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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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Objective:To explore the protective effect of zonisamide (ZNS) on oxygen-glucose deprivation (OGD) cell model of traumatic brain injury (TBI), and its underlying mechanism.Methods:Human neuroblastoma cells (SH-SY5Y) were cultured in vitro and divided into the control group, OGD group, and drug administration group (OGD+ZNS group) according to the random number table method. The OGD method was used to establish a TBI cell model. After modeling, the cell activity, the release of lactate dehydrogenase (LDH), and β-galactosidase staining were detected to evaluate cell function and senescence. Additionally, mitochondrial morphology and potential membrane changes were observed using Mito Tracker Red and JC-1 mitochondrial membrane potential staining. ATP concentration was measured, and protein was extracted from SH-SY5Y cells and then subjected to Western blot analysis to detect endoplasmic reticulum stress-related markers, including glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), protein disulfide isomerase (PDI), and β-actin.Results:The OGD group had a significantly lower cell survival rate compared to the control group ( P<0.01), while the OGD+ZNS group had a significant higher cell survival rate than the OGD group ( P<0.01). The LDH release rate was significantly higher in the OGD group than in the control group ( P<0.01), while the OGD+ZNS group had a significant lower LDH release rate compared to the OGD group ( P<0.01). Moreover, the cell staining results indicated that compared to the control and OGD+ZNS groups, the cells in the OGD group exhibited significant damage and senescence with darker staining while the mitochondrial staining results demonstrated a significant reduction in mitochondrial linear junctions and decreased mitochondrial activity in the OGD group compared to the control and OGD+ZNS groups. Compared to the control and OGD+ZNS groups, the OGD group exhibited a significant reduction in mitochondrial staining red fluorescence, a significant increase in green fluorescence, and a significant decrease in mitochondrial membrane potential. The OGD group demonstrated a significant decrease in ATP concentration compared to the control group ( P<0.01), whereas the OGD+ZNS group exhibited a significant higher ATP concentration compared to the OGD group ( P<0.01). Western blot analysis revealed significant upregulation of GRP78, CHOP, and PDI in the OGD group compared to the control group (all P<0.05), while in the OGD+ZNS group, the expression levels of these proteins were significantly downregulated compared to the OGD group (all P<0.05). Conclusions:Zonisamide can protect OGD TBI cell model by preserving mitochondrial activity and inhibiting endoplasmic reticulum stress.
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Objective:To survey the first-aid ability of general practitioners (GPs) and the emergency service capacity of primary health institutions in southern Zhejiang province.Methods:The questionnaire of first-aid ability of GPs in primary care institution was developed on the basis of the Delphi method during August to October 2018. The questionnaire was employed in a survey on the first-aid ability among 480 GPs from 169 community health service centers of three regions in southern Zhejiang province. The survey covered basic information and first-aid skills and emergency response ability of GPs, and the emergency facilities of primary health institutions.Results:A total of 480 questionnaires were distributed and 447 were retrieved with an recovery rate of 93. 1%(447/480). Among the 447 responders, 55.9% (250/447) were males, 70.9% (317/447) had bachelor′s degree or above, and 60.2% (269/447) had middle and senior professional titles. There were 99.6% (445/447), 86.6% (387/447), 76.1% (340/447) and 69.8% (312/447) responders considered cardiopulmonary resuscitation(CPR), electrical defibrillation, respiratory balloon and endotracheal intubation as important first-aid skills, and corresponding mastery rates were 84.3% (377/447), 32.0% (143/447), 55.2% (247/447) and 12.9% (58/447), respectively. The 92.4% (413/447) responders thought that the rescue ability of common emergency and critical illness was the most important, while only 32.4% (145/447) responders mastered it. Least responders [41.4%(185/447)] thought that ability of using bedside ultrasound was important, and the corresponding mastery rate was only 3.8%(17/447); 77.4%(346/447) of general practitioners believed that CPR machines was important, while the available rate of CPR machines in primary health care institutions was only 16.0%(27/169).Conclusion:The GPs in southern Zhejiang province have a good grasp of cardiopulmonary resuscitation skills, but have a low mastery rate of first-aid skills such as electrical defibrillation, tracheal intubation, and emergency rescue capabilities, which are quite different from their perceived importance evaluation.
