Expression of Annexin A1 during Skin Incised Wound Healing in Mice / 法医学杂志

OBJECTIVES@#To investigate the expression changes of annexin A1 （ANXA1） during the process of skin incision healing, and to explore its expression and function during skin injury repair.@*METHODS@#The skin injury model of mice was prepared, and skin tissues of the controls and the injured group at 6 h, 12 h, 1 d, 3 d, 5 d, 7 d, 10 d and 14 d after injuries were taken. The morphological changes of the wound were observed by hematoxylin-eosin （HE） staining, and the expression of ANXA1 was detected by immunohistochemistry （IHC） and Western blotting.@*RESULTS@#HE staining showed normal healing of skin wounds. IHC results revealed that ANXA1 was expressed in the epidermis, hair follicle, sebaceous gland and vascular endothelium. In the injured group, the expression of ANXA1 was enhanced in epidermis and skin appendages around the wound 6-12 h after injury, and ANXA1 was also highly expressed in neutrophils and a small number of mononuclear cells. ANXA1 was mainly positively expressed in monocytes, neovascular endothelial cells and fibroblasts, and small amount of fibroblasts at 1-3 d, 5-10 d, and 14 d after injury, respectively. Western blotting showed that, compared with the controls, the expression of ANXA1 was significantly increased at 6 h after injury, peaked at 1 d, and then decreased gradually in the injured group.@*CONCLUSIONS@#ANXA1 may be involved in the regulation of skin damage repair, with time-dependent expression during skin wound healing, and thus is expected to be a biological marker for inferring the wound formation time.

Value of trauma and injury severity score in predicting mortality of trauma patients in different rank hospitals / 中华创伤杂志

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.

Analysis of Factors Influencing the Severity of Cultivator-Related Trauma patients and Correlation between these Factors

PURPOSE: Rural areas of Korea are already aged societies, and the victims of trauma in these areas are increasingly associated with an elderly demographic and farm equipment use. In addition, rural medical services are often not well supported. The purpose of this study was to evaluate the factors that influence the severity and prognosis of cultivator-related trauma, and the correlations between these factors. METHODS: We retrospectively analyzed patients who visited the Chonnam National University Hospital emergence center due to cultivator-related trauma, from January 2006 to December 2010. The injury severity of these patients was analyzed according to the injury severity score (ISS), the revised trauma score (RTS), the new injury severity score (NISS) and the trauma score and injury severity score (TRISS). RESULTS: A total of 376 cases, 322 male and 54 female, of cultivator-related trauma were reviewed. Patient ages ranged from 25 to 85 years (median, 57 years). Patients were divided into two age groups, those older than 65-years of age and those younger than 65. The primary causes of traumatic injury were falling down (57.2%), and vehicle overturning (16.5%). The site most frequently injured was the chest (35.1%). Rate of acute complication was 29.8% and operation was required in 41% of cases. The average ISS was 9.0 (median range [quartile], 4-16). ISS, NISS, RTS and TRISS were statistically correlated with the mechanism of injury, site of injury, and mortality and complication rates. In particular, TRISS was significantly lower in cultivator-related trauma for those older than 65-years of age. CONCLUSION: Among the severity indexes in assessing cultivator-related trauma, TRISS is helpful in assigning severity and predictable index in older, rural patients. However, this result is not representative of all possible cultivator-related traumas. A new statistical model is necessary to accurately analyze the severity and mortality in cases of cultivator-related trauma.

