Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 38
Filter
Add filters








Year range
1.
Chinese Journal of Traumatology ; (6): 311-319, 2021.
Article in English | WPRIM | ID: wpr-922350

ABSTRACT

Rib fracture is the most common injury in chest trauma. Most of patients with rib fractures were treated conservatively, but up to 50% of patients, especially those with combined injury such as flail chest, presented chronic pain or chest wall deformities, and more than 30% had long-term disabilities, unable to retain a full-time job. In the past two decades, surgery for rib fractures has achieving good outcomes. However, in clinic, there are still some problems including inconsistency in surgical indications and quality control in medical services. Before the year of 2018, there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad, focusing on the guidance of the overall treatment decisions and plans; another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures. The Chinese Society of Traumatology, Chinese Medical Association, and the Chinese College of Trauma Surgeons, Chinese Medical Doctor Association organized experts from cardiothoracic surgery, trauma surgery, acute care surgery, orthopedics and other disciplines to participate together, following the principle of evidence-based medicine and in line with the scientific nature and practicality, formulated the Chinese consensus for surgical treatment of traumatic rib fractures (STTRF 2021). This expert consensus put forward some clear, applicable, and graded recommendations from seven aspects: preoperative imaging evaluation, surgical indications, timing of surgery, surgical methods, rib fracture sites for surgical fixation, internal fixation method and material selection, treatment of combined injuries in rib fractures, in order to provide guidance and reference for surgical treatment of traumatic rib fractures.


Subject(s)
China , Consensus , Flail Chest , Fracture Fixation, Internal , Humans , Rib Fractures/surgery , Thoracic Injuries
2.
Article in Chinese | WPRIM | ID: wpr-870586

ABSTRACT

Objective:To explore the clinical diagnosis and treatment of invasive gastrointestinal fungal infection plus pulmonary infection after renal transplantation.Methods:Clinical data were analyzed retrospectively for one patient with invasive fungal infection plus pulmonary infection after renal transplantation. The middle-aged female recipient underwent allogeneic kidney transplantation due to end-stage uremia. After successful kidney transplantation, there was postprandial epigastric pain not relieved by proton pump inhibitor. Gastroscopy after admission suggested that the nature of gastric mucosal lesions was to be determined. Pathological examination and special staining confirmed mucor.Results:After clarifying her conditions, the doses of such immunosuppression as tacrolimus, mycophenolate mofetil and prednisone were tapered and discontinued when necessary and using amphotericin B liposome plus posaconazole alleviated the digestive tract symptoms. Chest tightness, fever, shortness of breath after activities hinted at pulmonary infection after renal transplantation. Treatment was guided by the results of sputum culture.Conclusions:Mucor infection is rare in digestive tract complicated with pulmonary infection after renal transplantation. Clinicians should actively search for etiological evidence, seek multidisciplinary consultations for a definite diagnosis and provide empirical anti-infection treatments. Due attention is to be paid for double infection caused by anti-infection treatments and anti-infection treatment strategy should be timely adjusted and the dosage of immunosuppressant based upon immune monitoring.

3.
Article in Chinese | WPRIM | ID: wpr-773205

ABSTRACT

The aim of this paper was to discuss the protective effect and mechanism of Acanthopanax senticosus polysaccharides( ASPs) on immunological liver injury caused by conanavalin A( Con A). BALB/c mice were randomly divided into seven groups: control group,model group( Con A),low-,medium-,and high-dose( 36. 25,72. 5,145 mg·kg~(-1)) ASPs groups,bifendate( 200 mg·kg~(-1),positive drug) group and pyrrolidinedithiocarbamate( PDTC,NF-κB inhibitor,200 mg·kg~(-1)) group. ASPs groups and bifendate group were given with corresponding drugs by ig administration once daily for 7 d. Control group,model group and PDTC group were given with normal saline by ig administration once daily for 7 d. After the last ig administration,PDTC was given in DTC group by iv administration( 200 mg·kg~(-1)); 0. 5 h after that,Con A( 20 mg·kg~(-1)) was injected via the tail vein to induce immunological liver injury in all the mice except normal control group. The mice were killed 8 h later and their liver tissues were collected for histopathological examination. The contents of nitric oxide( NO),superoxide dismutase( SOD),malondialdehyde( MDA),reduced glutathione( GSHPX),interleukin( IL-1β) and tumor necrosis factor( TNF-α) in liver tissues were detected by kit assay. Western blot method was used to detect TNF-α,intercellular cell adhesion molecule-1( ICAM-1),inducible nitric oxide synthase( i NOS) and nuclear factor( NF-κB) protein expression in liver tissues. As compared with model group,ASPs not only could reduce the activity of MDA,NO,IL-1β and TNF-α,but also increase the content of GSH-PX and SOD; at the same time,the protein expression levels of TNF-α,ICAM-1,i NOS and NF-κB were reduced in liver tissues; in addition,inflammatory cell infiltration was alleviated,hepatocyte cytoplasm was loose and swollen,and nuclear condensation and staining were improved. ASPs has a protective effect on immunological liver injury,and the mechanism may be associated with regulating secretion of inflammatory cytokines and the expression of adhesion factor through NF-κB signaling pathway.