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Objective:To observe the effect of systematic graded rewarming measures on body temperature and prognosis of patients with moderate and severe trauma [revised trauma score (RTS) < 12] requiring emergency operation.Methods:A prospective randomized double-blind controlled study was conducted. From January 2020 to January 2021, 104 patients who underwent emergency trauma surgery in the Second Affiliated Hospital of Wenzhou Medical University were selected as the research object. According to random number table method, the patients were divided into traditional rewarming group and systematic graded rewarming group, with 52 cases in each group. Patients in traditional rewarming group (only record the body temperature without intervention, and start the rewarming process when the body temperature at any time was less than 36 ℃); the patients in the system graded rewarming group start the preventive measures as soon as they were admitted to the hospital, and record the body temperature. When the body temperature at any time was less than 36 ℃, start the graded rewarming process. Observe the rewarming effect, coagulation function, blood gas analysis and postoperative anesthesia recovery time of the two groups and final outcome.Results:With the extension of time, the body temperature of the two groups increased gradually. The body temperature of the systematic grade rewarming group was significantly higher than that of the traditional rewarming group at 2 hours after rewarming and at discharge (℃: 36.23±0.77 vs. 35.84±0.93 at 2 hours after rewarming, 36.54±0.87 vs. 35.82±0.92 at discharge, both P < 0.05). The incidence of subsequent hypothermia was significantly lower than that in the traditional rewarming group [7.7% (4/52) vs. 25.0% (13/52), P < 0.05]. The postoperative activated partial thromboplastin time (APTT) of the two groups was significantly shorter than that at admission (s: 35.74±8.05 vs. 45.55±28.02 in the systematic rewarming group, P < 0.05; 38.35±6.48 vs. 42.40±13.18 in the traditional rewarming group, P < 0.05); the intraoperative and postoperative pH values in the systematic rewarming group were significantly higher than those at admission (7.33±0.05, 7.36±0.06 vs. 7.30±0.07, both P < 0.05), while there was no significant difference between the intraoperative and postoperative pH values in the traditional rewarming group and those at admission (7.31±0.06, 7.33±0.06 vs. 7.31±0.05, both P > 0.05). The postoperative prothrombin time (PT) and anesthesia recovery time in the systematic graded rewarming group were significantly shorter than those in the traditional rewarming group [PT (s): 15.05±2.44 vs. 17.94±3.48, anesthesia recovery time (hours): 14.40±11.76 vs. 17.35±10.51, all P < 0.05], and the pH value was significantly higher than that in the traditional rewarming group (7.36±0.06 vs. 7.33±0.06, P < 0.05). The systematic graded rewarming group had higher improvement rate and lower disability rate than the traditional rewarming group (76.9% vs. 65.4% and 17.3% vs. 25.0%, both P < 0.05). Conclusion:Systematic graded rewarming measures can improve the hypothermia of emergency trauma patients who received surgery, reduce the incidence of subsequent hypothermia of trauma patients, shorten the time of postoperative resuscitation, improve the coagulation function and blood gas indexes, improve the treatment rate, and reduce the incidence of disability.
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Objective To investigate the significance of diameter measurement in descending aorta and ascending aorta as predictors of Stanford B type aortic dissection.Methods A total of 156 patients with chest pain and 100 healthy volunteers as control were enrolled in this study.The descending aorta diameter (dDA) and ascending aorta diameter (dAA) were measured by computed tomography (CT) and CT angiography(CTA),and the ratio of dDA to dAA or to rDA(radius of descending aorta) was calculated.Various metrics were analyzed for their specificity and sensitivity as screening measurements for Stanford B type aortic dissection.Results Fifty-six cases were diagnosed with Stanford B type aortic dissection by CTA with significant increases in dDA and rDA compared with control group(P＜0.05).When dDA was ≥ 30 mm,the sensitivity was 94.6％ and specificity was 82.0％ for Stanford B type aortic dissection,and when the rDA was ≥ 0.8,sensitivity and specificity were 96.4％ and 91.0％,respectively.Conclusions The dDA ≥ 30 mm and rDA ≥ 0.8 may be used to predict Stanford B type aortic dissection in suspected patients with chest pain,and the latter is more accurate than the former.
