简介：Interhemisphericsubduralhaematoma(ISH)probablyrepresentsoneoftherarestformsofposttraumaticintracranialhaemorrhagesbecauseofthepeculiaranatomicallocation.ItwasfirstdescribedatautopaybyAirrngandEransin1940andfewcases(110)havebeenreportedsinceJobobefirstdescribedclinicalcasesin1955.1-7SincethereisnoinitialpathognomoniccharacteristicpresentingmodeofISH,ISHwouldresultinaserioussituationifnottreatedproperlyandpromptly.Recently,wetreatedtwopatientssufferingISHinourneurosurgeryunit.

简介：AbstractIn this paper, we review the results of previous studies and summarize the effects of various factors on the regulation of bone metabolism in traumatic bone infections. Infection-related bone destruction incorporates pathogens and iatrogenic factors in the process of bone resorption dominated by the skeletal and immune systems. The development of bone immunology has established a bridge of communication between the skeletal system and the immune system. Exploring the effects of pathogens, skeletal systems, immune systems, and antibacterials on bone repair in infectious conditions can help improve the treatment of these diseases.

简介：AbstractPurpose:To discuss and share the experience of treatment of traumatic innominate arterial injury.Methods:A retrospective analysis was performed on patients with innominate arterial injuries admitted from January 2016 to July 2018 at the department of vascular surgery, Beijing Jishuitan Hospital, China. All the arterial injuries were confirmed by arteriography. Clinical data including mechanism of injury, type of injury, demographics, concomitant injuries, time interval from trauma to blood flow reconstruction, and operation methods were collected. Follow-up program included outpatient visit and duplex-ultrasonography. SPSS version 23.0 was adopted for data analysis. Categorical variables are presented as number and/or frequency and continuous variables as mean ± standard deviation.Result:Altogether 7 patients were included and 6 (85.7%) were male. The mean age of patients was (29.43 ± 7.98) years, range 19-43 years. Six patients had isolated innominate arterial injuries and the rest 1 combined innominate arterial and vein injuries. The injury causes were road accidents in 3 patients, stab wound in 2, gunshot wound in 1, and crush injury in 1. All the 7 patients presented hemorrhagic shock at admission, which was timely and effectively corrected. No perioperative death or technical complications occurred. Intimal injury (n = 2) and partial transaction (n = 2) of the innominate artery were treated with covered stents. Two patients with complete transection of artery received vascular reconstruction by artificial grafts. One patient with partial transaction received balloon dilation and open surgical repair (hybrid operation). The mean time interval from trauma to blood flow reconstruction was (4.27 ± 0.18) h, range 4.0-4.5 h; while the operation time was (48.57 ± 19.94) min, range 25-75 min. Cerebral infarction occurred in one patient with brain injury due to anticoagulation contraindication. The average follow-up was (13.29 ± 5.65) months, range 6-24 months. No severe stenosis, occlusion, and thrombosis of covered stents or artificial vessels were found by color Doppler ultrasound.Conclusion:Urgent control of hemorrhage and restoration of blood supply are critical for the treatment of traumatic innominate arterial injury. Endovascular therapy is a feasible and effective method with short operation time and less trauma.

简介：Objective:Todiscussthediagnosisandmanagementoftraumaticcarotidcavernousfistula(TCCF).Methods:Inall15patientswithTCCFconfirmedbyangiography,8patientsgotearlydiagnosisandcure.WithSeldingertechniqueadpotedinthepunctureoffemoralartery,Magic3F-1.8FBDcatheterscombiningwithballoonwereusedtoembolizethefistulaortheinternalcarotidartery.Results:Earlydiagnosisandcurewereachievedin8patientswithinoneweekandnosequelaeoccurred.Sevenpatientswithdelayeddiagnosiswhowerecuredbeyondoneweekhadsomesequelaesuchashypopsiain5cases,incompleteoculomotorparalysesin3andincompleteabducentparalysesin2.Amongallthe15cases,theinternalcarotidarterywaspreservedin12casesacountingfor80%.Occludingthefistulawithsacrificeoftheinternalcarotidarterywasperformedin3casesandnorepatencyofthefistulaoccurredbyfollowingupbeyondthreemonths.Conclusions:ThepreferredtherapyforTCCFistooccludethefistulausingdetachableballoon.ThediagnosisandtreatmentforTCCFcansignificantlyreduceoccurrencerateofthecomplicationsandsequelae.