Subject(s)
Animals , Chemical and Drug Induced Liver Injury , Drug Therapy , Cytokines , Metabolism , Eleutherococcus , Chemistry , Liver , Mice , Mice, Inbred BALB C , NF-kappa B , Metabolism , Peptides, Cyclic , Polysaccharides , Pharmacology , Random Allocation , Signal Transduction
4.
Article in Chinese | WPRIM | ID: wpr-773109

ABSTRACT

Classical prescriptions are precious wealth left by ancient Chinese medical scientists. Moreover,they are also the important part of the treasure-house in Chinese medicine. Classical prescriptions have a long and rich history for human-use in China and play an important role in keeping people healthy. The state administration of traditional medicine of China published the Catalogue of Classical Prescriptions(first batch) in 2018. This measure has inspired the enthusiasm of Chinese medicine manufacturers to study ancient classical prescriptions and develop classical compound prescriptions. Based on the first batch of classical prescriptions, the dosage forms, sources, prescription components, decocting degree, use of toxic drugs and processing methods of classical prescriptions. The results showed that most of the classical prescriptions in the first batch were decoction and boiled powder,while only four of them were powder and paste forms,all of which were originated from representative classics in the past dynasties. The dosage and decocting degree of decoction were greater than those of boiled powder. The dosage and decocting degree of decoction in Han and Tang Dynasties was close to that in Ming and Qing Dynasties,higher than that in Song and Jin Dynasties. Moreover,the average number of herbs in the prescriptions in Han Dynasty was the smallest. The use of toxic traditional Chinese medicine was the most frequent in Han Dynasty, and Pinellia ternata was the most common toxic medicine. There were various processing methods, including cleansing, cutting, stir-frying, roasting and so on. In this paper, the dosage forms of traditional paste, the time concept of decoction in the ancient times, the traditional roasting method and the processing method of toxic drugs were summarized to provide ideas and reference for further development of classical prescriptions.


Subject(s)
China , Drugs, Chinese Herbal , Reference Standards , Medicine, Chinese Traditional
5.
International Journal of Surgery ; (12): 456-460, 2018.
Article in Chinese | WPRIM | ID: wpr-693261