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Objective To investigate the effects of basic fibroblast growth factor (bFGF) on pericytes in the blood brain barrier at acute stage after traumatic brain injury (TBI) in mice.Methods A total of 90 mice with a C57BL/6 background were randomly divided into sham group,TBI group,and TBI + bFGF group,with 30 rats per group.The models of moderate TBl were established using the controlled cortical impactor.After 24 hours,the changes of nerve function were evaluated by Garcia neurological score.Each mouse received an intraperitoneal injection of Evans blue dye for measuring the permeability of blood brain barrier.Western blot was used to test the related indices of pericytes after the cerebral cortex was quickly dissected:platelet-derived growth factor receptor beta (PDGFR-β),aminopeptidase N (CD13),desmin,neurogliocyte 2 (NG2),and glyceraldehyde-3-phosphate dehydrogenase (GAPDH).Paraffin sections were prepared for HE staining and morphological changes were observed.Immunofluorescence assay was used to test the related indices of pericytes:PDGFR-β,CD13,and cell surface glycoprotein MUC18 (CD146).Results Garcia neurological score revealed that the score in TBI group was significantly decreased compared with that in sham group (P ＜ 0.01),but the score of TBI + bFGF group was significantly increased compared with that of TBI group (P ＜ 0.05).Permeability of blood brain barrier in TBI group was significantly increased compared with that in sham group (P ＜0.01),but in TBI + bFGF group this parameter significantly reduced compared with that in TBI group (P ＜ 0.01).Western blot analysis revealed that the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI group were significantly decreased compared with those in sham group (P ＜0.05),while the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI + bFGF group were significantly increased compared with those in TBI group (P ＜ 0.05).HE staining revealed injury of brain parenchyma in TBI group was the severest compared with both sham group and TBI + bFGF group.Immunofluorescence staining results revealed that the proteins expressions of PDGFR-β,CD13,and CD146 in TBI group were significantly decreased compared with those in sham group (all P ＜0.01),and those in TBI + bFGF group were significantly increased compared with those in TBI group (all P ＜ 0.05).Conclusions bFGF can prevent pericyte death via protecting its proteins to conserve blood-brain barrier,bFGF can also significantly ameliorate the injury of brain parenchyma.
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Objective To assess the clinical application value of radiofrequency ablation (RFA) by using different-depth needle-puncturing through medial wall of oval foramen under fluoroscopic guidance in treating primary trigeminal neuralgia.Method A total of 32 patients with primary trigeminal neuralgia were enrolled in this study.Guided by fluoroscopic monitoring,RFA by using different-depth needle-puncturing through medial wall of oval foramen was carried out in all patients.The intraoperative exact replication rates of responsible nerve were recorded,and the postoperative one-day,one-week,3-month and one-year cure rates were calculated.Results During the operation,the precise replication rates the neuralgia of branch Ⅰ,branch Ⅱ and branch Ⅲ of the trigeminal nerve were 85.7％(6/7),96.4％ and 100％ respectively.The postoperative one-day,one-week,3-month and one-year cure rates were 87.5％,93.8％,93.8％ and 87.5％ respectively.Conclusion In treating trigeminal neuralgia with RFA,fluoroscopy-guided needle-puncturing through medial wall of oval foramen can accurately replicate the pain symptoms of the dominating region of responsible nerve,thus,the trigeminal neuralgia can be precisely treated.Being minimally-invasive and safe with reliable effectiveness,this technique is worthy of clinical application.
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Objective To verify the feasibility and accuracy of the quantitative evaluation of the volume of internal abdominal hemorrhage based on CT images.Methods The clinical data of 76 patients diagnosed as abdominal hemorrhage or hemoperitoneum and performed with emergency surgery in the Second Affiliated Hospital to Wenzhou Medical University from January 2009 to September 2016 were retrospectively analyzed by case-control study.The Noboru Oriuchi's formula was used to calculate the volume of abdominal hemorrhage based on CT images,and the results were compared and adjusted with the volume of actual abdominal hemorrhage recorded during the operation.SPSS 21.0 was used to statistically analyze the data.The linear regression was analyzed on the results measured by the two methods.Results The volume of abdominal hemorrhage measured by the CT calculation method ranged from 10 to 4 335 ml,while the corresponding volume measured by operational calculation method ranged from 200 ml to 4 490 ml.The absolute difference in the volume measured by these two methods ranged from 4.8 ml to 500 ml.The ratio of the absolute difference to the volume of abdominal hemorrhage by operational calculation method ranged from 0.2％ to 95.0％,the median of which was 4.5％ (2.8％,8.9％).When the exact volume of abdominal hemorrhage was ＜ 500 ml,the absolute difference in the exact volume ranged from 30.0％ to 95.0％,the median of which was 69.1％ (51.2％,78.6％).When the volume was less than 500 ml,the ratio ranged from 0.2％-13.6％,the median of which was 4.2％ (2.7％,6.4％).Analysis of the numbers of the two measuring methods with linear correlation method after eliminating the cases in which the bleeding volume was less than 500 ml showed that two methods presented a linear correlation (r =0.971,P ＜ 0.05).Conclusion After the conventional abdominal CT scanning,the Noboru Oriuchi's formula can be used to accurately calculate the volume of abdominal hemorrhage in patients with volume of abdominal hemorrhage more than 500 ml.
