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【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of herpes zoster wounds secondary to systemic lupus erythematosus (SLE), especially large ulcer wounds. 【Methods】 The treatment process of a patient with massive herpes zoster wounds in perineum and hip accompanied by extensive soft tissue necrosis secondary to SLE was retrospectively analyzed. The clinical efficacy of allogeneic PRP was explored combined with treatment key points and literature review. 【Results】 The patient′s wound bed was prepared until the wound was fresh, then treated externally with allogeneic PRP 3 times a week. The wound was healed completely after 42 days. 【Conclusion】 In the case of autologous PRP unavailable or unsuitable, allogeneic PRP is a safe alternative, which can effectively promote tissue regeneration, and this patient achieved curative effect in a short period of time.
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Objective:To assess the correlation between frailty and cardiac autonomic nervous system function in elderly patients.Methods:Elderly hospitalized patients aged 65 years and over were enrolled and assessed for frailty by using the clinical frailty scale.Cardiac autonomic modulation was evaluated by heart rate variability analysis through 24 h electrocardiogram recording.Results:A total of 180 elderly patients were enrolled in this study, including 66 patients with frailty and 114 patients without frailty.The mean age of the frailty group was higher than that of the non-frailty group(79.8±6.0 vs.75.0±6.3, t=5.030, P<0.001). The proportions of patients with hypertension, stroke/transient cerebral ischemia attack(TIA), heart failure and osteoarthritis were higher in the frailty group than in the non-frailty group(all P<0.05). Compared with the non-frailty group, the standard deviation of normal-to-normal intervals(SDNN)[103.0(76.0, 121.2) vs.107.5(92.0, 136.0), Z=-2.108, P=0.035], the standard deviation of the averages of NN intervals in all 5-min segments(SDANN)[86.0(67.7, 106.5) vs.97.5(78.0, 126.0), Z=-2.694, P=0.007], normalized low frequency(LFnorm)(53.1±13.0 vs.59.3±13.9, t=-3.024, P=0.003)and low frequency/high frequency(LF/HF)ratio[1.2(1.0, 1.4) vs.1.4(1.1, 1.7), Z=-3.041, P=0.002]were decreased and normalized high frequency(HFnorm)(36.8±9.2 vs.32.2±10.7, t=3.033, P=0.003)was increased in the frailty group.HFnorm in the frailty group was significantly higher than that in the non-frailty group.The incidents of SDANN<92 ms, LFnorm<50 nU, HFnorm>32 nU and LF/HF ratio<1.5 were higher in the frailty group than in the non-frailty group(59.1% or 39/66 vs.41.2% or 47/114, 42.4% or 28/66 vs.22.8% or 26/114, 72.7% or 48/66 vs.49.1% or 56/114, 84.8% or 56/66 vs.65.8% or 75/114, χ2=5.346, 7.660, 9.547, 7.664, P=0.021, 0.006, 0.002, 0.006). Logistic multivariate regression analysis showed that LFnorm, HFnorm and LF/HF ratio were correlated with frailty( OR=0.971, 1.039 and 0.333, all P<0.05), and HFnorm>32 nU and LF/HF ratio<1.5 were risk factors for frailty( OR=2.401 and 2.773, both P<0.05). Conclusions:Cardiac autonomic nerve system function is impaired in elderly frail patients, with the imbalance between the sympathetic and vagus nerves.Therefore particular attention should be paid to heart rate variability in elderly patients with frailty.