ABSTRACT

Objeetive To evaluate the relationship between the metabolic syndrome and the risk of prostate cancer.Methods The clinical data of 118 patients with primary prostate cancer who were admitted to the Beijing Friendship Hospital,Capital Medical University from February 2013 to September 2017 were retrospectively analyzed.All the patients were divided into metabolic syndrome group (n =50) and non-metabolic syndrome group (n =68) according to the diagnosed standard of metabolic syndrome.The patients' clinical data were expressed as percentage(%) and collected including age between the two groups,body mass index,blood pressure,fasting blood glucose,triglyceride,high density lipoprotein,low density lipoprotein,prostate volume,prostate specific antigen (PSA) value,Gleason score and TNM staging.The data were analysed by the statistical analysis method.Chi-square test was used to compare the enumeration data.Measurement data were expressed as ((x) ± s),and using t test comparison between groups.The relationship between various variable factors and prostate cancer used multivariate logistic regression analysis.Results There was no significantly difference between the two groups including age,blood pressure,triglyceride,low density lipoprotein and Gleason score (P > 0.05).The body mass index,fasting blood glucose and prostate volume in the metabolic syndrome group [(26.62 ± 16.43) kg/m2,(8.1 ± 1.7) mmol/L,(50.1 ± 12.2) ml] are significantly higher than in the non-metabolic syndrome group [(22.16±15.64) kg/m2,(6.3 ±1.5) mmol/L,(40.3 ±14.1) ml] (P<0.05).The high density lipoprotein and PSA value in the metabolic syndrome group [(0.9 ± 0.4) mmol/L,(21.4 ± 7.9) ng/dl] were significantly lower than in the non-metabolic syndrome group [(1.40 ± 0.64) mmol/L、(36.2 ± 8.2) ng/dl] (P < 0.05).The proportion of high-risk prostate cancer in the metabolic syndrome group (62%,31/50) was significantly higher than that in the non-metabolic syndrome group (33.8%,23/68),P < 0.05.Logistic regression analysis showed that the body mass index and high density lipoprotein hypertension had a positive correlation with high risk of prostate cancer.Conclusions The metabolic syndrome might increase the incidence risk of high risk of prostate cancer.The two components of metabolic syndrome,body mass index and high density lipoprotein,should be paid attention in clinical practice.

6.
Article in Chinese | WPRIM | ID: wpr-705276

ABSTRACT

OBJECTIVE To explore the effects and underlying mechanism of Jieyu Anshen granule (JY) in chronic unpredictable mild stress (CUMS)-treated rats after ischemic stroke. METHODS A rat model of post-stroke depression(PSD)was developed by additional CUMS procedures after middle cere-bral artery occlusion(MCAO).Sprague-Dawley rats were given 1 g·kg-1and 3 g·kg-1of JY by gastrogavage for 4 weeks.Escitalopram(10 mg·kg-1)served as a reference drug.Behavioral tests including sucrose preference test, forced swim test and open-field test were performed to evaluate the antidepressant effects. Levels of norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) in rat brain were assayed. The anti-inflammatory activity was evaluated by measuring TNF-α and IL-1β in brain. Serum adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were estimated as indices of hypothalamic-pituitary-adrenal (HPA) axis activity. Western blot analysis was used to evaluate hippo-campal expression of the 5-HT1A receptor (5-HT1AR) and brain-derived neurotrophic factor (BDNF). RESULTS PSD rats exhibited decreased sucrose consumption and motor activity, increased immobility time (P<0.01). JY treatment reversed the depressive behaviors in PSD rats (P<0.05, P<0.01). Treat-ment with JY resulted in significantly increased levels of NE, DA and 5-HT in the hippocampus and prefrontal cortex (P<0.05, P<0.01), and increased expression of 5- HT1AR and BDNF in the hippocampus(P<0.01). JY treatment significantly down-regulated the levels of TNF-α and IL-1β in hippocampus andprefrontal cortex (P<0.05). Treatment with JY also resulted in significantly decreased ACTH and CORTin serum which had been increased (P<0.05). CONCLUSION These findings suggest that JY treat-ment could ameliorate PSD, and the effects are likely ascribed to inhibiting HPA axis hyperfunction andinflammatory, up-regulating the levels of neurotransmitters (NE, DA and 5-HT), and the expression ofhippocampal 5-HT1AR and BDNF.

7.
Article in Chinese | WPRIM | ID: wpr-360145

ABSTRACT

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction. While its etiology and pathogenesis remain not fully understood, SCAD occurs most frequently in patients at a young age and of a female gender. We report a case of SCAD in a 52-year-old healthy postmenopausal woman who developed acute myocardial infarction and subsequent ventricular aneurysm after emotional stress. This case may provide valuable insight into this rare disease and highlights the importance of psychological factors as contributing factors of SCAD in postmenopausal women with acute onset of chest pain.

8.
Chinese Journal of Traumatology ; (6): 235-239, 2017.
Article in English | WPRIM | ID: wpr-330423

ABSTRACT

In recent years, global natural disasters have been frequent and resulted in great casualties and property loss. Since Wenchuan earthquake, the disaster emergency rescue system of China has obtained considerable development in various aspects including team construction, task scheduling, personnel training, facilities and equipments, logistics, etc. On April 25, 2015, an earthquake that measured 8.1 on the Richter scale attacked Nepal. Chinese government firstly organized a medical team, named China Medical Team, and sent it to the attacked region in Nepal to implement medical rescue. The medical team completed the rescue mission successfully and creatively based on their experiences.