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<p><b>OBJECTIVE</b>To investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).</p><p><b>METHODS</b>Seventy-eight SD rats were randomly divided into traumatic group (n=36), RSTN group (n=36) and sham operation group (n=6). Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat. At respectively 12 h, 24 h, 72 h, 1 w, 2 w, and 4 w after operation, venous blood was collected and the right hind leg skeletal muscle tissue was sampled. We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles, western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels. Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted. The above mentioned indicators and their correction were statistically analyzed.</p><p><b>RESULTS</b>Compared with sham operation group, the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05), and reduced Q value (P<0.05) in traumatic group. Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.</p><p><b>CONCLUSION</b>The expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism. RSTN may play an important role in the process of insulin resistance after TBI.</p>
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Animais , Masculino , Lesões Encefálicas , Metabolismo , Glucose , Metabolismo , Resistência à Insulina , Músculo Esquelético , Química , Metabolismo , Ratos Sprague-Dawley , ResistinaRESUMO
Objective To evaluate the clinical effect of DSA-guided foam sclerotherapy for lower extremity varicose veins.Methods A total of 41 legs in 26 patients with lower extremity varicose veins were treated with foam sclerosing agent of lauromacrogol un-der DSA guidance.4 cases with venous return disorder (3 in iliac vein and 1 in inferior vena cava)were treated with balloon dilatation first,and then lauromacrogol foam sclerotherapy after 24 hours.For injection method,2 patients were injected sclerosing agent through a catheter inserted in the trunk of great saphenous vein of sick limb with retrograde catheterization,and the others were in-j ected sclerosing agent directly in the varicose veins.Results The sclerotherapy was successfully accomplished in all affected limbs of 26 patients.The average dose of lauromacrogol for each patient was 5.88 mL.No serious complications occurred during and after operation.In 1 to 12-month follow-up,varicose veins disappeared in 24 patients (92.3%),the soreness,fatigue and pigmentations disappeared in all patients,the ulcer healed in all limbs.Conclusion DSA-guided foam sclerotherapy is a micro-invasive,safe and ef-fective treatment for lower extremity varicose veins.
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Objective To investigate the expression pattern of resistin in subcutaneous adipose tissue and its effect on glycometabolism in rats with traumatic brain injury (TBI).Methods Fifty-six SD rats were randomly divided into TBI group (n =48) and control group (n =8) according to the random number table.mRNA and protein expressions of resistin in subcutaneous adipose tissue were detected with real-time PCR and Western-blot.Concentrations of serum insulin and serum fasting blood glucose were evaluated using the ELISA method and quantitative estimation of insulin sensitivity was performed.Indices measured and their correlations were statistically analyzed.Results Levels of the resistin,serum insulin and FBG were significantly higher in TBI group than in control group (P ＜ 0.05).Quantitative estimation of insulin sensitivity lowered in TBI group compared to control group (P ＜ 0.05).Single factor linear correlation analysis showed negative correlation between resistin expression and quantitative insulin sensitivity check index in TBI group (P ＜ 0.05).Conclusions Resistin is shown to have significant expression in subcutaneous adipose tissue and involve in glycometabolism.Obviously,resistin may play a significant role in insulin resistance after TBI in rats.