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Objective:To assess the cardiac autonomic nervous function in elderly patients with frailty.Methods:Patients aged ≥ 65 years old admitted in Beijing Hospital from September 2018 to August 2019 were enrolled in this study. Clinical frailty score was used to assess the frailty. The cardiac autonomic modulation was evaluated by sinus heart rate turbulence analysis through 24 h electrocardiogram recording.Results:A total of 129 elderly patients were finally enrolled in this study with a mean age of (77.5±6.4) years, 58.1% of them were male. There were 53 patients in frail group and 76 patients in non-frail group. The age of the frailty group was significantly higher than that of the non-frailty group [(80.5±5.5) vs.(75.3±6.2)]; the prevalence of hypertension [84.9%(45/53)], heart failure [32.1%(17/53)] and peripheral vascular diseases [32.1%(17/53)] in the frailty group was significantly higher than that in the non-frailty group [65.8%(50/76), 1.3%(1/76), 17.1%(13/76); t=5.001, χ 2=5.879, 24.606, 3.921; all P<0.05]. Compared with non-frailty group, turbulence onset (TO) [-0.05(-0.92, 0.82)% vs. -0.74(-1.58, 0)%; Z=2.616, P=0.009] was significantly higher in frailty group, while turbulence slope (TS) [2.34(1.30, 5.00)ms/RR vs. 4.34(2.66, 6.39)ms/RR; Z=-3.048, P=0.002] was significantly lower. The rate of TO abnormality [49.1% (26/53) vs. 26.3%(20/76), χ 2=7.038, P=0.008] and TS abnormality [34.7%(29/53) vs. 21.0%(16/76); χ 2=15.579, P<0.001] in the frailty group was significantly higher than that in the non-frailty group. Multivariate logistic regression analysis showed that TO abnormality( OR=2.970, P=0.010, 95 %CI:1.300-6.785) and TS abnormality( OR=3.618, P=0.003, 95 %CI:1.565-8.364) were correlated with frailty. Conclusion:Cardiac autonomic nerve function may be impaired in elderly frail patients, and decreased vagal nerve tension may be presented.
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To meet the requirement on trauma database construction and trauma care quality evaluation for trauma center by National Health Commission of the People’s Republic of China, the authors put forward the basic fields of trauma database and determine the basic content of trauma database V4.0 by referring to the National Trauma Database content of US based on the fields of trauma database V3.0 and guided by the requirement of trauma care quality control and clinic research. This database consists of 137 fields, covering the whole process of trauma occurrence, first aid, diagnosis, treatment and outcome. Thirty-five quality control indices for trauma care are established. Preliminary application of trauma database V4.0 shows that it meets the basic requirements of trauma center construction and clinical research in China.
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OBJECTIVE:To observe clinical efficacy and safety of Bufeihuayu decoction combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC)and its effects on vascular endothelial growth factor(VEGF)and immune func-tion. METHODS:A total of 120 NSCLC patients in our hospital during Oct. 2013 to Jun. 2015 selected as research object were di-vided into observation group and control group according to random number table,with 60 cases in each group. Control group was given GP(gemcitabine combined with cisplatin)chemotherapy. Observation group was additionally given Bufei huayu decoction, one dose a day,decocted to 400 mL,morning and night,on the basis of control group. Clinical efficacies of 2 groups were com-pared,and VEGF-A,VEGF-B,VEGF-C and immune indexes (CD3+,CD4+,CD8+,CD4+/CD8+) levels were compared before and after treatment. The occurrence of toxic reaction was recorded. RESULTS:Response rate and disease control rate of observa-tion group were 58.33％ and 85.00％,significantly higher than 40.00％ and 68.33％ of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in levels of VEGF or immune indexes between 2 groups (P>0.05). After treatment,VEGF of 2 groups were decreased significantly,and observation group was significantly lower than the con-trol group,with statistical significance(P<0.05);CD4+and CD4+/CD8+of 2 groups were decreased significantly,while CD8+was increased significantly,with statistical significance(P<0.05);CD4+ and CD4+/CD8+ of observation group were significantly higher than those of control group,while CD8+ was decreased significantly;CD3+ of control group was decreased significantly and lower than observation group,with statistical significance (P<0.05). The incidence of leucopenia,thrombocytopenia,decrease of hemo-globin,elevation of transaminase,increase of bilirubin and digestive tract reaction in observation group was significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Bufei huayu decoction combined with chemotherapy shows significant therapeutic efficacy for NSCLC,can effectively inhibit VEGF,improve immune function and relieve toxic reaction.