9.
Article in Chinese | WPRIM | ID: wpr-710138

ABSTRACT

AIM To study the chemical constituents from Hylocereus undatus cv.Vietnam peels.METHODS The ethyl acetate and n-butyl alcohol fractions of 95% ethanol extract of H.undatus peels were isolated and purified by silica,ODS and semi-preparative HPLC column,then the structures of obtained compounds were identified by spectral data.RESULTS Thirteen compounds were isolated and identified as typhaneoside (1),kaempferol-3-O-β-D-glucopyranosyl-(1→2)-[α-L-rhamnopyranosyl-(1 →6)-β-D-glucopyranoside] (2),quercetin-3-O-neohesperidoside (3),isorhamnetin-3-O-α-L-rhamnopyranosyl (1→2)-β-D-glycopyranoside (4),3'-O-methylquercetin-3-O-α-L-rhamnopyranosyl-(1→6)-β-D-glucopyranoside (5),benzyl alcohol-β-D-glucopyranoside (6),physcion (7),resveratrol (8),adenosine (9),uridine (10),2-methyl-3-(3 '-indolyl)-propionic acid (11),α-spinasterol (12),β-sitosterol (13).CONCLUSION Compounds 1-12 are isolated from this plant for the first time.

10.
Article in Chinese | WPRIM | ID: wpr-660967

ABSTRACT

Objective To observe the expressions of voltage-gated sodium channel (NaCh)αsubunits in adult rat ventricular myocytes.Methods Single ventricular myocytes were isolated from adult rat heart.Expressions of various αsubunits (Nav1.1,Nav1.2,Nav1.3,Nav1.5,Nav1.6 and Nav1.7)of NaCh in the ventricular myocytes were detected by immunocytochemistry staining.Sodium current was recorded by whole-cell patch clamp method. Results The neuronal subunits Nav1.1,Nav1.6 and Nav1.7 as well as the cardiac subunit Nav1.5 of NaCh were expressed in adult rat ventricular myocytes.Nav1.1,Nav1.5 and Nav1.7 were distributed along the cell membrane of the ventricular myocytes and around the transverse tubule;Nav1.6 was labeled along the cell membrane by lengthways.All these subunits were not colocalized with Cx43 at the intercalated disc.Both transient sodium current (I Na,T )and late sodium current (I Na,L )were recorded from adult rat ventricular myocytes.Conclusion Various neuronal subunits (Nav1.1,Nav1.6 and Nav1.7)as well as cardiac subunit (Nav1.5 )of NaCh were expressed in adult rat ventricular myocytes,which is important for normal function of I Na,T and I Na,L .

11.
Article in Chinese | WPRIM | ID: wpr-658168

ABSTRACT

Objective To observe the expressions of voltage-gated sodium channel (NaCh)αsubunits in adult rat ventricular myocytes.Methods Single ventricular myocytes were isolated from adult rat heart.Expressions of various αsubunits (Nav1.1,Nav1.2,Nav1.3,Nav1.5,Nav1.6 and Nav1.7)of NaCh in the ventricular myocytes were detected by immunocytochemistry staining.Sodium current was recorded by whole-cell patch clamp method. Results The neuronal subunits Nav1.1,Nav1.6 and Nav1.7 as well as the cardiac subunit Nav1.5 of NaCh were expressed in adult rat ventricular myocytes.Nav1.1,Nav1.5 and Nav1.7 were distributed along the cell membrane of the ventricular myocytes and around the transverse tubule;Nav1.6 was labeled along the cell membrane by lengthways.All these subunits were not colocalized with Cx43 at the intercalated disc.Both transient sodium current (I Na,T )and late sodium current (I Na,L )were recorded from adult rat ventricular myocytes.Conclusion Various neuronal subunits (Nav1.1,Nav1.6 and Nav1.7)as well as cardiac subunit (Nav1.5 )of NaCh were expressed in adult rat ventricular myocytes,which is important for normal function of I Na,T and I Na,L .

