ABSTRACT
The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
ABSTRACT
Objective:To explore the application value of ventricular intracranial pressure monitoring (V-ICPM) in the treatment of unilateral temporal lobe cerebral contusion.Methods:A retrospective cohort study was conducted to analyze the clinical data of 295 patients with unilateral temporal lobe cerebral contusion admitted to 904th Hospital of PLA Joint Support Force from January 2014 to August 2021, including 172 males and 123 females; aged 14-78 years [(46.3±14.7)years]. V-ICPM was used in 136 patients (V-ICPM group), who received surgical or non-surgical treatment according to the monitoring, while not in 159 patients (non-V-ICPM group), who received routine surgery or non-surgical treatment. The two groups were compared in terms of the rates of intracranial hematoma clearance by craniotomy, decompressive craniectomy (DC) and dehydration and osmotic therapy during hospitalization, use time of 20% mass fraction of mannitol and 30 g/L hypertonic salt, displacement rate of brain midline structure of head CT≥10 mm after discharge, rate of intracranial infection, hydrocephalus and epilepsy, and Glasgow Outcome Scale (GOS) at 6 months after discharge.Results:All patients were followed up for 6-12 months [(8.9±2.1)months]. During hospitalization, the rate of intracranial hematoma clearance by craniotomy and the rate of DC in V-ICPM group were 35.3% (48/136) and 8.1% (11/136), lower than 47.2% (75/159) and 22.0% (35/159) in non-V-ICPM group ( P<0.05 or 0.01). There was no significant difference between the two groups in the rate of dehydration and osmotic therapy or the use time of mannitol (all P>0.05). The use time of hypertonic salt in V-ICPM group was (7.2±2.5)days, more than (4.1±1.8)days in non-V-ICPM group ( P<0.05). After discharge, the displacement rate of brain midline structure of head CT in V-ICPM group was 29.4% (40/136), lower than 42.8% (68/159) in non-V-ICPM group ( P<0.05). There was no significant difference between the two groups in the rate of intracranial infection, hydrocephalus and epilepsy (all P>0.05). Six months after discharge, the good rate of GOS in V-ICPM group was 91.2% (124/136), significantly better than 81.8% (130/159) in non-V-ICPM group ( P<0.05). Conclusion:For unilateral temporal lobe cerebral contusion, V-ICPM is associated with reduced rate of craniotomy exploration and DC, decreased incidence of complications and improved prognosis of the patients in spite of longer use time of hypertonic salt.
ABSTRACT
Subarachnoid hemorrhage (SAH) is a common and serious type of stroke. Studies have shown that multimodal monitoring of brain temperature, intracranial pressure and cerebral blood flow is helpful for the perioperative management of patients with SAH, and further improves the outcomes of patients. This article reviews the brain temperature changes and mechanism after SAH as well as the role of mild hypothermia treatment.
ABSTRACT
Objective:To systematically evaluate the effect of serum albumin content on the prognosis of patients with severe traumatic brain injury (TBI).Methods:PubMed, Embase, Cohrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), China Journals Full-text Database (CJFD), VIP database and Wanfang Database were used for retrieval from inception to November 10, 2020. Through retrieving Chinese and English literatures, relevant studies on serum albumin content in different types of TBI patients and in severe TBI patients with different prognostic results were included. The difference of serum albumin content in patinets with severe TBI with healthy people and patients with mild illness TBI, and the difference in serum albumin content between patients with good and poor prognosis of severe TBI were observed. At the same time, the differences in serum albumin content between subgroups were evaluated by subgroup analysis of the authors' country, literature quality and severity of the control group according to characteristics that might cause heterogeneity.Results:A total of 9 articles were included in this study, including 1, 438 study subjects. The serum albumin content in patients with severe TBI was significantly lower than that in healthy individuals and patients with mild TBI ( WMD=-6.42, 95% CI -9.95--2.80, Z=3.82, P<0.01). Subgroup analysis showed that serum albumin content in patients with severe TBI was significantly lower than that in healthy people ( WMD=-8.77, 95% CI-10.28--7.25, Z=11.37, P<0.01). Serum albumin content in patients with severe TBI was significantly lower than that in patients with mild TBI ( WMD=-4.07, 95% CI -9.53 -1.39, Z=1.46, P<0.05), suggesting that mild TBI patients are the main source of heterogeneity. The serum albumin content in patients with poor prognosis of severe TBI was significantly lower than that in patients with good prognosis of severe TBI ( WMD=-4.48, 95% CI-7.39--1.58, Z=3.02, P<0.01). Conclusion:Serum albumin content in patients with severe TBI is significantly lower than that in healthy individuals as well as in patients with mild TBI, and low albumin content indicates a poor prognosis in patients with severe TBI.