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AIM: To investigate the role of transcription factor hairy and enhancer of split 1 (Hes1) in the malignant transformation of human bronchial epithelial cell line BEP2D induced by tobacco.METHODS: The BEP2D cells were chronically exposed to cigarette smoke condensate (CSC) at 1 cigarette per L until the 70th generation.The phenotype of malignant transformation of the cells induced by CSC was detected by soft agar clony formation assay.RT-PCR and Western blot were used to determined the expression of Hes1 at mRNA and protein levels in each generation of the cells.The proliferation and apoptosis of the BEP2D cells exposed to CSC were analyzed with the methods of MTT assay, flow cytometry and cell colony formation assay after treatment with Notch pathway bloker DAPT or liposome transfection with Hes1-siRNA.The expression of Hes1 in the peripheral small airway tissues of the smoking rats was evaluated by immunohistochemical staining.The expression of Hes1 in non-small-cell lung cancer and normal airway tissues was also detected by the methods of immunohistochemistry and RT-PCR.RESULTS: The BEP2D cells in the 70th generation had a malignant transformation phenotype.The expression of Hes1 in the BEP2D cells exposed to CSC for different time showed an increa-sing trend.DAPT and liposome transfection with Hes1-siRNA down-regulated the expression of Hes1, inhibited the cell proliferation and induced cell apoptosis.The expression of Hes1 in the airway mucosa of the rats exposed to cigarette smoke for 1 month and 6 months was significantly higher than that in control group.Cigarette smoking induced the expression of Hes1 in lung cancer and normal airway tissues.CONCLUSION: Hes1 may be involved in smoking-induced lung cancer by promoting the imbalance between apoptosis and proliferation.
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Objective To observe the effects of seawater immersion at different temperatures on survival time and mortality and physiological state of non-anesthetized rats.Methods Totally 100 SD male rats(The abdominal cavity was implanted with a temperature sensor in advance)were randomly divided into five groups which were immersed in 20 ℃,17 ℃,15 ℃,13 ℃ and 10 ℃ seawater,respectively.Each group contains 20 rats.The changes of respiration,heart rate and muscle fibrillation within 2 hours were observed and the survival time and mortality of each group were counted in 24 hours.The decrease trend of intraperitoneal temperature in rats was analyzed retrospectively within 2 hours.Results Soaking for 10 minutes,the respiratory and heart rate of each group were significantly increased,but there was no significant difference among groups(P>0.05).The respiratory and heart rate decreased rapidly between 10 and 40 minutes,and the decline was slower relatively between 40 and 80 minutes.Soaking for 80 minutes,the respiration rate of rats among groups had significant difference(P0.05),hereafter the muscle fibrillation was maintained at a certain level.The mean survival time of 20 ℃ group,17 ℃ group,15 ℃ group,13 ℃ group and 10 ℃ group in 24 hours were(23.6±1.23)hours,(15.0±4.16)hours,(7.7±3.21)hours,(2.4±0.91)hours and (1.1±0.39)hours,respectively,and the survival curve of each group was statistically significant(P<0.05).The intraperitoneal temperature of rats showed a decline in the cliff,the lower the water temperature,the faster the descending.Soaking for 40 minutes,the difference of intraperitoneal temperature of each group was statistically significant(P<0.05).Conclusion The effects of seawater immersion at different temperatures on the physiological state and survival time and mortality of rats are significantly different.With the decrease of water temperature,the physiological state changes more obviously,the survival time is shorter and the mortality rate is higher.