12.
Article in Chinese | WPRIM | ID: wpr-513896

ABSTRACT

BACKGROUND: Experimental proof for the efficacy, safety, and immunological assessment is needed when minocycline is used for root canal disinfection.OBJECTIVE: To investigate the effect of minocycline for root canal disinfection on levels of interleukin-17 in apical exudates of periapical periodontitis and periapical exudate volume.METHODS: Sixteen patients with acute periapical periodontitis (16 teeth) scheduled for root canal therapy were enrolled and randomly divided into calcium hydroxide and minocycline groups, respectively, followed by root canal disinfection.One week after disinfection, periapical index, periapical exudate volume and interleukin-17 level were detected prior to the root canal filling. Another 16 patients with normal pulp vitality (16 teeth) scheduled for single root canal filling were enrolled as control group, in which periapical index, periapical exudate volume and interleukin-17 level were detected.RESULTS AND CONCLUSION: The periapical exudate volume and interleukin-17 level in the calcium hydroxide and minocycline groups were significantly higher than those in the control group (P < 0.05). The periapical index and interleukin-17 level in the calcium hydroxide and minocycline groups were decreased significantly at 1 week after root canal disinfection (P < 0.05), while there was no difference between these two experimental groups in the periapical index, periapical exudate volume and interleukin-17 level. To conclude, the use of minocycline significantly reduces interleukin-17 level and periapical exudate volume, and thus achieves effective outcomes in periapical disease.

13.
Article in Chinese | WPRIM | ID: wpr-328305

ABSTRACT

<p><b>OBJECTIVE</b>To explore the effect of Danggui Yinzi (DY) on delayed allergy in model mice with qi-blood deficiency syndrome (QBDS).</p><p><b>METHODS</b>QBDS model was established in 48 Kuming mice of SPF grade by using reserpine and acetophenone hydrazine. Forty of them were then randomly divided into the model group, the loratadine group, the high dose DY group, the middle dose DY group, and the low dose DY group, 8 in each group. Another 8 in line with the same standard were recruited as a blank group. Mice in high, middle, and low dose DY groups were administered with DY concentrated solution at 60, 30, 15 g/kg by gastrogavage. Mice in the loratadine group were administered with loratadine solution at 1.66 mg/kg by gastrogavage. Equal volume of normal saline was administered to mice in the model group and the blank group by gastrogavage. All medication was given once per day for 1 successive week. Except those in the blank group, the rest mice were evenly smeared with 1% DNCB solution on the abdomen. Five days after skin allergy, 1% DNCB solution was smeared to right ear of all mice to stimulate allergic reaction. Mice in the blank group were smeared in the same way without allergenic reaction. The auricle swelling and the inhibition ratio were determined at 24 h after attack. Blood was collected from orbit and serum IgE level detected using double-antibody sandwich ELISA.</p><p><b>RESULTS</b>Compared with the blank group, auricle swelling obviously increased and serum IgE level was obviously elevated in the model group (P < 0.01). Compared with the model group, auricle swelling obviously decreased and serum IgE level was obviously reduced in the 3 dose DY groups (P < 0.05, P < 0.01). Meanwhile, the auricle swelling degree was superior in high and middle dose DY groups to that in the loratadine group (P < 0.05). The inhibition ratio of auricle swelling was sequenced from high to low as 67.3% in the high dose DY group, 56.0% in the middle dose DY group, 48.1% in the low dose DY group, 47.3% in the loratadine group.</p><p><b>CONCLUSIONS</b>DY could inhibit auricle swelling and lower serum IgE level. It also could inhibit delayed allergic reaction in model mice with QBDS to some extent.</p>


Subject(s)
Animals , Disease Models, Animal , Drugs, Chinese Herbal , Pharmacology , Edema , Drug Therapy , Hypersensitivity, Delayed , Drug Therapy , Immunoglobulin E , Blood , Loratadine , Pharmacology , Mice , Qi , Random Allocation
14.
Article in Chinese | WPRIM | ID: wpr-259439