简介：Traumatichematomaofposteriorfossa(THPF)isaspecialkindofcraniocerebralinjurywithitsowncharacteristicsinclinicalmanifestations,diagnosisandtreatment.Ingeneral,theprognosisofTHPFispoor.Withoutearlydiagnosisandprompttreatment,theoutcomewouldbeverypoor,withhighoccurrenceofmorbidityandmortality.Sincetheavailabilityofcomputedtomography(CT)in1983,wehavereceivedandsuccessfullytreated44patientswithTHPFuntilNovember2000.

简介：Traumatictricuspidvalveinsufficiency(TTVI)isarelativelyuncommondisease.

简介：AbstractPurpose:Traumatic brain injury (TBI) is one of the major public health concerns worldwide. Developing a TBI registry could facilitate characterizing TBI, monitoring the quality of care, and quantifying the burden of TBI by collecting comparable and standardized epidemiological and clinical data. However, a national standard tool for data collection of the TBI registry has not been developed in Iran yet. This study aimed to develop a national minimum data set (MDS) for a hospital-based registry of patients suffering from TBI in Iran.Methods:The MDS was designed in 2 phases, including a literature review and a Delphi study with content validation by an expert panel. After the literature review, a comprehensive list of administrative and clinical items was obtained. Through a two-round e-Delphi approach conducted by invited experts with clinical and research experience in the field of TBI, the final data elements were selected.Results:A MDS of TBI was assigned to 2 parts: administrative part with 5 categories including 52 data elements, and clinical part with 9 categories including 130 data elements.Conclusion:For the first time in Iran, we developed a MDS specified for TBI consisting of 182 data elements. The MDS would facilitate implementing a TBI's national level registry and providing essential, comparable and standardized information.

简介：AbstractSubcutaneous emphysema is commonly associated with infection caused by gas-producing organisms. In this case report, we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand. Our objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues, thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway.A 16-year-old, otherwise healthy white female, presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right hand. She appeared nontoxic and had a clinically benign presentation. A comprehensive work-up was performed. She was splinted by the orthopedic surgery resident on call, and was admitted to the Pediatric Intensive Care Unit for overnight monitoring. She received tetanus vaccination and broad-spectrum antibiotics. The patient was discharged 2 days after admittance, with a splint applied to her right hand and forearm. She undertook home-based physical and occupational therapy. She had a pain-free range-of-motion in the right wrist, elbow and shoulder. The swelling in the right hand subsided completely.Although initially alarming, traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds (as featured in this case) does not necessarily mean one ought to proceed down an aggressive treatment algorithm. Careful evaluation of the patient's history, clinical examination findings, and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.

简介：AbstractBackground:Traumatic brain injury, one of the leading causes of death in adults under 40 years of age in the world, is frequently caused by mechanical shock, resulting in diffuse neuronal damage and long-term cognitive dysfunction. Many existing TBI animal models revival with expensive equipment or special room are needed or the processes of operations are complex and not easy to be widely used. Therefore, a simpler TBI model needs to be designed.Methods:Our TBI model is an innovation of the modeling method through air guns shutting rubber bullets. A core facet is the application of our designed rubber bullet impact device. It could focus the hitting power to the fixed site of the brain, thus triggering a mild closed head injury. Moreover, the degree of damage can be adjusted by the times of shots.Results:Our model induced blood-brain barrier leakage and diffused neuronal damage. Besides, it led to an increased level of Tau phosphorylation and resulted in cognitive dysfunction within several weeks post-injury.Conclusion:Our TBI model is not only simple and time-saving but also can simulate mild brain injuries in clinical. It is suitable for exploring pathobiological mechanisms as well as a screening of potential therapies for TBI.

简介：Objective:Toprobetheincidence,pathogenesisandclinicalcharacteristicsoftraumaticsubduralhydroma(TSH)developingintochronicsubduralhematoma(CSDH).Methods:Weretrospectivelyanalyzedtheclinicaldataof32patientswithTSHdevelopingintoCSDHandreviewedrelatedliterature.Results:16.7%ofTSHdevelopedintoCSDHinthisstudy.Thetimeofevolutionwasfrom22to100daysafterheadinjury.Allthepatientswerecuredwithhematomadrainage.Conclusions:TSHisoneoftheoriginsofCSDH.TheclinicalcharacteristicsofTSHdevelopingintoCSDHfollowthattheagesofthepatientsarepolarized,thattheevolutionoftenhappensinthepatientswithsmallchronichydromasandbeingtreatedconservatively,thatthepatientsareusuallyinjureddeceleratedlyandthattheaccompanyingcerebraldamageisoftenverymild.