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Objective To establish an animal model of severe blast lung injury in baby rabbits,and to provide a way to study the char-acteristic and treatment of blast lung injury in minors.Methods Randomly selected sixteen 4-weeks old New Zealand white rabbits,and the blast lung injuries were made by BST-Ⅰ biological shock tube with different drive pressure (4.0 MPa and 4.5 MPa)respectively.Then compared the injury severity of the 4.0 Mpa group and the 4.5 MPa group.Selected forty-eight 4-weeks old New Zealand white rabbits and di-vided them into the control group (8 rabbits)and the blast lung injury group (40 rabbits)Rabbits in the blast lung injury group were injured with 4.5 MPa drive pressure.Observed the vital signs,physiological index,gross anatomy of the lung,pathology,and pulmonary water content at the time of injury immediately (0 hour),2 hours,4 hours,6 hours,12 hours,24 hours,48 hours and 72 hours after the injury.Results Rabbits inthe 4.0 Mpa group and the 4.5 MPa group were all alive.The overpressure of blast wave of the 4.0Mpa group was (328.16 ± 4.78)kPa,rate of severe pulmonary defense was 12.5%,and the AIS score was (3.38 ±0.52)points.In the 4.5 MPa group,the overpressure of blast wave was (395.04 ±11.74)kPa,rate of severe pulmonary defense was 87.5%,and the AIS score was (4.13 ±0.64) points.Rabbits in the control group and the blast lung injury group were all alive.The spirits of rabbits were drooping immediately after inju-ry,and it last about 0.5 hour.Then the breathing and heart rate was accelerated,pulmonary water content was increased significantly,and there were extensive hemorrhage and edema in the lung.Most of the rabbits suffered severe lung injury,and the AIS score was (3.98 ±0.55) points.Lung tissue rupture,hemorrhage,edema,and inflammatory cells infiltration were the main pathological manifestations under light microscopy. Conclusion The model of severe blast lung injury in baby rabbits could be established with BST-Ⅰbiological shock tube and drive pressure of 4.5 MPa.It is relatively simple,easily controllable and highly repeatable,which can be used as a feasible model for the study of blast lung injury.
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Objective To retrospectively review the epidemiological data from 159,242 patients hospitalized after traumatic brain injury in traffic accidents and provide epidemiological evidences for the prevention and treatmentmeasures.Methods Patient data were collected using the Chinese Trauma Database for the years 2001-2007.Epidemiological features of age,gender,time distribution,length of hospital stay,state of injury,and treatment outcome were recorded.Results Age of the patients was (33.01 ± 15.20) years and ratio of male to female patients was 2.39∶ 1.The majority were aged 21-50 years with the 31-40 age group were more vulnerable.Annual average growth of age was 3.92％.Within a year,number of the patients accounted for 54.10％ from July to December with it reached the peak in October.Mean length of stay was 20.20 days with the longest stay in the ≥90 age group and shortest stay in the ≤10 age group.Mean hospital charges was 13 689.8 yuan with the ≤10 age group occupying the least and 51-60 age group occupying the most.Overall cure rate was 66.92％ and mortality was 4.22％.Proportion of severe traumatic brain injury in traffic accidents increased and related cure rate decreased with increased age.Male patients showed higher death rate and lower cure rate compared with female patients.Conclusions Incidence of traffic accidents-related traumatic brain injury is the most in the young and middle-aged population and is prevalent in the second half year.There should be emphasis on the aged or male patients.Measures to prevent and treat the injury may produce better results when defined based upon these epidemiologic features.