ABSTRACT
Objective To analyze the epidemiological and clinical characteristics of 403 local cases with dengue fever , and to provide guidance for dengue fever's prevention , diagnosis and treatment . Methods The epidemical data ,clinical characteristics ,laboratory results ,therapy and outcomes of 403 cases with dengue fever treated in Mengchao Hepatobiliary Hospital of Fujian Medical University ,Fuzhou from July to November 2016 were collected and analyzed retrospectively .Results Among the 403 cases , 56 cases (13 .89％ ) were younger than 20 years old ,160 cases (39 .71％ ) were 21 to 50 years old ,and 187 cases (46 .40％ ) were over 50 years old .The peak incidence period of dengue fever was from August to October ,accounting for 94 .29％ of the cases .The clinical classification was dominated by typical dengue fever (98 .01％ ) .Most of the cases had sudden onset .The main clinical symptoms included fever in 391 cases (97 .02％ ) , body aches in 355 cases (88 .09％ ) , and rash in 156 cases (38 .71％ ) . All patients were tested for serology and etiology of dengue virus at the early stage of disease .Among them , the positive rate of NS1 antigen was 95 .04％ ;the positive rate of IgM antibody was 13 .90％ ,and the positive rate of IgG antibody was 8 .19％ . Thrombocytopenia was founded in 332 cases (82 .38％ ) .Neutrophil count decreased in 293 cases (72 .70％ ) , w hite blood cell count decreased in 274 cases (67 .99％ ) .Aspartate aminotransferase increased in 256 cases (63 .52％ ) and alanine aminotransferase increased in 146 cases (36 .23％ ) .Creatine kinase elevated in 130 cases (32 .26％ ) and prothrombin time was prolonged in 40 cases (9 .93％ ) .A total of 289 cases (82 .75％ ) had bilateral lesions in both lungs and 25 cases (6 .20％ ) had pleural effusions . Color doppler ultrasound found 46 cases (11 .41％ ) of hepatomegaly ,84 cases (20 .84％ ) of splenomegaly ,8 cases (1 .99％ ) of a small amount of ascites . Conclusions Most of the 403 cases of dengue fever show typical clinical manifestations .Dengue fever mainly affects the blood system ,liver ,heart ,lung ,kidney ,skeletal muscle system ,and immune system . Clinicians should carefully observe the condition ,master the warning signs of severe dengue fever ,and achieve early identification and timely treatment of severe cases ,thereby reducing the mortality rate .