ABSTRACT

<p><b>OBJECTIVE</b>To study the effect of extracellular DNA(eDNA) on the formation of Streptococcus mutans(Sm) biofilms during different growth periods in sucrose environment.</p><p><b>METHODS</b>Sm biofilms were established on smooth glass surfaces under the environment of 1% sucrose and cultured in the condition of 37 ℃, 5% O2, 85% N2 and 10% CO2. Samples were randomly divided into four groups based on fourculture time(6,12, 24 and 48 h), respectively. Each group was further divided into two subgroups: control group(without deoxyribonuclease Ⅰ[DNaseⅠ] treatment) and test group(with DNaseⅠtreatment). DNaseⅠ was added 1 h advance in the treatment group to a final concentration of 100 U/ml. Each sample was stained with mixed SYTO-9/PI fluorescent dye. Confocal laser scanning microscopy was used for biofilm observation and scanning. The total biomass, the thickness and the volume of red fluorescence of each biofilm sample were measured following three-dimensional reconstruction using the softwear of Imaris 7.2.3.</p><p><b>RESULTS</b>Under the environment of 1% sucrose, the Sm bacterial adhesion and distribution density increased over time, the quantity of eDNA and membrane-damaged bacteria which were indicated by red fluorescence also increased within 24 h but dropped later. The biofilm biomasses of Sm biofilm in 6, 12, 24 and 48 h DNaseⅠ treatment group reduced significantly(P<0.05) compared to those in the corresponding control groups by 81.3%, 85.0%, 90.1% and 12.4%, respectively. The biofilm thicknesses in each DNase Ⅰ treatment group (except 6 h group) also reduced significantly(P<0.05) compared to those in the corresponding control group by 34.4%, 45.6% and 23.6%, respectively. The quantities of eDNA and membrane-damaged bacteria reduced in each treatment group except 48 h group compared to that in the corresponding control group.</p><p><b>CONCLUSIONS</b>Under the environment of 1% sucrose, eDNA plays an important role in promoting the formation of Sm biofilm.</p>


Subject(s)
Bacterial Adhesion , Biofilms , DNA , Physiology , Deoxyribonuclease I , Pharmacology , Microscopy, Confocal , Streptococcus mutans , Physiology , Sucrose , Sweetening Agents , Temperature
15.
Article in English | WPRIM | ID: wpr-316863

ABSTRACT

In the 21st century, natural disasters and emergencies occur frequently worldwide, which leads to the loss of hundreds of thousands of lives as well as the direct and indirect economic losses. China has a vast territory frequently struck by natural disasters. However, the reality is not optimistic. Poor organization and management during the rescue actions, the lack of large-scale, systematic medical rescue equipment were all great barriers to the outcomes. Mobile hospitals are expected to provide better health care. We were inspired by the concept of mobile hospital. Chongqing Emergency Medical Center, has set up trauma care system since 1988, in which prehospital care, intensive care, and in-hospital treatment is fully integrated. As a major advantage, such a system provided assurance of "golden hour" rescue treatment. Providing mobile intensive care and prehospital surgical service for severe trauma patients could reduce mortality significantly. Based on the civilian experiences in Chongqing Emergency Medical Center, the mobile emergency (surgical) hospital was developed.


Subject(s)
China , Earthquakes , Emergency Medical Services , Humans , Mobile Health Units , Relief Work , Rescue Work
16.
Article in English | WPRIM | ID: wpr-316859

ABSTRACT

<p><b>PURPOSE</b>Traumatic diaphragmatic rupture (TDR) needs early diagnosis and operation. However, the early diagnosis is usually difficult, especially in the patients without diaphragmatic hernia. The objective of this study was to explore the early diagnosis and treatment of TDR.</p><p><b>METHODS</b>Data of 256 patients with TDR treated in our department between 1994 and 2013 were analyzed retrospectively regarding to the diagnostic methods, percentage of preoperative judgment, incidence of diaphragmatic hernia, surgical procedures and outcome, etc. Two groups were set up according to the mechanism of injury (blunt or penetrating).</p><p><b>RESULTS</b>Of 256 patients with a mean age of 32.4 years (9-84), 218 were male. The average ISS was 26.9 (13-66); and shock rate was 62.9%. There were 104 blunt injuries and 152 penetrating injuries. Preoperatively diagnostic rate was 90.4% in blunt injuries and 80.3% in penetrating, respectively, P < 0.05. The incidence of diaphragmatic hernia was 94.2% in blunt and 15.1% in penetrating respectively, P < 0.005. Thoracotomy was performed in 62 cases, laparotomy in 153, thoracotomy plus laparotomy in 29, and combined thoraco-laparotomy in 12. Overall mortality rate was 12.5% with the average ISS of 41.8; and it was 21.2% in blunt injuries and 6.6% in penetrating, respectively, P < 0.005. The main causes of death were hemorrhage and sepsis.</p><p><b>CONCLUSIONS</b>Diagnosis of blunt TDR can be easily obtained by radiograph or helical CT scan signs of diaphragmatic hernia. For penetrating TDR without hernia, "offside sign" is helpful as initial assessment. CT scan with coronal/sagittal reconstruction is an accurate technique for diagnosis. All TDR require operation. Penetrating injury has a relatively better prognosis.</p>


