory cytokines production, and neuropathological changes at 24 h, 1, 4, and 8 weeks post-bTBI were examined to evaluate the brain injury in early and prolonged stages. Adenosine A1 receptor expression was detected using qPCR.</p><p><b>RESULTS</b>All of the three ways of chronic caffeine exposure ameliorated blast-induced memory deficit, which is correlated with the neuroprotective effects against excitotoxicity, inflammation, astrogliosis and neuronal loss at different stages of injury. Continuous caffeine treatment played positive roles in both early and prolonged stages of bTBI; pre-bTBI and post-bTBI treatment of caffeine tended to exert neuroprotective effects at early and prolonged stages of bTBI respectively. Up-regulation of adenosine A1 receptor expression might contribute to the favorable effects of chronic caffeine consumption.</p><p><b>CONCLUSION</b>Since caffeinated beverages are widely consumed in both civilian and military personnel and are convenient to get, the results may provide a promising prophylactic strategy for blast-induced neurotrauma and the consequent cognitive impairment.</p>

Comparative analysis of characteristics and risk factors of traffic injury in aged people from urban and rural areas in Chongqing / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan'an district (urban) and Jiangjin district (rural) of Chongqing, and to discuss the corresponding strategies for its prevention and cure.</p><p><b>METHODS</b>Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries. Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.</p><p><b>RESULTS</b>Between the year 2000 and 2006, the average annual incidence of traffic injuries and mortality rate in the aged people in Nan'an district were 124.62/100 000 and 13.85/ 100 000 respectively, higher than that in Jiangjin district (27.49/ 100 000, 7.13/100 000, P less than 0.01). However, the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%, higher than that in Nan'an district (10.00%, P less than 0.01). Head injury was the primary cause of death. Totally 76.58% of casualties were pede-strians. Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.</p><p><b>CONCLUSIONS</b>The traffic environment is unfavorable to the aged people. It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law, so as to provide a safe road traffic environment for the aged people.</p>

Effects of low frequency resonance on physiological function in rats / 医用生物力学

Objective To study the effect of continuous low frequency resonance on blood pressure, heart rate, breath rate and body temperature of the rat so as to provide basic data for the study of organs’ resonance injury and its reaction. Method Thirty two SD rats were divided into four groups randomly: false vibration group, 3 Hz vibration group, 6 Hz vibration group and 21 Hz vibration group. Femoral artery intubatton was given after anaesthesia with 1.5% sodium pentobarbital. All the rats were fastened on their back on the vibration platform staying calmly for 30 min. Then the vibration groups were given sine wave vibration with 5 mm amplitude(p-p), while the blood pressure, heart rate, breath rate and body temperature of the rats were measured at 0, 1, 3, 5, 10, 30, 60, 120, 180, 240, 300 and 360 min. The above physiological data were also observed in false vibration group at corresponding time. Results Continuous low frequency resonance could cause the blood pressure, heart rate, breath rate of the rat to rise rapidly after 1 min of vibration, and to reach the maximum value after 1 min to 3 min of vibration, and then to descend gradually and to be lower than the normal value after 30 min of vibration. The body temperature of the rat did not change at the beginning of vibration, but descended gradually after 10 min of vibration. At the beginning of vibration, the effect of 6 Hz resonance on blood pressure, heart rate, breath rate was dominating, while at the later stage, 3 Hz resonance was dominating. But the effect of the two frequencies on body temperature was accordant. Conclusions Continuous low frequency resonance can cause the blood pressure, heart rate, breath rate of the rat to rise rapidly at the beginning of vibration and then to descend gradually, and it can also depress the ability of body temperature regulation in rats.

Analysis of injuries and treatment of 3,401 inpatients in 2008 Wenchuan earthquake--based on Chinese Trauma Databank / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>A catastrophic earthquake struck Wenchuan region of West China on May 12, 2008 and caused more than 69 225 deaths. This study was to analyze injury characteristics and treatment of the seismic patients based on Chinese Trauma Databank, which will be helpful for improvement of future medical rescue in potential disasters.</p><p><b>METHODS</b>Based on inpatients'medical records of seismic patients admitted into 11 hospitals, data were registered with Trauma Database System Version 3.0. Patients'general information, causes, clinical characteristics and treatment of injuries were studied.</p><p><b>RESULTS</b>Main causes for seismic injuries were blunt strike (68.2%), crush/burying (18.7%) and slip/falling (11.5%). Slip/falling was the main cause for spinal injuries and accounted for 19.1%, which was higher than the percentage for other body part. Extremity injuries accounted for 54.8% of all injuries. Fractures accounted for 53.1%. Lower extremity fracture accounted for 70.1% of lower extremity injury and spinal fracture accounted for 85.9% of spinal injury. The proportion of spinal injuries with AIS larger than or equal to 4 was higher than that of other injured locations except for the abdomen. Debridement and suturation for single injury and multiple injury patients accounted for 64.7% and 42.9% of their operations respectively.</p><p><b>CONCLUSIONS</b>Blunt strike, crush/burying and slip/falling are the main causes for seismic injuries. The most frequently injured site is extremity. The main injury type is fracture, especially for the lower extremities and the spine. Multiple injury patients were mainly treated by operation, including debridement and suturation, closed reduction and external fixation, etc.</p>