ABSTRACT
Objective To investigate the prognostic influence factors of Solitaire stent thrombectomy in patients with acute anterior circulation macrovascular occlusion. Methods From March 2015 to March 2017,222 consecutive patients with acute anterior circulation macrovascular occlusion admitted to the Department of Neurosurgery,the 101stHospital of People′s Liberation Army and the Nanjing Jinling Hospital were enrolled retrospectively.They were all confirmed by DSA and were treated with Solitaire stent thrombectomy. According to the modified Rankin Scale(mRS) scores at 90 d after treatment,they were divided into a good prognosis group (0-2,n=120) and a poor prognosis group (3-6,n =102). The baseline data and clinical data of the two groups of patients were analyzed,including the risk factors for cardiocerebrovascular diseases,baseline National Institutes of Health Stroke Scale (NIHSS) score,occlusion sites (internal carotid artery or middle cerebral artery occlusion),collateral compensatory,onset to puncture time, operation time,onset to recanalization median time,recanalization status,preoperative Alberta stroke programme early CT score(ASPECTS),and symptomatic cerebral hemorrhage,and then further multivariate logistic regression analysis was conducted for the prognostic factors of patients. Results (1) The rate of good prognosis was 54.1% (120/222).There were no significant differences in patients′ age,NIHSS at admission,ASPECTS at admission,sex,hypertension,occlusion site,and rate of good collateral branches in both groups(all P<0.05).There were no significant differences in other baseline data (all P >0. 05). (2) Onset to puncture time and onset to successful recanalization median time of the patients in good prognosis group was lower than that of the poor prognosis group (182 [138,230]min vs.236[170,305]min, 237[175,269]min vs.288[223,367]min).The proportion of successful recanalization was higher than that of the poor prognosis group (98.3% [118/120] vs.78.4% [80/102]).The proportion of postoperative symptomatic intracerebral hemorrhage was lower than that of the poor prognosis group (2.5% [3/120] vs.21.6% [22/102]).There was significant difference between the two groups (all P <0.01). There was no significant difference in operative time between the two groups (P >0.05). (3)In the single factor analysis,the parameter of P <0.05 was used as an independent variable,and prognosis was used as a dependent variable,multivariate logistic regression analysis showed that the increased age (OR,1.096,95% CI 1.050-1.144),history of hypertension (OR,8.401,95% CI 2.960-23.845),increased baseline NIHSS score (OR,1.071,95% CI 1.007-1.138),prolonged onset to successful recanalization time (OR,1.019,95% CI 1.003-1.035),symptomatic intracerebral hemorrhage after procedure (OR,18.110,95% CI 4.656-70.434) were all the risk factors for poor prognosis(all P<0.05);higher ASPECTS score at admission(OR,0.641,95% CI 0.451-0.911) and successful recanalization (OR,0.127,95% CI 0.024-0.664) were all the protective factors of good prognosis (all P<0.05). Conclusions Higher ASPECTS at admission and successful recanalization were the protective factors of poor prognosis of Solitaire stent thrombectomy in patients with acute anterior circulation macrovascular occlusion.Increased age,history of hypertension,increased baseline NIHSS score,prolonged onset to successful recanalization time,and symptomatic intracerebral hemorrhage after procedure were the risk factors for poor prognosis of Solitaire stent thrombectomy in patients with acute anterior circulation macrovascular occlusion.
ABSTRACT
Objective To analyze the epidemiological and clinical characteristics of 5 patients with importing yellow fever ,and to explore the preventive and control strategies of infection in hospital .Methods The epidemiological and clinical characteristics of 5 cases of importing yellow fever in Infectious Disease Hospital of Fujian Medical University from March 18th to April 6th in 2016 were retrospectively reviewed and analyzed .Results Five patients were all from Angola Luanda .One of them was vaccinated before going aboard ,and the others were vaccinated 1—10 days before disease onset in Angola .All of them were bitten by mosquitoes ,and their onset date ranged from March 11th to March 27th ,before returned to Fujian .The main clinical symptoms were fever ,chilly ,shivering ,fatigue ,arthrodynia ,headache ,and liver and kidney injury .At manifestations ,two patients had positive nuclear acid of yellow fever virus in serum samples and 3 patients were positive in urine samples .All of these patients were negative for dengue virus and Zika virus testing ,meanwhile no plasmodium was found in blood smears .All patients were cured and discharged . Conclusions There is risk of yellow fever transmission in Fujian Province . Prevention and control of the disease should be focus on improving the ability of finding and coping with the importing cases .Vaccination and hygiene knowledge propagation should be given for those who are going to epidemic country/area .Emergency monitoring and control of mosquitoes are necessary .