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Objective To investigate effect and mechanism of Xuebijing administration at various concentrations on ischemia reperfusion injury (IRI) of rabbit limbs.Methods Thirty New Zealand rabbits were divided into control group (n =10),Xuebijing group Ⅰ (n =10) and Xuebijing group Ⅱ(n =10) according to random number table.Rabbit models of IRI in lower extremities were established.Each group received corresponding therapy after reperfusion:rabbits in Xuebijing group Ⅰ were firstly administered 4 ml/kg Xuebijing solution and 6 ml/kg isotonic saline; rabbits in Xuebijing group Ⅱ were administered 2 ml/kg Xuebijing solution and 8 ml/kg isotonic saline; rabbits in control group were simply administered 10 ml/kg isotonic saline.Venous blood samples were collected before reperfusion and at 1 h,2 h,4 h after reperfusion to measure coagulation parameters (APTT,Fib,INR and PT) and biochemical items (ALB,LDH and CK).Results APTT in Xuebijing group Ⅰ presented obvious improvement at 1 h and 4 h after reperfusion as compared with control group (P ＜ 0.01).PT in Xuebijing groups Ⅰ and lⅡ was significantly longer after reperfusion than that before reperfusion (P ＜0.05).Fib level in Xuebijing group Ⅰ was much higher at 4 h after reperfusion than that before reperfusion (P ＜ 0.05).ALB level at 1 hour after reperfusion showed no statistical differences from that before reperfusion in Xuebijing groups Ⅰ and Ⅱ (P ＞ 0.05).LDH and CK levels in Xuebijing group Ⅰ were much lower than those in control group after reperfusion (P ＜ 0.05).Conclusions Xuebijing injection relieves limb IRI,with better effect in Xuebijing group Ⅰ than in Xuebijing group Ⅱ.Therapeutic mechanism may be associated with its involvement in adjusting clotting function and mitigating injury of muscle tissues.
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Objective To summarize the experiences with early treatment of the wounded associated with 4 · 20 Lushan earthquake in army hospitals.Methods Emergency response programs were started and tent hospitals were set up.According to the basic principle of wartime wound treatment regulation,emergency triage,emergency medical care,transferring,specialized treatment and evacuation were performed for the wounded in this earthquake.Results After the earthquake,the emergency rescue programs were started in the hospital.Twenty minutes later,emergence medical team with full equipment were set out for the epicenter and the tent hospitals were set up.A total of 181 earthquake cases were admitted within two weeks,of which 68 (37.6％) were transferred from the scene of earthquake and 113 (62.4％) were transferred after the primary treatment (including cases evacuating from other hospitals).Forty-nine surgeries had been done,including 30 emergence ones.Thirty-four cases (including 14 severe wounded) were evacuated to superior hospitals as their vital signs turned stable.There was no death or surgical wound infection.Conclusions Peacetime complete emergence programs and materials reserves,unified and well-organized command as well as normative grading treatment system in army hospitals assure the standardized medical care with high efficiency and high quality for earthquake victims.However,more researches are needed over diagnosis methods and standards for wound severity,equipment improvement and standards for casualty evacuation.
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Objective To study and compare the effects and mechanisms between the Xuebijing injection and Danshen injection on ischemic-reperfusion injury of rabbit limb .Methods 30 New Zealand rabbits were randomly divided into control group ,Xuebi-jing group and Danshen group ,with 10 in each group .The Crinnion model of ischemic-reperfusion injury of rabbit limb was used . Each group was treated correspondingly after the blood flow was restored .Xuebijing group and Danshen group were treated with 4 mL/kg Xuebijing injection 2 mL/kg Danshen injection in saline with 10 mL total volume .Control group was treated with 10 mL sa-line .Before releasing clip and 1 h ,2 h and 4 h after reperfusion ,the blood samples were collected for detecting clotting function (APTT ,FIB ,PT-INR ,PT) ,biochemistry items (ALB ,LDH ,CK) ,MDA level and SOD level .Results Compared with control group ,the APTT of Xuebijing group in 1 h and 2 h and Danshen group in 4 h after reperfusion improved significantly (P<0 .05) . The PT of Xuebijing group after reperfusion extended significantly compared with the PT before reperfusion (P<0 .05) .The FIB level of Xuebijing group and Danshen group in 4 h after reperfusion was much higher than before (P<0 .05) .The LDH and CK level of Xuebijing group after reperfusion was much lower than that of control group (P< 0 .05) .The MDA level of Xuebijing group in 2 h and Danshen group in 1 h ,2 h after reperfusion was much lower than that of control group (P<0 .05) .The SOD activ-ity of Xuebijing group in 1-4 h and Danshen group in 2 h after reperfusion was much higher than that of control group (P<0 .05) .Conclusion Xuebijing injection and Danshen injection have the relieving effect on the limb ischemic-reperfusion injury by ad-justing clotting function and decreasing free oxygen radicals .In terms of relieving the injury of muscle tissue ,the effect of Xuebijing injection might be better than Danshen .
