Electric bicycle-related injuries presenting to a provincial hospital in China: A retrospective study.

The use of electric bicycles (EBs) in China is growing. In the present study, we aimed to characterize the pattern and outcomes of EB-related injuries presenting to a major general hospital in China.This was a retrospective review of EB-related injuries presenting to Zhejiang Provincial People's Hospital from 2008 to 2011. Cases were identified from medical records according to diagnosis codes. Data captured included demographics, injury characteristics, and outcomes.A total of 3156 cases were reviewed in the present study. There were 1460 cases of traffic accidents, of which 482 cases were EB-related (32.7%). In addition, most of EB-related cases (44.6%) belonged to the 41- to 60-year-old age group. Median injury severity score was 10. Moreover, 34.9% underwent surgery and 24.7% were admitted to intensive care unit. The median hospitalization cost was 14,269 USD. Fracture (56.5%) was the most frequently diagnosed injury type, and head was the most commonly injured body region (31.1%).EB-related injuries have become a major health concern, making up a sizeable proportion of injuries presenting to the emergency department. Therefore, it is necessary to establish injury prevention and strategies for EB road safety. Implementation of policy such as compulsory helmet use, as well as popularization of EB road safety education should be considered to improve the current situation of EB-related injuries in China.

Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients.

BACKGROUND: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies. OBJECTIVES: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population. METHODOLOGY: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge. RESULTS: We included a total of 40,159 OHCA cases, 40% of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment. CONCLUSION: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.

A Rare Case of Metachronous Bilateral Angiosarcoma of the Breast.

BACKGROUND: Primary angiosarcoma of the breast (PAB) is a rare occurrence of highly aggressive biological behavior. Bilateral PAB is even more infrequent. CASE REPORT: We present the case of a 39-year-old Chinese woman with metachronous bilateral PAB (2005 and 2008). The diagnosis of PAB was confirmed. The respective masses were removed via simple mastectomy. The extent of malignancy differed microscopically between the two tumors and indicated a different source. After two surgeries and a 3-year follow-up, the patient is alive and well. The current case illustrates an unusual presentation of this rare type of breast sarcoma, in that none of the clin-icopathological findings are thought to confer a good prognosis. We also review the literature and summarize relevant findings concerning definition, pathology, clinical features, treatment, and follow-up. CONCLUSIONS: We believe that the survival rate depends on tumor size and differentiation. Surgical resection followed by chemotherapy may prove to be effective and afford the best prognosis in the future.