ABSTRACT
Objective To establish a rabbit posttraumatic acute diffuse brain swelling (PADBS) model and investigate the mechanism of action.Methods Fifty New Zealand rabbits were assigned to control group (n =10) and model group (n =40) according to random number table.The animal model of sinus balloon compression was established under intracranial pressure monitoring by using intracranial pressure probe.The model group was subdivided equally at 1.5 hours after compression,1.5 hours after decompression,3 hours after decompression and 4.5 hours after decompression,for which intracranial pressure,brain water content,pathological mechanism and ultrastructure were measured dynamically.Results The success rate of modeling was 83％ (33/40).Intracranial pressure was (4.9 ± 0.8)mmHg in control group,(50.1 ± 4.3) mmHg in 1.5 hours after compression group,(45.2 ± 1.7) mmHg in 1.5 hours after decompression group,(48.6 ± 2.2) mmHg in 3 hours after decompression group,and (59.1 ±2.5)mmHg in 4.5 hours after decompression group (P ＜0.05).Brain water content was (75.0 ± 0.6) ％ in control gorup,(76.7 ± 0.8) ％ in 1.5 hours after compression group,(77.3 ± 0.5) ％ in 1.5 hours after decompression group,(78.5 ± 0.6) ％ in 3 hours after decompression group,and (79.4 ± 0.7) ％ in 4.5 hours after decompression group (P ＜ 0.05).Vasogenic brain oedema was seen 1.5 hours after decompression.Cytotoxicity brain swelling generated with brain tissue destroyed 3 hours after decompression.The vicious cycle of high intracranial pressure and brain tissue destruction occurred 4.5 hours after decompression.Conclusion Under intracranial pressure probe monitoring,the rabbit model of PADBS by sinus balloon compression has stable pressure of the sinus balloon and has good reliability and repeatability,which provides a reliable evidence for further study on the possible mechanism and treatment methods of PADBS.
ABSTRACT
Subarachnoid hemorrhage (SAH) is a common cerebrovascular disease,its disability and mortality rates are higher.It has been confkmed that early brain injury (EBI) and cerebral vasospasm (CVS) are the major pathophysiological mechanisms of causing neurological dysfunction and death after SAH.There are a variety of factors of causing CVS and EBI,including nitric oxide,endothelin,oxyhemoglobin,and proinflarnmatory cytokines.A large number of animal experiments and clinical research have confrmed that statins have neuroprotective effects.This article reviews the neuroprotective effects and its mechanisms of statins in SAH
ABSTRACT
[ABSTRACT]OBJECTIVETo investigate the clinic significance of nasal septal swell body by observing and measuring it in the normal and deviated nasal septum on CT images.METHODSThe locations of the nasal septal swell bodies on horizontal CT images in 50 normal subjects and 30 patients with deviated nasal septum were studied, and their length, width and the thicknesses of the mucosa of the both sides were measured. The data were analyzed with SPSS.RESULTSSeptal swell bodies were observed in most of CT images. The swell body was fusiform and located anterior to the middle turbinate, with mean(SD) width of (10.30±1.27) mm and length of (31.35±5.18) mm. There no marked difference in thickness of the nasal septal swell body between two sides of the nasal septum in normal nasal septum, but the thickness of the nasal septal swell body in camber side was thicker than that in the other side of the deviate nasal septum.CONCLUSIONThe shape and location of spetal swell body suggests its potential capacity may be to alter the nasal airflow. Additional study is required for its clinical significance.
