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Objective:To evaluate the trauma center model in general hospitals for patients with severe trauma.Methods:The data of 1,248 patients with severe trauma (ISS≥16) were retrospectively analyzed who had been admitted to the trauma centers in 6 Chinese general hospitals from January 2019 through June 2020. They were 987 males and 261 females with an age of 50.4 years ± 15.4 years. Their injuries were caused by a traffic accident in 622 cases, falling from a height in 357 cases, a knife in 62 cases, and others (like a heavy object and fall) in 207 cases. Upon admission, their injury severity scores (ISS) were 24.9±8.5 and their Glasgow coma scores (GCS) 12.6±3.6. They were all treated in a scientific and standard manner by a multidisciplinary team at the trauma center of their specific general hospital. Recorded were deaths within 30 days after admission, 30-day mortality and causes of death.Results:All the patients were treated effectively. 101 deaths occurred within 30 days after admission, yielding a 30-day mortality of 8.1%. The main causes of death were severe craniocerebral injury in 56 cases, hemorrhagic shock in 26 cases, multi-organ failure in 11 cases and others in 8 cases.Conclusions:Establishment of trauma centers in China can make up for the disadvantage of over-division of clinical specialties in large general hospitals which has led to insufficient care for patients with severe trauma and multiple injuries. The trauma centers in general hospitals may be a feasible model to be popularized in treatment of patients with severe trauma and multiple injuries.
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Objective@#To investigate the effect of construction of trauma care center on the treatment of patients with severe multiple trauma.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 412 patients with severe multiple trauma admitted to the First Affiliated Hospital of Soochow University from December 2015 to November 2017. There were 250 males and 162 females, aged 19-80 years [(45.8±15.9)years]. The injury severity score (ISS) ranged from 18 to 57 points [(28.2±9.3)points]. The observation group included 211 patients who were treated after the establishment of the provincial trauma treatment center in Jiangsu Province, and the control group included 201 patients who were treated before the establishment of the provincial trauma treatment center. The durations from arrival to the start of rescue, from consultation to completion of CT examination, from applying for blood transfusion to the execution of blood transfusion by nurses, the time of stay at the resuscitation room and the mortality rate were compared between the two groups.@*Results@#The observation group presented better results in the durations from arrival to the start of rescue [(2.5±1.7)minutes vs. (5.4±2.6)minutes], from the start of the rescue to completion of CT scan [(36.2±11.6)minutes vs. (53.2±12.9)minutes], the transfusion time [(28.7±11.3)minutes vs. (46.5±14.1)minutes], and the time of stay at resuscitation room [(3.0±2.0)hours vs. (5.0±2.8)hours] (P<0.05 or 0.01). The mortality rate in the observation group was 3.8% (8/211), which was significantly lower than 8.5% (17/201) in control group (P<0.05).@*Conclusion@#The construction of trauma treatment center can effectively shorten the treatment time of patients with severe multiple trauma, reduce the mortality rate and improve the efficacy, which is worthy of promotion.
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Objective To investigate the effect of construction of trauma care center on the treatment of patients with severe multiple trauma.Methods A retrospective case control study was conducted to analyze the clinical data of 412 patients with severe multiple trauma admitted to the First Affiliated Hospital of Soochow University from December 2015 to November 2017.There were 250 males and 162 females,aged 19-80 years [(45.8 ±15.9)years].The injury severity score (ISS) ranged from 18 to 57 points [(28.2 ±9.3)points].The observation group included 211 patients who were treated after the establishment of the provincial trauma treatment center in Jiangsu Province,and the control group included 201 patients who were treated before the establishment of the provincial trauma treatment center.The durations from arrival to the start of rescue,from consultation to completion of CT examination,from applying for blood transfusion to the execution of blood transfusion by nurses,the time of stay at the resuscitation room and the mortality rate were compared between the two groups.Results The observation group presented better results in the durations from arrival to the start of rescue [(2.5 ±1.7) minutes vs.(5.4 ± 2.6) minutes],from the start of the rescue to completion of CT scan [(36.2 ±11.6) minutes vs.(53.2 ± 12.9) minutes],the transfusion time [(28.7 ± 11.3) minutes vs.(46.5 ±14.1) minutes],and the time of stay at resuscitation room [(3.0 ± 2.0) hours vs.(5.0 ± 2.8) hours](P＜0.05 or 0.01).The mortality rate in the observation group was 3.8％ (8/211),which was significantly lower than 8.5％ (17/201) in control group (P ＜ 0.05).Conclusion The construction of trauma treatment center can effectively shorten the treatment time of patients with severe multiple trauma,reduce the mortality rate and improve the efficacy,which is worthy of promotion.