简介：Objective:Toreporttheexperienceinthediagnosisandtreatmentofpost-traumaticpseudoaneurysmsandarteriovenousfistulas.Methods:Aseriesof30patients(11womenand19men)withposttraumaticpseudoaneurysmswerereviewedretrospectively.Amongthem7patients(5womenand2men)wereassociatedwitharteriovenousfistula.Results:Thecausesincludedsharppenetrationtrauma(18cases),blunttrauma(6cases)andiatrogenicarterialinjury(6cases).Themainclinicalmanifestationsconsistedoflocalpulsatilemass(26cases),vascularbruits(19cases),thrill(13cases),ischemiaofdistallimb(9cases),neuropathy(5cases)andpseudoaneurysmrupture(2cases).Allpatientsunderwentsurgery.Theoperationsincluded:ligationofthevessels(12cases),surgicalresectionandprimarysuturerepainofthevasculardefectoranastomosis(11cases),vascularreconstructionwithautogenoussaphenousvein(3cases)andsyntheticvasculargraft(4cases).Conclusions:Becauseoftheimminentclinicalcourse,earlyoperationisusuallyindicated.Theoperativetreatmentiseffectiveandsafeformostofthepatientswithpost-traumaticpseudoaneurysmsandarteriovenousfistulas.

简介：客观：在在人的创伤的奔流和正常透镜的上皮的房间之间的原子factor-KB(NF-κB)的表示学习差别。方法：全部的RNAof前面的囊标本从受不了创伤的奔流做半量的RT-PCR并且在在他们之间的NF-κB的表示进行差别的分析的正常cadaveric眼睛施主和那些在显微镜下面被拿。结果：作为与在正常控制组的0.8337的平均数相比，NF-κB的表示等价物为在创伤的奔流患者的透镜的上皮的房间是0.9074，并且差别具有显著意义(t=2.447，P<0.05)因此。结论：NF-κB是可能的对必要的一种抄写因素维持正常透镜的上皮的房间的新陈代谢。在创伤的奔流患者可得到的更高的NF-κB“透镜的上皮的房间工具NF-κB具有到创伤的奔流的出现和开发的可能的关联的s。

简介：Objective:Tostudytheemergencymanagementprinciplesofseveretraumainhospital(injuryseverityscore≥16).Methods:Weused'ATPprinciple'tomanageseveretraumaticpatients.TheATPprincipleiscomposedof:1)attendingsurgeonsofferinginitialmanagement(A);2)teamworkcommencementimmediatelyafterpatientsadmittedtohospital(T);3)parallelprinciple,ie,emergencyresuscitation,evaluationandlaboratorytestperformedsimultaneously(P).ClinicaleffectsbeforeandafterapplyingATPprinciplewereretrospectivelyanalyzedandcompared.Results:DuringJanuary1,2002toDecember31,2003,338patientsweretreatedwithoutapplyingATPprinciple,inwhichISSwas25.9±6.4,152casesdiedwiththemortalitybeing39.2%,andthetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionwere(102.8±16.7)min,(140.3±20.6)min,respectively.DuringJanuary1,2004toDecember31,2005,438patientsweretreatedbasedonATPprinciple,inwhichISSwas28.6±7.8,87casesdiedwiththemortalitybeing19.9%,andthetimeinemergencydepartmentandthetimetooperationroomafteradmissionwere(69.5±11.5)min,(89.6±9.3)min,respectively.ISSshowednosignificantdifferencebetweenthetwogroups(P>0.05),butthemortality,thetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionweregreatlyreducedandshowedsignificantdifferencebetweenthetwogroups(P<0.05).Conclusions:ApplyingATPprincipletotreatseveretraumaticpatientscanshortenemergencytreatmenttimeinhospitalanddecreasemortality.

简介：Traumaticmultipleintracranialhematomas(TMICHs)areintracranialhematomas(ICHs)formedinmorethantwopositionsorwithmorethantwotypesafterheadinjury.1Thisarticlereports147casesofTMICHstreatedinourhospitalbetweenJuly1993andDecember1999.

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简介：62patientswithtraumaticparaplegiaweretreatedwithacupuncture(GovernorVesselelectro-stimulation),accordingtothetheoriesofTCMsuchasdredgingthemeridians,regu-latingvitalenergyandblood,improvingbloodcirculation,reinforcingmarrowandreplenishingbrain.Theeffectofacupunctureonurinarybladderdisturbancewasstudied.Theresultsindicatedthattotaleffectratewas96.8%(Ⅰ—Ⅲ),markedeffectratewas66.1%(Ⅰ—Ⅱ).Themarkedeffectrateincompleteparaplegiawassignificantlydifferentfromthatinimcompleteparaplegia;itwas63.0%and87.5%respectively.Furthermore,theresultssuggestedthatthedegreeofspinalcordinjurywasveryimprotantfactorthataffectedtheeffectofacupuncturetherapy.