ABSTRACT
OBJECTIVE@#To observe anatomic structure of jugular foramen region by endoscope, to provide anatomic data for avoiding damnification in the surgery.@*METHOD@#We performed the retrolabyrinthine and retrosigmoid endoscopic surgery on 8 fomalin-fixed adult cadaver specimens and observed the structures of jugular foramen by endoscope and compared the different surgeries at the same time. We excised the calvarium and cereburm and exposured and observed the nerves and vessels. Moreover we measured the the distance from internal accoustic pore to glossopharyngeal and analyse the data by SPSS.@*RESULT@#All retrolabyrinthine endoscopic surgeries were performed successfully. Only 4 postsigmoid endoscopic surgeries were performed without damage of cerebellum which is the major obstacles. The distance from internal accoustic pore to glossopharyngeal was(8.26 ± 1.05) mm. About half of posterior inferior cerebellar arteries located to inboard of nerves.@*CONCLUSION@#The jugular foramen region endoscopic surgery can be performed successfully by retrolabyrinthine. The "lockhole" technology by retrosigmoid is more difficult for blocking of cerebella. The internal acoustic porus is a fixed structure of the cerebellopontine angleand a perfect landmark to the surgery.
Subject(s)
Adult , Humans , Cadaver , Endoscopy , Foramen Magnum , Jugular Veins , Temporal BoneABSTRACT
Objective:To optimize the extraction process of total flavonoids in Gynostemma pentaphyllum by the method of response surface analysis ( RSM) . Methods: Based on the choice of factors and levels according to the results of single factor test, Box-Be-hnken response surface experiment was designed with the extraction rate of total flavonoids as the index to obtaln the best operation con-ditions and two equations of the response surface model. Results: The optimal extraction conditions of total flavonoids in Gynostemma pentaphyllum were as follows:the volume fraction of ethanol was 71%, the ratio of solid to liquid was 1∶14, and the ultrasonic time was 32 min. Under the conditions, the model predictive value of extraction rate of total flavonoids in Gynostemma pentaphyllum was 4. 676%, and the extraction rate in the verification test was 4. 641%. Conclusion:The fit of the regression model is good, and the ex-traction technology is feasible and reliable.
ABSTRACT
Objective To explore the diagnostic value of nerve root sedimentation disease to symptomatic lumbar spinal stenosis (LSS) and nonspecific low back pain(LBP).Methods One hundred and eighty lumbocrural pain patients in the People's Hospital of Binzhou from Jan.2010 to Jun.2013 were divided into LSS group and LBP group,and 90 patients in each group.The rate of nerve root sedimentation in two groups was recorded.Results There were 84 cases(93.3％) with positive nerve root sedimentation in group LSS,while 0 case in LBP group,and the difference was significant (P =0.000).The pain visual analogue score (VAS) between the two groups were no significant difference (P ＞ 0.05).The Oswestry disability index (ODI) in LSS group was (60.3 ± 5.1) ％,lower than that in LBP group (66.4 ± 6.3) ％,and the difference was statistically significant (P =0.021).Cross-sectional area (CSA) of the LSS group was (68.9 ± 7.0) mm2,lower than that in LBP group ((168.2 ± 13.8) mm2),and the difference was statistically significant (t =26.173,P =0.000).There was no significant correlation between ODI and CSA (r =0.18,P =0.098).Conclusion The nerve root sedimentation disease is higher in LSS patients and positive of sedimentation disease can serve as a diagnosed marker of LSS.
ABSTRACT
Objective Toobservetheeffectofperioperativeuseoflowmolecularheparin(LMH)forpreventinglowerlimbdeep vein thrombosis(DVT ) in elderly hip peripheral fracture .Methods 105 cases of elderly hip peripheral fracture from July 2007 to July 2011 were divided into the LMH group(65 cases) and the conventional treatment group(40 cases) .The two groups were per-formed the physical therapy for preventing lower limb DVT .The LM H group was added with LM H for preventing DVT .The sta-tuses of DVT occurrence and the coagulation related indicators were compared between the two groups .Results In the LM H group ,the thrombus events happened in 4 cases ,accounting for 6 .15% .In the conventional treatment group ,thrombosis occurred in 13 cases ,accounting for 32 .5% .The difference between the two groups had statistical significance (P<0 .05) .Hemoglobin on post-operative 1 ,10 d was obviously improved ,the difference had statistical significance(P<0 .05) .Conclusion Using LMH has rela-tively ideal effect for preventing lower limb DVT in elderly hip peripheral fracture .
