Repair of complex defects in right upper extremity with microsurgery: A case report / 中华显微外科杂志

This is a report of a complex defects in the right upper extremity treated in the Department of Hand and Microsurgery, 521 Hospital of Norinco Group, in October 2016. The patient received multi-transfers of flaps for one-stage reconstruction, including a double-paddled ALTPF and a compound flap of the great toe and the second toe. Vascular compromises occurred in flaps on the 2nd day after surgery. All the flaps were rescued and survived completely after surgical exploration. Followed-up at 3 year after surgery showed that the appearance and function of the affected limb recovered well. The flexion and extension of elbow and wrist were normal. The pinch function of the reconstructed thumb and index finger recovered well.

Relationship between emergency department crowding and initial management, mortality of severe trauma patients

OBJECTIVE: This study examined whether emergency department (ED) crowding influences the timing of the initial assessment and treatment in severe trauma patients, as well as their mortality rates. METHODS: This retrospective, observational study was conducted between January 2015 and October 2016, and included adult severe trauma patients who presented to the ED. The emergency department occupancy rate (EDOR) was used to measure ED crowding. The patients were divided into four groups using the EDOR quartile. The timeliness of the initial assessment and treatment in the four groups as well as the mortality rates were compared. RESULTS: This study investigated 307 patients. The timing of the first computed tomography (CT) and laboratory test order, CT and laboratory test result acquisition, first transfusion, and patient transfer from the ED to the operating room were similar in the four groups. Multivariable logistic regression analysis did not show a significant difference in mortality between the groups. CONCLUSION: ED crowding was not associated with delays in the initial assessment and treatment of severe trauma patients, or in their mortality rates.

Amputation or Salvage-the Medical and Ethical Reflection on the Children with Lower Limbs Severe Injury / 中国医学伦理学

We often have to choosea between amputation and salvage after severe injuries in lower limbs of children.We have established the score scale and discriminatory equation in judging the severity of low limb injury in children.Through medical ethical analysis,the author makes a conclusion that the score scale and the discriminatory equation is valuable in determining severity of lower limbs injury in children.