简介：Deareditor,Itiswithgreatinterestthatwereadthearticle“Relationshipofcalcitoningene-relatedpeptidewithdiseaseprogressionandprognosisofpatientswithseveretraumaticbraininjury”(Chenetal.,2018).Inthisstudy,theauthorsevaluated121patientswhoweredividedintomild/moderatetraumaticbraininjury(TBI)(n=61),severeTBI(n=35)andcontrol(n=25)groups,andmeasuredserumlevelsofcalcitoningene-relatedpeptide(CGRP)andserumendothelin-1(ET-1).TheyfoundthatlowlevelsofCGRPandhighlevelsofET-1wereassociatedwithhighmortalityat6months.IdentificationofmorphologicalabnormalitiesonCTscansisveryimportantforevaluatingpatientswithTBIbecausedifferentdiagnosesaremadebasedondifferentimagingfindings(Maasetal.,2005).

简介：作者报导了支撑了臀部的无法缩减的postero侧面的创伤的脱臼与的一个27岁的人的案例胶囊并且labral陷阱。起始的X光显示出仅仅小acetabular碎片。在在一般麻醉下面与肌肉麻痹减少臀部的二次尝试失败了以后，病人被立即的开的减小通过一条postero侧面的途径对待。臀部的外科的探索表明小osteochondral碎片属于上唇和囊的一大片，堵塞髋臼。大腿骨的头与扭扣孔效果在撕的囊上交叉。这些元素被减轻，骨头碎片与2公里螺丝钉被修理，囊被修理。在10年的后续，功能的结果与100个点的一个哈里斯分数和坏死或骨关节炎的没有迹象是优秀的。作者建议这不平常的损害的文学评论。

简介：ObjectiveTrauma在在沙特阿拉伯的年轻年龄组之中是死亡和病态的领先的原因并且开发国家。这研究试图为临床的严厉作为一个潜在的预言者与创伤的大脑损害(TBI)在孩子评估血小板计数的秋天，outcome.MethodsTotally，有TBI的74个病人从开始2008年1月到目的进入我们的医院的小儿科的特别护理单位(PICU)2010年3月(27个月)。基线注册标准是很长时间12年，在在损伤事件以后的4个小时以内的承认，和缩短的损害规模(AIS)(或)，3.1；相对风险(RR)，2.15。接收装置操作特征(巨鸟)曲线和Youden索引证明PFP的最佳截止点在51.5%.ConclusionPFP与TBI的严厉被增加，它能也为它的结果作为一个重要独立预言因素被拿。

简介：客观：调查创伤的有三个尖头的不足的外科的治疗的最佳的时间和过程。方法：从1984年5月到2004年9月，八个病人为创伤的有三个尖头的阀门不足经历了操作。所有病人，男性，从7～67年变老[中部：38年，意味着：（38。5±18。1)年]。在损伤和操作之间的间隔从1个月到20年[中部：19个月，意味着：(52.5±80.3)月)]。Inseven病人，有三个尖头的不足被归因在三个病人包括车辆事故弄钝胸损伤，另外的病人是一处stab创伤。诊断是证实的byechocardiography。在病人的外科手术前的心脏的功能作为纽约HeartAssociation(NYHA)班Ⅱ-Ⅳ被分类。在手术期间，有三个尖头的阀门的前面的传单完全或部分在所有病人由于索的破裂被乱摆。氏族的传单的索的破裂在一个病人被发现。前面的传单在二个病人被穿孔。Septalleaflet被缩回并且支持者到在二个病人的室的中隔。阀门修理为所有病人被打算。最后，阀门修理在3个病人成功地被执行，有三个尖头的代替在5个病人被执行。结果：没有早或迟了的死亡发生了。与follow-upthrough为7-129月的临床的表明和回响心动描记法[中部：39个月，平均数:(53.4±42.8)月]，所有病人作为NYHA班Ⅰ被分类，没有任何changes.Conclusions：创伤的有三个尖头的不足的令人满意的治疗能被外科的治疗获得。更早的外科可以增加有三个尖头的阀门修理的可行性并且阻止恰好室的功能的恶化。