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Objective To compare the differences of disease spectrum between patients with brain trauma injury (TBI) in the high altitude areas and those in the plain areas.Methods The front page information of medical records of local TBI patients admitted to military hospitals from 2001 to 2007 was extracted from the Chinese Trauma Database.Ten military hospitals from high altitude areas (high altitude group) and 10 military hospitals with the same hospital level from plain areas (plain group) were selected and the patients in the two groups were compared for their differences in general condition and disease spectrum.Results High altitude group displayed a larger proportion of male patients (P＜0.01),a lower age (P＜0.01),a smaller proportion of patients with Han nationality (P＜0.01),asmaller proportion of emergency patients (P＜0.01),a larger proportion of critically ill patients (P＜0.01),a lower median of hospital days (P＜0.01),a lower operation rate (P＜0.01),as compared with the plain group.The injury of the patients with TBI in turn were intracranial organ injury (excluding those with skull fracture),open wound of head,neck,and trunk,skull fracture,injury of nerves and spinal cord.The orders of TBI disease spectrum of the high altitude and plain groups were the same,but the disease compositions of the two groups had significant difference (P＜0.01).Conclusions Thereexist significant differences in demographics,admission status and disease spectrum of TBI patients inhigh altitude and plain areas.However,the current clinical treatments of TBI in high altitude areas are usually with reference to the experience in plain areas,which is worthy of paying attention by relevant departments.
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Objective To investigate the characteristics of spinal injury caused by earthquake as well as to improve its therapeutic ability by comparatively studying the medical records of the inpatients with spinal injuries caused by Wenchuan earthquake and the inpatients with spinal injuries in peace time.Methods Medical records of inpatients with spinal injuries were extracted from 5.12 earthquake injury database(earthquake group) and medical records of the patients with spinal injuries firstly admitted to Daping Hospital between 2001 and 2007 were extracted from Chinese trauma database systems (control group).The epidemiological characteristics of the two groups were comparatively studied,including gender,age,injury causes,injury severity,treatments and outcomes.Results (1) The incidence of spinal injuries in the earthquake group was 16.7％ (524/3145),which was significantly higher than that (6.4％,682/10644) in control group (P＜0.01).(2) The female ratio in the earthquake group was significantly higher than that in the control group (57.4％:31.8％) (P＜0.01).(3) The age range of the earthquake group was (47.9 ±20.9) years.The wounded number presented an undulately rising trend in the earthquake group as the growth of age,while it showed a parabolic distribution in the control group.(4)The main causes for spinal injuries were crush injury (69.3％) and multi-factor injury (2.8％) in the earthquake group,while slipping up/fall (56.0％) and traffic accidents (23.6％) were the main causes in the control group.(5) There were 82.3％ of the earthquake group that were combined with multiple injuries and 48.1％ combined with at least two injuries,while the control group accounted for only 28.9％ and 12.0％ respectively.The NISS (new injury severity score) in the earthquake group was significantly higher than that in the control group [(11.6±8.8) points vs (7.5±4.8)points](P＜0.01).Meanwhile,the proportion of NISS≥16 in earthquake group was significantly higher than that in the control group as well (P＜0.01).(6) The length of hospital stay of the wounded in the earthquake group was significantly longer than that in control group [(40.5±24.5)d VS (23.9±26.7)d](P＜0.01).The treatment inefficiency rate in the earthquake group was higher than that in the control group (9.2％ vs 4.8％) (P＜0.01).Conclusions The earthquake group has a higher proportion of spinal injuries,female and elder cases,and combined injuries,a much severer injury,a longer length of hospital stay,and a higher treatment inefficiency rate,as compared with the control group.In the earthquake relief,more importance should be attached to salvage,diagnosis,transfer regulation and missed diagnosis,misdiagnosis and secondary injury should be avoided so as to improve the treatment level of the spinal injuries in earthquake.