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Objective To assay the protective effect of endothelial progenitor cells (EPCs) on acute lung injury (ALI) in rabbits.Methods Forty male New Zealand rabbits were divided into EPCs low-dose group,EPCs mid-dose group,EPCs high-dose group,ALI group,and control group according to the random number table,with 8 rabbits per group.Emulsified oleic acid was used to induce ALl.Instead,saline emulsion was injected to rabbits in control group.PBS containing 1 × 105,1 × 106,and 1 ×107 EPCs were respectively administered to rabbits in EPCs low-dose,mid-dose,and high-dose groups; on the contrary,blank PBS was injected to rabbits in ALI and control groups.Lung weight to dry ratio (W/D) and pulmonary permeability index (PPI) were detected before and after operation; protein expressions of TNF-α and IL-1 βby western blot,and mRNA expression of NF-κB by RT-PCR.Results PPI and W/D value lowered in EPCs low-dose group (15.0 ± 1.1,5.04 ± 0.11),mid-dose group (13.8 ± 0.7,4.80 ± 0.13),and high-dose group (13.7 ± 0.7,4.87 ± 0.08) when compared to 17.1 ± 1.5 and 5.21 ±0.05 in ALI group (P ＜0.05).EPCs low-dose,mid-dose,and high-dose groups showed decreased levels in NF-κB (0.75 ± 0.04,0.41 ± 0.05,0.42 ± 0.03),TNF-α (0.364 ± 0.020,0.312 ±0.015,0.310 ±0.013),and IL-1β (0.230 ±0.017,0.206 ±0.010,0.210 ±0.018) compared to ALI group (0.87 ±0.11,0.387 ±0.018,0.262 ±0.019,P ＜0.05).Moreover,all indicators were lowered significantly in EPCs mid-dose and high-dose groups when compared to EPCs low-dose (P ＜0.05),but the two groups themselves revealed no statistical difference.Conclusion EPCs protect ALI via improving pulmonary edema,pulmonary permeability,and inflammatory response in a dose-dependent correlation with EPCs,but ceiling effect is observed as well.
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Objective To compare the clinical efficacy of two different injection ways in treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol. Methods During the period from Dec. 2010 to Dec. 2012 a total of 80 patients with clinically-proved lower extremity varicosis were admitted to authors’ hospital. The patients were randomly and equally divided into two groups:anterograde group (n=40) and retrograde group (n=40). For patients of anterograde group, under fluoroscopy guidance the needle was directly punctured into the distal end of the varicose vein with subsequent injection of 1%lauromacrogol foam sclerosing agent, while for patients of retrograde group the opposite femoral vein was punctured by using Seldinger technique, then a catheter was inserted into the proximal part of the great saphenous vein of the diseased side, and 1%lauromacrogol foam sclerosing agent was injected into the varicose vein. The operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment were recorded, and the results were statistically analyzed. All the patients were followed up for 3 - 6 months. Results No significant difference in the overall effective rate existed between the two groups at 3-6 months after the treatment (P>0.05). The preoperative and postoperative CEAP scores of the anterograde group were 3.70 ± 0.63 and 0.88 ± 1.18 respectively, while the preoperative and postoperative CEAP scores of the retrograde group were 3.73 ± 0.59 and 0.88 ± 1.27 respectively. The difference in CEAP score between preoperative values and postoperative ones was statistically significant in both anterograde group and retrograde group (P < 0.05). Besides, the differences in the operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment between the two groups were also statistically significant. Conclusion In treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol, the overall effectiveness of anterograde injection and retrograde injection is quite the same. As each injection way has its own advantages and disadvantages, the therapeutic scheme should be individualized for each patient.
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Objective To detect the epidemiologic features of pediatric patients with fall from height injury in an effort to provide a reference for prevention and scientific treatment.Methods Data of pediatric patients with fall from height injury treated from January 2011 to December 2012 were collected in the form of questionnaires.Epidemiologic features and relationship of associated factors were measured.Results Pediatric fall injury occurred very often in warmer season,namely on April and May,and in a day,it was more likely to happen when parents slacked at noon and night.Stairs and balconies were the most common sites of falls and head was most vulnerable to the injury.Falling height was the primary factor to the severity of injury.Conclusion To strengthen the protection reform in key areas,the supervision in peak time for falls and the care to children of the migrant workers can reduce fall injury in a certain extent.
