小儿颅脑外伤合并胸腹部复合伤16例

目的通过对16例颅脑外伤合并严重复合伤病例的回顾性分析,探讨提高小儿颅脑外伤合并胸腹部复合伤救治成功率的方法。方法回顾性分析本院收治的16例小儿颅脑外伤合并胸腹部复合伤患儿临床资料。判别严重休克的病因,准确发现胸腹部合并伤等重要损伤,快速纠正休克和分别处置。结果16例颅脑外伤合并胸腹部损伤的严重复合伤患者,经上述处理,均抢救成功,治愈13例,平均格拉斯哥（GCS）评分13．7分;致残3例,平均GCS评分6．67分。无一例死亡。结论准确判断病情,在颅脑外伤影响患儿意识时及时准确地判断可能合并的胸腹部外伤,迅速纠正失血性休克,处置合并的胸腹部外伤,可挽救大部分危重病例,提高救治效果。     

Neuroprotective effect of epidural hypothermia after spinal cord lesion in rats

OBJECTIVES

: To evaluate the neuroprotective effect of epidural hypothermia in rats subjected to experimental spinal cord lesion.

METHODS:

Wistar rats (n = 30) weighing 320-360 g were randomized to two groups (hypothermia and control) of 15 rats per group. A spinal cord lesion was induced by the standardized drop of a 10-g weight from a height of 2.5 cm, using the New York University Impactor, after laminectomy at the T9-10 level. Rats in the hypothermia group underwent epidural hypothermia for 20 minutes immediately after spinal cord injury. Motor function was assessed for six weeks using the Basso, Beattie and Bresnahan motor scores and the inclined plane test. At the end of the final week, the rats'' neurological status was monitored by the motor evoked potential test and the results for the two groups were compared.

RESULTS:

Analysis of the Basso, Beattie and Bresnahan scores obtained during the six-week period indicated that there were no significant differences between the two groups. There was no significant difference between the groups in the inclined plane test scores during the six-week period. Furthermore, at the end of the study, the latency and amplitude values of the motor evoked potential test were not significantly different between the two groups.

CONCLUSION:

Hypothermia did not produce a neuroprotective effect when applied at the injury level and in the epidural space immediately after induction of a spinal cord contusion in Wistar rats.     

单侧唇裂继发鼻下端畸形张力平衡的重建

目的：探讨单侧唇裂继发鼻下端畸形两侧张力平衡重建的手术方法及临床意义。方法：通过健侧降鼻中隔肌的处理及＂C＂形鼻中隔的纠正,重建鼻小柱两侧的肌张力及软骨弹性张力平衡;将鼻翼软骨外侧脚充分游离,解除鼻翼软骨周边组织的病理影响;用三点缝合二点高位悬吊法重塑外鼻下端软骨支架结构;最后施鼻翼外侧脚软组织的移位。结果：32例患者鼻下端形态恢复满意、持久。结论：用重建鼻下端两侧组织张力平衡的手术方法整复单侧唇裂继发鼻下端畸形,可获得可靠的治疗效果。     

Gefahren in den neuen Schneesportarten

Due to their attractiveness and excitement the new snow sport disciplines are a great addition to the program of winter sport events. They are characterized by high dynamics and pose a huge challenge to body and mind of the athlete. As statistics show the risk of injury compared to traditional snow sports is quite high even involving very severe traumas. Because of this apart from the necessity of a differentiated record and analysis of the injuries of these new disciplines a perfect organization in terms of building competition sites and providing medical care by the race organizer is essential. Furthermore the athlete himself, supported by his team, is maximally challenged to deal with the high demands.     

Hybrid Procedure for a Traumatic Aortic Rupture Consisting of Endovascular Repair and Minimally Invasive Arch Vessel Transposition without Sternotomy

Emergency surgical repair for acute traumatic aortic ruptures has been associated with a high peri-procedural mortality rate. Endovascular stent-grafting, as a less invasive procedure, has shown encouraging results. This report describes a patient with a short landing zone, who was treated by transposing the supra-aortic branch without sternotomy, followed by covered stent-grafting with an extended proximal bare portion to enhance fixation.     