Subject(s)
Abdominal Injuries , Diagnostic Imaging , Adolescent , Adult , Aged , Aged, 80 and over , Child , Diaphragm , Diagnostic Imaging , Wounds and Injuries , Female , Humans , Male , Middle Aged , Multiple Trauma , Diagnostic Imaging , Retrospective Studies , Rupture , Thoracic Injuries , Diagnostic Imaging , Tomography, X-Ray Computed , Wounds, Nonpenetrating , Diagnostic Imaging , Wounds, Penetrating , Diagnostic Imaging
17.
Article in English | WPRIM | ID: wpr-316858

ABSTRACT

<p><b>PURPOSE</b>To investigate the diagnostic value of multi-slice computed tomography (MSCT) for combined thoracoabdominal injury.</p><p><b>METHODS</b>A retrospective study was conducted to analyze the clinical data and MSCT images of 68 patients who sustained a combined thoracoabdominal injury associated with diaphragm rupture, and 18 patients without diaphragm rupture. All the patients were admitted and treated in the Chongqing Emergency Medical Center (a level I trauma center) between July 2005 and February 2014. There were 71 males and 15 females with a mean age of 39.1 years (range 13e88 years). Among the 86 patients, 40 patients suffered a penetrating injury, 46 suffered a blunt injury as a result of road traffic accident in 21 cases, fall from a height in 16, and crushing injury in 9. The MSCT images were retrospectively reviewed by two radiologists. The results of CT diagnosis were compared with surgical findings and/or follow-up results.</p><p><b>RESULTS</b>Among the 86 cases, diaphragm discontinuity was found in 29 cases, segmental nonrecognition of the diaphragm in 14, diaphragmatic hernia in 21, collar sign in 14, dependent viscera sign in 18, elevated abdominal organs in 21, bowel wall thickening and/or hematoma in 6, and pneumoperitoneum in 8. CT diagnostic accuracy for diaphragm rupture was 88.4% in the right side and 90.7% in the left side. CT diagnostic accuracy for hemopneumothorax, pulmonary contusion, mediastinal hemorrhage, kidney and adrenal gland injuries was 100%, while for liver, spleen and pancreas injuries was 96.5%, 96.5%, 94.2% respectively.</p><p><b>CONCLUSION</b>To reach an early diagnosis of combined thoracoabdominal injury, surgeons and radiologists should be familiar with all kinds of images which might show signs of diaphragm rupture, such as diaphragm discontinuity, segmental nonrecognition of the diaphragm, dangling diaphragm sign, diaphragm herniation, collar sign, dependent viscera sign, and elevated abdominal organs.</p>


Subject(s)
Abdominal Injuries , Diagnostic Imaging , Adolescent , Adult , Aged , Aged, 80 and over , Diaphragm , Wounds and Injuries , Female , Humans , Male , Middle Aged , Multidetector Computed Tomography , Methods , Multiple Trauma , Diagnostic Imaging , Retrospective Studies , Thoracic Injuries , Diagnostic Imaging
18.
Article in Chinese | WPRIM | ID: wpr-279092