ABSTRACT
Objective To observe effect of intra-and post-operative mild hypothermia using an ice blanket on patients with severe traumatic brain injury (sTBI).Methods Twenty sTBI patients with Glasgow Coma Scale (GCS) of 3-8 points were included and were assigned to either ice bag cooling (Bag group) or ice blanket cooling (Blanket group) (n =10 each) according to random number table.Patients in Bag group had temperature reduction by placing ice bag over great vessels,whereas in Blanket group an ice blanket (temperature was set as the nasopharyngeal temperature of 33℃-34℃) was employed to have temperature reduction.Hypothermia therapy in the two group groups was initiated from the beginning of operation and continued for 48 hours after operation.Intracranial pressure,cerebral perfusion pressure (CPP) and GCS in both groups were recorded respectively at 10 minutes before operation (T0) and at 8,12,24,48 and 72 hours after operation (T1,T2,T3,T4 and T5).Venous blood of the two groups was harvested to assay the serum concentration of neuronspecific enolase (NSE),myelin basic protein (MBP)and S-100β at T0,T3,T4,-Ts and at 96 hours after operation (T6) by ELISA method.Glasgow Outcome Scale (GOS) was evaluated at postoperative six months.Results In Bag group,body temperature (T1-T5) of the patients had no significant decrease (P ＞ 0.05) and NSE (T3-T6),S-100β (T3-T6) and MBP (T4-T6) were increased (P ＜ 0.05 or 0.01) when compared with those in T0 ; intracranial pressure (T2-T5) was increased (P ＜ 0.05) and CPP (T3-T5) was lowered (P ＜ 0.05) when compared with those in T1.In Blanket group,body temperature (T1-T6) of the patients presented was decreased significantly (P ＜ 0.01) and NSE (T3-T6),MBP (T5-T6) and S-100β (T4-T6) were increased (P ＜ 0.05 or 0.01) when compared those in T0 ; intracranial pressure (T2-T6) was increased (P ＜ 0.05) and CPP had no significant changes (P ＞0.05) when compared with those in T1.By contrast with those in the same time points in Bag group,lower body temperature (T1-T5) (P ＜ 0.001),lower intracranial pressure (T2-T5),higher CPP (T3-T5) as well as lower NSE (T4-T6),MBP (T4-T6) and S-100β(T6)were observed in Blanket group (P ＜0.05 or 0.01).Changes of GCS and GOS in the two groups were no significance (P ＞0.05).Conclusion Intraoperative and postoperative mild hypothermia therapy using an ice blanket may alleviate the degree of brain injury in sTBI patients.
ABSTRACT
Objective To observe the changes of cerebral vascular morphology and blood flow after craniocerebral trauma so as to investigate the role of transcranial Doppler sonography (TCD) combined with CT angiography (CTA) in judgment of the operative effect and prognosis of severe craniocerebral trauma.MethodsA total of 56 patients with craniocerebral trauma were monitored dynamically by using TCD before and after surgery.Dynamic CTA of head was also performed by using 128-slice spiral CT.Results TCD and CTA indicated that both the cerebral blood flow and vascular morphologychanged after craniocerebral trauma.CTA manifested mainly the vascular displacement or angiostegnosis and TCD showed mainly the high-resistance blood flow,indicating good operative effect.For the patients with vasospasm,the TCD manifested high-resistance flow (relatively good operative effect) or nail flow(mostly poor operative effect). The patients with vascular occlusion were associated with nail flow on TCD,with poor operative effect.ConclusionsTCD shows the velocity of cerebral blood flow and CTA shows the morphological change of cerebral vessels.Thereby,the combination of TCD and CTA can effectively judge the cerebral perfusion and provide a promising way for validating the operative effect and prognosis of craniocerebral trauma.