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Objective To investigate the risk factors affecting the mortality in patients with severe chest trauma (SCT).Methods A total of 777 patients with SCT (AIS≥ 3) treated at Chongqing Emergency Medical Center from January 2006 to April 2009 were involved for retrospective study.Multivariate stepwise logistic regression analysis was used to analyze 15 possible risk factors affecting their mortality.Results The factors affecting mortality in patients with SCT included hemorrhagic shock (X6,B =1.710,OR =1.291,P＜0.01),multiple organ dysfunction syndrome (MODS) (X7,B=3.453,OR =1.028,P＜0.01 ),pulmonary infection ( X9,B =2.396,OR=10.941,P ＜ 0.01 ),abdominal organ injury (X11,B=1.542,OR=1.210,P＜0.01) and thoracic AIS ≥3 (X14,B =0.487,OR =1.622,P＜0.01 ).While the protective factors affecting mortality in patients with SCT contained age ≤60 years old (X1,B =-0.035,OR =0.962,P＜0.05) and GCS≥12 (X13,B=- 0.635,OR=0.530,P＜0.05).Conclusions The age,posttraumatic complications (hemorrhagic shock,MODS,pulmonary infection)and accurate diagnosis and evaluation of trauma severity are the related factors to predict the prognosis.Development of effective treatment measures based on these risk factors plays a key role in the survival rate of patients with SCT.
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ObjectiveTo study the characteristics and explore risk factors of traffic injuries in Wenzhou part of the Ningbo-Taizhou-Wenzhou (Yong-tai-wen for short) highway during 2005-2009 so as to provide scientific evidence for promoting prevention and cure level of highway traffic injury.Methods The original data of traffic accident in Wenzhou part of the Yong-tai-wen highway during 2005-2009 were collected to carry out the descriptive epidemiological investigation of the injury characteristics.Simultaneously,multi-factor analysis was conducted to screen out the risk factors for traffic accidents.Results A total of 308 traffic accidents involving 603 casualties (157 deaths) were interviewed during 2005-2009.The casualties from expressway traffic accidents declined yearly,but annual death rate was still very high (26.04％).Meanwhile,the males were more likely subjected to traffic injuries than females.The most common injury sites were the head and limb and the main fatal injuries were the head and pelvic injuries.Accident-prone period was from 0:00 to 8:00 in the morning and traffic scenarios were mainly characterized by rear collision (39％).Risk factors for traffic accidents included poor lighting conditions,overloaded vehicles on the road sections,male drivers,driving without a license,fatigue driving and speeding.ConclusionsTraffic accidents present high incidence and casualty rates,and are mainly resulted from overloaded and fatigue driving.Therefore,the training and education on safe driving should be done particularly for the males and low driving age drivers to strictly forbid the overload driving,fatigue driving or overspeed driving.
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Objective To investigate the harm of drug abuse of drivers on traffic safety and discuss the countermeasures.Methods Data were collected from sources including statistics of drug driving traffic accidents reported by mass media,inference analysis of the theoretical data,survey of outpatients in drug rehabilitation center,drug-related screening with drivers license during Shanghai World Expo 2010 Moat Security and integrated data from various areas.ResultsOf the over 10 million drug abusers including the registered and unregistered in China,more than 2 million drug abusers had drivers license,which greatly threatened the traffic safety.Conclusion Drug abuse (drug driving) has done great harm on traffic safety,which calls for appropriate preventive countermeasures.