Analysis of causes and associated risk factors for unintentional injuries among 2 672 hospitalized children / 中国小儿急救医学

Objective To explore the common causes and associated risk factors for unintentional injuries among inpatient children from Yuying Children's Hospital of Wenzhou Medical College during 2007～2008.Methods This retrospective study involved 2 672 children of 0～18 years of age treated for unintentional injuries in Yuying Children's Hospital of Wenzhou Medical Collge from 2007 to 2008.Statistical evluation included x2 analysis and computation of relative risk(RR)with a 95％ confidence interval(CI).Results The top five types of unintentional injury were falls from one level to another(e.g.from playground equipment,chair,bed,stationary vehicle,and so on.)or falls on same level(e.g.from slipping,tripping,stumbling,collision,and so on)(30.84％),traffic accident(25.15％),falls from height(e.g.from balcony,bridge,building,window,and so on)(11.56％),foreign body ingestion/inhalations(6.89％),open wounds including cut,lacerarion and puncture wound(6.51％).The types of unintentional injury were not uniform among different age groups(x2 =602.12,P ＜0.01).Boys had a higher incidence of injury than did girls with a ratio of 2.34∶ 1.Unintentional injury rates varied considerably by age(x2 =583.90,P ＜0.01).The most prevalent age group was 1～4 years old.The most common body part injuried was the extremity region(54.00％).20.40％ of cases had injuried to the neck and head,15.27％ had thorax and abdomen injuries,3.78％ had vertebral column injuries and 1.87％ had pelvis injuries.Significant differences existed in injuried body site among different age children(x2 =315.21,P ＜0.01).The discharge departments were traumatic department(42.07％),hand surgery and spinal department(22.16％),department of otorhinolaryngology(6.89％),orthopaedic department(6.32％),neurosurgical department(5.84％),and the other discharge departments included pediatric surgical department,chest surgery department,stomatology department,ophthalmic department,pediatric intensive care unit and pediatric internal department.The number and rate of unintentional injury were the highest in summer(July-September),accounting for 28.63％.The estimated days and cost of unintentional injuries were 1 1.72 d and 9 617.96 yuan RMB each child,respectively.Conclusion Injury prevention efforts should include consideration of the substantial differences in the leading causes of unintentional injuries,in regard to sex,age and type of injury.Unintentional injuries lead to a threat to health and well-being and waste a majory source of medical spending in China for children and youth 0 to 18 years age.Making efforts to prevent child injury and establishing a complete emergency medical system are very important.

The diagnosis and treatment of traumatic duodenal injury / 中国基层医药

Objective To investigate the prognostic factors and managements of the duodenal trauma.Meth- ods Clinical data of duodena trauma from January 1988 to September 2005 were collected and retrospectively anal- ysed.Results One case(4.76%)got preoperative diagnosis,and 20(95.2%)missed and 4(19.04%)died,compli- cations occurred in 6(28.5%),duodenal fistula and abdomina abscess were the major complications.Conclusion The rate of confirmed diagnosis is quite low,and early laparotomy,anti-infection and surgical nutrition are the key factor to reducing death rates and its complications.

Alternative Method of Trauma Patient Evaluation and Quality Assessment

PURPOSE: The Injury Severity Score (ISS) has limited predictive power and is difficult to calculate. We used the New Injury Severity Score (NISS) and compared it to the ISS. The purpose of this study was to give a prognosis and predict the mortality for trauma patients by using the ISS and the NISS and to compare Trauma and Injury Severity Score (TRISS) method using NISS with the TRISS method using ISS. METHODS: A retrospective study of 100 trauma victims who visited the emergency room of Kyungpook National University Hospital from September 2000 to May 2001 was made using the ISS, the NISS, and the TRISS methods. RESULTS: A comparison between survivors and nonsurvivors showed differences in the revised trauma score (RTS), ISS, NISS, and TRISS Ps-1 by using RTS and the ISS and TRISS Ps-2 by using RTS and NISS (p<0.01). We found that the NISS was more predictive of survival than the ISS. A receiver operating curve analysis and Hosmer Lemeshow statistics showed that both the NISS and the ISS provided a good fit throughout its entire range of prediction. CONCLUSION: By comparing the ISS with the NISS, we concluded that the NISS better separated survivors from nonsurvivors. The NISS predicted survival better and was easier to calculate than the ISS. The results of the TRISS method using NISS were satisfactory, and we expect to use this method in quality assessment with further study and modification.