ABSTRACT
Objective To investigate the strategies of reducing the incidence of missed diagnosis of severe traumatic brain injuries combined with multiple trauma. Methods Data of 432 patients with severe traumatic brain injuries and multiple trauma (ISS≥20) from January 2000 to August 2007 were analyzed retrospectively. All patients were divided into missed diagnosis group (MD group, n =54) and non-missed diagnosis group (NMD group, n =378) for correlation analysis on ISS, GCS, anatomical locations of the missed diagnosis, the time of delayed diagnosis and the prognosis. Results ISS was (42.97±10.94) points in MD group, with statistical difference compared with NMD group (P < 0.05). The patients with GCS≤8 in MD group was more than those in NMD group (P < 0.05). Conclusions It is effective to prevent missed diagnosis and improve the survival of patients with severe traumatic brain injuries combined with multiple trauma by judging injury severity quickly and precisely based on the principle of "life first" and repeated and systemic physical examination.
ABSTRACT
Objective: To investigate the prophylactic effect of EEN on pulmonary infection in patients with severe traumatic brain injury.Methods: 60 cases of young adults with severe brain injury were randomized into the early enteral nutrition group(experimental group) or the control group.The experimental group was feeded 12～24 hours after injury or surgery and the control group was feeded 24 h～5 d after injury or surgery.The double-sugar test method was used for determination of intestinal barrier function,and the duration of pulmonary infection was recorded.Results: The lactulose/mannitol ratio in experimental group was significantly lower than in control group on the 7th postoperative day.The average body temperature and duration of pulmonary infection in experimental group were significantly lower than in control group.According to ADL scores,the daily capacity of convalescent patients in experimental group was significantly better than in control group.Conclusion: The early enteral nutrition can improve mucosal barrier function,reduce the incidence of pulmonary infection and improve overall prognosis in patients with severe traumatic brain injury.
ABSTRACT
Objective To understand the efficiency of defluoridation facilities used in drinking water defluoridation in the rural high fluoride areas in Tianjin and the sanitary characteristics of treated drinking water. Methods The raw water samples and treated water samples were collected from 4 water stations where the electrodialysis technics was applied and 6 water stations where the reverse osmosis technics was applied and the facilities had been operated for 2-3 years in a county, as well as 3 water stations applied activated aluminium oxide adsorption technics and 2 water stations applied nanofiltration membrane technics in the other counties in Tianjin in 2002-2004. The pH value,turbidity, total dissolved solids, total hardness, fluoride, sulfate, aluminium, in all water samples were determined and evaluated according to the Sanitary Standard for Drinking Water(2001). Results The treated water samples from electrodialysis and reverse osmosis defluoridation facilities showed lower fluoride level(below 1.0 mg/L with fluoride removal rates of 90.01% and 75.32%),and lower total dissolved solids and total hardness levels with removal rates of 75.83%-93.48%. The treated water samples from nanofiltration membrane defluoridation facilities also showed lower fluoride level(below 1.0 mg/L with fluoride removal rates of 75.16%,and lower total dissolved solids and total hardness levels with removal rates of 64.90% and 77.22% respectively. Conclusion The investigated electrodialysis, reverse osmosis and nanofiltration membrane defluoridation facilities show a reliable efficiency and are suitable for application of removal of fluoride in drinking water with different levels of total dissolved solids in the rural high fluoride areas. The effects of defluoridated water produced by reverse osmosis defluoridation facilities on human health need to be studied further more.
ABSTRACT
Taking 5 modes of large-scale X-ray apparatus as examples including GE TX-Ⅲ 500mA, Shimadzu ED125L 500 mA, GE VR 500 mA, Siemens Tridoros 5S 1 000 mA, Siemens Heliophos 5S 500 mA, the replacement techniques are introduced in such aspects as the preparation of rooms and tools before replacement, disassembly, transport, reinstallation, electrifying and test. Cooperation of personnel is an important factor to smoothly complete the task.