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical values of basic vital signs in early identification of critical hand-foot-mouth disease (HFMD).</p><p><b>METHODS</b>The clinical data of 358 children with severe HFMD [212 cases in stage 2 (central nervous system involvement) and 146 cases in stage 3 (earlier stage of cardiopulmonary failure, critical type)] were reviewed. The diagnostic values of peak temperature and duration of fever, as well as the heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in different age groups, for critical HFMD (stage 3) were analyzed using the receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>HFMD might progress to critical type in case of HR≥148.5 beats/minutes, RR≥36.5 times/minutes, SBP≥95 mm Hg, and DBP≥59 mm Hg among children aged 0-1 year. HR≥142.5 times/minutes, RR≥31.5 times/mintes, SBP≥103 mm Hg, and DBP≥60.5 mm Hg in children aged 1-2 years had a certain diagnostic value for critical HFMD. HFMD might progress to critical type in case of HR≥139.5 times/minutes, RR≥29.5 times/minutes, and SBP≥103 mm Hg among children≥3 years of age. The sensitivity and specificity of every indicator were higher than 0.517 and 0.769, respectively. The area under the ROC curve (AUC) for peak temperature was 0.507 (P=0.816, compared with AUC=0.5). When the duration of fever was ≥5.5 days, the sensitivity and specificity were 0.589 and 0.571, respectively.</p><p><b>CONCLUSIONS</b>HR, RR, and BP are good indicators to identify critical HFMD (stage 3) early. The optimal cut-off points conform to the age characteristics of children. DBP in children≥3 years of age, peak temperature, and duration of fever have a low value in early identification of critical HFMD.</p>


Subject(s)
Blood Pressure , Child , Child, Preschool , Female , Hand, Foot and Mouth Disease , Diagnosis , Heart Rate , Humans , Infant , Male , ROC Curve , Respiration
19.
Chinese Journal of Traumatology ; (6): 286-287, 2013.
Article in English | WPRIM | ID: wpr-358933

ABSTRACT

A 46-year-old male sustained severe pe- netrating injury by a sharp instrument to his right upper sternoclavicular junction. The wound tract was from suprasternal notch to mediastinum. Exploratory operation via median sternotomy under general anesthesia found a large mediastinal septum hematoncus, as well as brachiocephalic trunk and left brachiocephalic vein injuries. The perforating vascular wounds were repaired with 5-0 prolene suture. He was recovered uneventfully and discharged 9 days after operation. There was no sequel found during 7 years follow-up.


Subject(s)
Brachiocephalic Trunk , Wounds and Injuries , General Surgery , Brachiocephalic Veins , Wounds and Injuries , General Surgery , Humans , Male , Middle Aged , Sternoclavicular Joint , Wounds and Injuries , General Surgery , Wounds, Penetrating , General Surgery
20.
Article in Chinese | WPRIM | ID: wpr-284301

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the risk factors of mortality in patients with severe chest trauma (SCT).</p><p><b>METHODS</b>The clinical data of 777 SCT [abbreviated injury scale (AIS) ≥3] patients who were treated in the Chongqing Emergency Medical Center from January 2006 to April 2009 were retrospectively reviewed. Stepwise logistic regression analysis was used to explore 15 possible mortality-related risk factors.</p><p><b>RESULTS</b>Seven factors were found to be correlated with the mortality of SCT: age, hemorrhagic shock, multiple organ dysfunction syndrome (MODS), pulmonary infection, abdominal organ injury, Glasgow coma scale (GCS) score, and thorax AIS score. Among them five factors were the independent factors that might increase the mortality of SCT: hemorrhagic shock (B=1.710, OR=1.291, P=0.001), MODS (B=3.453, OR=1.028, P<0.001), pulmonary infection (B=2.396, OR=10.941, P<0.001), abdominal organ injury (B=1.542, OR=1.210, P=0.005), and thorax AIS score ≥4 (B=0.487, OR=1.622, P<0.001). Two factors showed protective effects: age ≤60 years (B=-0.035, OR=0.962, P=0.01) and GCS score ≥12 (B=-0.635, OR=0.320, P<0.001).</p><p><b>CONCLUSIONS</b>Age, disease severity, and complications (hemorrhagic shock, MODS, and pulmonary infection) are independent risk factors of the mortality of SCT. Effective treatment programs targeting these risk factors may improve the outcomes of SCT patients.</p>


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Logistic Models , Male , Middle Aged , Retrospective Studies , Risk Factors , Thoracic Injuries , Mortality , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL