Investigation on operation timing of limb fractures combined with severe craniocerebral trauma in children / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.</p><p><b>METHODS</b>From January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.</p><p><b>RESULTS</b>All patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).</p><p><b>CONCLUSION</b>The condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.</p>

Prevalence of human papillomavirus infection in women in Tibet Autonomous Region of China / 中华妇产科杂志

Objective To determine the prevalence of cervical type-specific human papillomavirus (HPV)infection as well as risk factors associated in Tibet Autonomous Region of China.Methods A cluster sampling study was performed in Lasa,Rikaze and Naqu of Tibet.An epidemiological questionnaire was applied and 3036 cervical specimens were obtained for liquid-based cytology and HPV DNA detection.Statistical analysis included Wald Chi-square and stepwise logistic regression model.Results The overall HPV prevalence of involved 3036 women was 9.19%(279/3036),of which 7.05%(214/3036)of the women were infected by high-risk types (including 14 sorts of types) and 2.14%(65/3036)by low-risk types(including 6 sorts of types).There were no significant differences of HPV prevalence between age groups(P=0.936),race(P=0.718)and areas(P=0.746),respectively.Twenty-one types of HPV were detected,of which HPV16(1.52%) was the most common type,followed by HPV33(1.42%).HPV58(1.22%),HPV52(1.15%),and HPV31(1.05%).HPV type distribution was varied by age.Of the 279 HPV infected women.14.3%(40/279)exhibited multiple HPV infections.Independent risk factors for HPV infection were smoking(P=0.027),number of sex partners(P=0.198)and early age of first intercourse(P=0.237).Conclusion The overall prevalence of HPV infection in Tibet Autonomous Region is lower than that in China or abroad,in which the most common genotype is HPV16 and the independent risk factors for HPV infection included early age of first intercourse,smoking,and number of Bex partners.