无张力疝修补术治疗腹股沟嵌顿疝85例分析

目的探讨无张力疝修补术治疗腹股沟嵌顿疝的临床效果。方法对83例腹股沟嵌顿疝患者选择性施行无张力疝修补术，分析其术后效果。结果83例患者中围手术期死亡2例，伤口感染1例，其余恢复良好．平均住院时间5．1d。结论应用无张力疝修补术治疗腹股沟嵌顿疝安全可靠，效果较为满意。     

Treatment of infrapatellar fat pad strain with mountain-burning fire method

Strain of infrapatellar fat pad extensively occurs in people aged over 30 years, who often walk up hills or squat while working. The clinical manifestations are aching and weakness in the knee joints, aggravated when the knee joints are totally extended. Discomfort occurs in mild cases only when walking for long or going up and down the stairs. There is aching feeling in moderate cases when the patients are quiet. The pain is aggravated during exercises when the knee joints are half flexed and the patient can not stand up when squatting for prolonged periods of time. There are aching and weak feelings in the severe cases.     

葡萄籽原花青素对糖基化终产物损伤内皮细胞的保护作用

目的：研究不同浓度葡萄籽原花青素(GSPC)对糖基化终产物(AGE)作用下人脐静脉内皮细胞的保护作用及其机制。　方法：体外培养人脐静脉内皮细胞(HUVEC),糖孵育法制备糖基化终产物修饰牛血清白蛋白(AGE-BSA)。实验分为6组,即空白对照组、实验对照组(BSA组)、损伤组(AGE组)、损伤加入GSPC低、中、高浓度组。将200mg/L AGE作用于不同浓度GSPC培养4h的内皮细胞,继续培养24?h,以细胞生存活力、血管性假血友病因子（vWF）、一氧化氮(NO)为检测指标。结果：200mg/L　AGE抑制HUVEC生存活力，细胞增殖活力下降为正常组的90.53％，GSPC预孵育组细胞生存活力逐渐增加，分别为正常组的0.95、1.12、1.23倍；AGE组vWF生成量较正常对照组明显增加(P<0.01)，NO含量较正常对照组明显降低(P<0.01)。GSPC预孵育组可显著降低增高的vWF水平，NO生成量显著高于AGE组(P<0.01), 100mg/L GSPC预处理组NO水平恢复至正常水平。结论：AGE会损伤内皮细胞，抑制内皮细胞的生存活力，减少NO的生成。GSPC可抑制AGE对内皮细胞的损伤作用，且可抑制AGE减少NO生成的作用，并呈浓度依赖性，提示GSPC保护内皮细胞免受AGE损伤的机制可能与增加内皮细胞NO生成量有关。     

台风所致严重伤害的流行病学研究

目的 了解台风所致严重伤害的流行病学特征和主要危险因素.方法 采用流行病学现况研究的方法调查台风所致严重伤害发生情况、治疗情况、后果及台风登陆前后风速、雨量等;同时采用病例对照研究对伤害发生的危险因素进行研究.结果 台风“云娜”在温岭共造成严重伤害422例,其中死亡50人,伤害发生率39/10万,男性明显高于女性,伤害发生时间分布与风速变化高度相关.79.69%病例在县级以上医疗机构接受救治,平均治疗费用7729.1元,其中67.9%接受急诊手术.主要伤害类型为骨折、割刺伤及裂伤和压砸伤.主要受伤原因为房屋例塌.仅有68%的受伤者曾得到过台风预警.“台风来临前未得到预警或虽得到预警但不重视”（OR=6.7,95?：1.9～7.7）和“台风来临时未呆在家中”（OR=3.8,95%C：3.1～14.5）的人发生严重伤害的危险性相对更大.结论 加强预警,提高台风预报的准确性和及时性,及时撤离危险场所,加强基层医疗急救能力,可以最大限度减少严重伤害的发生.