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Objective To investigate the effect of hypothyroxinemia on emotion and hippocampus neurons in developing rats.Methods Sixty-nine healthy postnatal day (PD) 1 rats were randomly divided into control group (n =36) and experimental group (n =33).On PD1,experimental group was bilaterally thyroidectomized to establish hypothyroxinemia model,the control group was only given thyroid exposure operation without thyroid resection.On PD10,21,40,serum triiodothyronine (T3),thyroxine (T4),thyrotropicstimulating hormone (TSH) were detected by radioimmunoassay.Tail suspension test,forced swimming test,the elevated-plus maze and open field were respectively employed to detect the anxiety/depression like behavior on PD30,31,32,33.Nisslg staining was used to determine the survival of neurons at PD10,21,40 in hippocampus CA1,CA3,DG regions.Results Serum T4 levels on PD10,21,40 in experimental group decreased significantly as compared with control group (P ＜0.01),while there was no significant difference in serum T3 or TSH level (P ＞ 0.05).In the tail suspension test,immobility time of experimental group [(197.00 ± 19.50) s] was longer than control group [(158.33 ± 32.90) s,P ＜0.05].In the forced swimming test,immobility time of experimental group[(92.11 ± 35.24) s] was longer than control group [(62.00 ± 23.73) s,P ＜ 0.05].In the elevated plus-maze test,total number of arm entries and closed arm entries in experimental group were increased as compared with control group(P ＜ 0.05),percentage of closed arm/total time of experimental group was decreased as compared with control group(P ＜ 0.05).In the open field,there was no obvious difference between the two groups(P ＞ 0.05).On PD10,21,40,the amount of neurons in DG region of experimental group were less than control group(P ＜0.05),while there was no significant difference in CA1 or CA3 on PD10,21,40(P ＞0.05).Contusions Hypothyroxinemia can cause depression,hyperactivity and hippocampus neuron damage of developing rats.
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Objective To investigate the protective effects of sulforaphen (SFN) on focal cerebral ischemia/reperfusion injuy (IRI) in rats in order to explore the mechanisms.Methods Twenty-four male SD rats were randomly (random number) divided into Sham-operated group (A group,n =8),IRI group (B group,n =12),sulforaphen group (C group,n =8).SD rats were made to be transient focal cerebral IRI models.SFN 5 mg/kg was injected intraperitoneally to rats 15 minutes after IRI in C group,and rats of group A and group B received equal volume PBS instead.Infarct volume was measured by TTC staining and morphologic changes were observed with HE staining.Neuronal cell apoptosis index was detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) assay.Rats were sacrificed at 24 h after IRI.The protein levels of NF-κB p65 and iNOS were detected by using western bloting and the mRNA expressions of NF-κB p65 and iNOS were detected by using RT-PCR.Results Compared with the group B,infarct volume was significantly smaller in group C,the number of neuronal cell apoptosis in brain tissue were decreased significantly in group C [(96.34 ±3.72) vs.(124.65 ±3.85),P ＜ 0.01],the levels of NF-κB and iNOS in brain tissue of rats were decreased in the SFN group (P ＜ 0.01).SFN reduced neuronal cell apoptosis,injury,and infarct volume [(0.26 ± 0.018) vs.(0.43 ±0.031),P ＜0.01].The mRNA expression and protein level of NF-κBp65 were decreased in the group C.And the mRNA expression and protein level of induced nitric oxide synthase (iNOS) in IRI affected brain tissue were decreased in the group C [(0.67 ± 0.042) vs.(0.56 ± 0.032),P ＜ 0.01].Conclusions SFN might decrease the neuronal cell apoptosis caused by ischemia/repeffusion injury,and this protective effect is mediated by decreasing the level of NF-κB and iNOS.
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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 analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience.Methods A total of 177 cases who were injured or died in the 7.23 Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause.ConclusionsThe causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.
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Objective To determine the effect of fast passage for patients' access to the emergency department of hospital on rescuing and triaging the traumatic casualties referred from the site of accident by collision between two bullet trains occurred at Wenzhou station on 23 July 2011 in order to accumulate experience of treating large number of traumatized casualties happened in a major accident or disaster.Methods A retrospective study was carried out to collect the data including the different courses of treatment for various types of injury in casualties and the length of stay of traumatized patients with different degrees of severity in the emergency department after casualties entered into the emergency department of hospital via fast passage.Results There were 136 traumatic casualties referred to hospital within 72 hours after the bullet train accident occurred at Wenzhou station.The average length of stay of patients with uncomplicated single injury in the hospital was 27min,and the average length of stay of 108 patients with multiple injuries in the emergency department was 62 min.In last year,the annually average length of stay of casualties in emergency department was 50 min longer when there was no fast passage available for patient to enter into.Conclusions The fast passage for casualties entering into emergency department not only guarantees the traumatized patients rescued in no time after bullet train accident but also shortens the length of stay in the Emergency Department.
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Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 ( July 23 train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89％ and 44.11％ respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41％.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be traumatized.Saving life,triaging and transferring the wounded as soon as possible were the major algorithm during the initial stage of medical rescue after the accident occurred.