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Objeetive To analyze traffic accidents involving pedestrians in Chongqing from 2000 to 2006 so as to understand injury characteristics of the pedestrians. MethodsThe data of pedestrian road traffic crashes and injuries in three districts including one district in downtown,one in suburb and one in county of Chongqing from 2000 to 2006 were collected from road traffic crash and road traffic injury database to analyze severity of crashes,casualties,action and location of pedestrians in crashes. Results The road crashes led to 7 934 pedestrian injuries (24.74％) and 867 pedestrian deaths (49.46％).Intensity of the pedestrian road crashes in rural areas was higher than that in downtowns and suburbs.Of all pedestrian casualties,57.91％ were due to illegally crossing the driveway,and 15.43％ of the casualties were on the crosswalk.Most of the casualties occurred on the main roads,the third class highways and second main roads in Chongqing.But serious crashes occurred on the first and second class highways and substandard highways,which led to average 3.17,4.13 and 5.42 deaths,respectively.Pedestrians accounting for 52.46％ of the total severe injuries were more than the proportion among the minor to moderate injuries.Head injuries were the most common for the pedestrians and chest injuries were also usual among the severe injuries. Conclusions The intensity of pedestrian road crashes is higher than that of other crashes,especially in rural areas.It should be noticed that the main injuries of the pedestrians are head injuries,which is mainly resulted from illegally crossing driveway.It is worth noticing that a rather high proportion of pedestrians are impaired on the crosswalks,indicating that we should pay more attention to protect right of the pedestrians on the crosswalks during transportation law enforcement and safety education in the future.
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Objective To study the positive influence of a standard trauma system on the care of severely injured patients.Methods The severely injured patients (NISS≥16 points)were divided into study group ( in 2006-2008,after the establishment of trauma center in our hospital) and control group (in 2001-2005,before the establishment of trauma center),which was bound by the establishment of the trauma center in our hospital in January 2006.The injury severity,care and outcomes were recorded by using China Trauma Database and changes in efficiency and quality of injury care were compared.Results The study group (66 patients) and control group (260 patients) with NISS of (20.59 ±4.63)points and (20.57 ± 5.38 ) points respectively,were similar in the distribution of severity ( P ＞ 0.05 ).The emergency care time was (0.33 ± 0.03) hour in the study group,which was significantly shortened compared with (0.57 ±0.35 ) hours in the control group (P ＜ 0.01 ).The length of hospital stay was (27.64 ±29.01 ) days in the study group,which was shorter than (30.84 ± 32.87 ) days in the control group (P ＞ 0.05 ),while the length of ICU stay was (2.98 ± 5.77 ) days in the study group,longer than (2.65 ± 7.00) days in the control group (P ＞ 0.05 ).The recovery rate was significantly increased from 76.5％ to 87.9％ (P ＜0.05) and mortality was significantly decreased from 20.8％ to 9.1％ (P ＜0.05).Conclusion The study indicates that the standard first aid model can notably improve the trauma care in our hospital.
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ObjectiveTo study the characteristics and risk factors of traffic injuries among the adolescents (0-19 years old) in the urban and rural areas of Chongqing and discuss the preventive strategy. MethodsData of road traffic crashes and injuries involving 0-19 years old adolescents over a seven-year period (2000-2006) in three districts of Chongqing was picked up from Road _Traffic Crashes and Injuries Database. Epidemiological characteristics of the traffic crashes and injuries among 0-19 years old adolescents were analyzed and differences between rural and urban areas were studied. ResultsFrom 2000 to 2006, both incidence rate and mortality rate peaked in the urban fringe area were 95.43/100 000 and 3.44/100 000 respectively. Traffic accidents in the suburbs and counties had the highest injury extent, with mortality rate of 9.06％ and severe injury rate of 17.33％. Brain injuries were the primary cause of death. Among the victims, 62.7％ were the pedestrians, of which 20.72％ bore equal responsibility because of disobeying traffic signals, suddenly walking across roads and not walking along the sidewalk. Ninety percentage of the traffic accidents occurred in the sections with no traffic signals or traffic control system. ConclusionIt is important to enhance the traffic safety consciousness of teenagers and children, strengthen preventive measures in fringe areas and rural areas and improve the emergency medical system in rural areas to provide the teenagers and children with a safety traffic environment.