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Objective:To investigate the influence of preoperative biliary drainage (PBD) on morbidity of severely obstructive jaundice patients after pancreaticoduodenectomy (PD).Methods:A total of 98 severely obstructive jaundice(Serum total bilirubin＞300 μ mool/L) patients underwent PD between February 2010 and October 2015 were enrolled in the study.The patients were divided into two groups based on undergoing PBD or not.The no-PBD group comprised 52 patients and the PBD group comprised another 46 patients.Perioperatives parameters,including operative time,intraoperative blood loss,postoperative mortality and morbidity and postoperative hospital stay were compared between the two groups.Results:The demographics,preoperative examinations and pathological results were similar between the two groups (P＞0.05).Operative time of the no-PBD group was statistically longer than the PBD group (379.44 ± 88.57min vs 346.98 ± 57.17 min,P＜0.05).Besides,intraoperative blood loss of the no-PBD group were much more than the PBD group (365.00 ± 187.07mL vs 297.83 ± 139.57 mL,P＜0.05).There was no statistical difference of mortality rate between the no-PBD group and the PBD group(3.85％ vs 2.17％,P＞0.05).The overall morbidity rate of the 2 groups were similar (53.85％ vs 43.48％,P＞0.05),but the pancreatic fistula rate of no-PBD group was significantly higher than the PBD group (30.77％ vs 13.04％,P＜0.05).Conclusion:PBD could reduce operative time,intraoperative blood loss and pancreatic fistula rate after PD.Meanwhile,the mortality and overall morbidity rates were similar between the two groups.PBD should be considered for severely obstructive jaundice patients.
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<p><b>OBJECTIVE</b>To investigate the expression of osteopontin (OPN) splice variant mRNA, including the three isoforms OPN-A, OPN-B, and OPN-C, to explore its correlation with clinicopathologic features in gastric cancer, and to elucidate their role in tumor invasion and distant metastasis of gastric cancer.</p><p><b>METHODS</b>The expression of OPN-A, OPN-B and OPN-C mRNA were detected by real-time reverse transcriptase-polymerase chain reaction in 66 gastric cancer tissues. The relationship between the expression of OPN-A, OPN-B and OPN-C mRNA and clinicopathologic features of gastric cancer was analyzed.</p><p><b>RESULTS</b>The expression of OPN-C mRNA in the gastric cancer tissue was 3.21-fold higher than that in peritumoral mucosal tissue, showing a significant difference between them (P < 0.001). OPN-C mRNA expression was correlated with the depth of tumor invasion, tumor diameter, lymph node meatastasis, distant meatastasis and had no correlation with differentiation grades. The low expression of OPN-C mRNA was correlated with long survival benefit (P = 0.03). The expression of OPN-A and OPN-B mRNA had no significant relationship with clinicopathologic features of gastric cancer.</p><p><b>CONCLUSIONS</b>One of the isoform of osteopontin (OPN) OPN-C mRNA is overexpressed in gastric cancer. The overexpression of OPN-C mRNA may reflect the progression and is associated with the prognosis of gastric cancer. OPN-C mRNA may have value as a prognostic biomarker in gastric cancer. However, the expression of OPN-A and OPN-B are not correlated with the progression and metastasis of gastric cancer.</p>