Characteristics of injuries among infants who fall from bed

IntroductionAccidental falls are the most common causes of injury among infants. Due to their limited ability to move independently, falling from bed or other types of furniture (such as sofas or armchairs) is considered the most common reason for such injury. However, little is known about the frequency and types of injury associated with this type of fall among infants. This study aimed to determine the incidence and characteristics of injury among infants presented at emergency departments (ED) after falling from bed or similar furniture.MethodsThe retrospective analysis of infants under one year old presenting at ED after falling from bed (or similar furniture) was performed over a four-year period (2016–2019). Patient demographics, incidence and patterns of injury, outcomes, and ED resources use were evaluated as part of the study.ResultsIn total, 1,439 infants were included in the study, of whom 782 (54.3%) were male and 657 (45.7%) female. The median age of the patients was 7 months (interquartile range [IQR]: 6–9 months). More than half the infants (n = 812, 56.4%) had minor injuries, such as abrasions, bruising, contusions, and lacerations. There were significant injuries for 135 (9.4%) infants. The most common fracture was skull fracture (n = 59, 4.1%), followed by proximal fracture of the upper extremities (n = 26, 1.8%). Six (0.4%) patients had radial head subluxation. Traumatic brain injury featured for 30 (2.1%) infants (intracranial hemorrhage/cerebral contusion). While the majority of patients (n = 1352, 94%) were discharged from ED, 86 (6%) infants were hospitalized, all due to head injuries. A neurosurgical intervention was performed with three (0.2% of all patients) of the hospitalized patients.ConclusionFalling from bed causes skull fractures, traumatic brain injury, and long bone fractures among infants. Therefore, campaigns should be organized to raise awareness of these risks among parents and caregivers of infants. In addition, the use of safety equipment (such as bed rails) and creating a safe environment can help prevent significant injuries.     

CO2点阵激光联合伊可尔治疗难治性掌跖疣疗效观察

目的观察CO₂点阵激光联合伊可尔治疗难治性掌跖疣的临床疗效及安全性。方法:选取掌跖部多发,经其他疗法治疗后复发的难治性掌跖疣患者58例,患者平均分为两组,对照组29例先选择激光功率0.5-2W将皮损磨削薄直至焦痂或点状出血,之后采用CO₂点阵模式10-20mJ/cm2治疗,每周治疗一次,连续治疗4周。观察组29例观察组:CO₂点阵激光治疗仪器及治疗方法与对照组相同。激光治疗完毕,使用伊可尔药水棉片湿敷患处2小时,激光治疗后连续湿敷伊可尔棉片5天,停药2天至下一次激光治疗后继续湿敷,连续治疗4周。2组均随访观察6个月。结果:58例患者均完成治疗,治疗4周后,观察组总有效率93.10%,病损清除率为77.82%,均高于对照组的72.41%、60.81%,组间差异均有统计学意义(P<0.05)。6个月后,观察组复发率10.34%,对照组复发率37.93%,组间差异有统计学意义(P<0.05),两组不良反应差异无统计学差异。结论:CO₂点阵激光联合伊可尔治疗难治性掌跖疣疗效优于单用CO₂点阵激光。联用伊可尔降低了难治性掌跖疣的复发率,并且操作简便,安全性高。     

Skeletal class II malocclusion caused by mouth breathing in a pediatric patient undergoing treatment by interceptive guidance of occlusion

A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.     

Microglial activation induced by traumatic brain injury is suppressed by postinjury treatment with hyperbaric oxygen therapy

BackgroundThe mechanisms underlying the protective effects of hyperbaric oxygen (HBO) therapy on traumatic brain injury (TBI) are unclear. TBI initiates a neuroinflammatory cascade characterized by activation of microglia and increased production of proinflammatory cytokines. In this study, we attempted to ascertain whether the occurrence of neuroinflammation exhibited during TBI can be reduced by HBO.MethodsTBI was produced by the fluid percussion technique in rats. HBO (100% O₂ at 2.0 absolute atmospheres) was then used at 1 h (HBO I) or 8 h (HBO II) after TBI. Neurobehavior was evaluated by the inclined plane test on the 72 h after TBI and then the rats were killed. The infarction area was evaluated by Triphenyltetrazolium chloride. Immunofluorescence staining was used to evaluate neuronal apoptosis (TUNEL + NeuN), microglial cell aggregation count (OX42 + DAPI), and tumor necrosis factor-alpha (TNF-α) expression in microglia cell (OX42 + TNF-α).ResultsThe maximum grasp angle in the inclined plane test and cerebral infarction of the rats after TBI were significantly attenuated by HBO therapy regardless of whether the rats were treated with HBO 1 or 8 h after TBI compared with the controls. TBI-induced microglial activation, TNF-α expression, and neuronal apoptosis were also significantly reduced by HBO therapy.ConclusionsOur results demonstrate that treatment of TBI during the acute phase of injury can attenuate microgliosis and proinflammatory cytokine TNF-α expression resulting in a neuroprotective effect. Even treating TBI with HBO after 8 h had a therapeutic effect.     

血清同型半胱氨酸水平与急性脑梗死严重程度及中国缺血性卒中亚型分型的关系

目的探讨急性脑梗死患者血清同型半胱氨酸与急性脑梗死严重程度及中国缺血性卒中亚型分型之间的关系。方法应用酶联免疫吸附法检测423例急性脑梗死患者血清同型半胱氨酸水平,按中国缺血性卒中亚型分型、神经功能缺失程度(NIHSS评分)进行分组,将各亚组之间以及与179例健康对照者进行比较。结果急性脑梗死组血清同型半胱氨酸水平显著高于对照组(18.07±10.23μmol/L比7.40±3.48μmol/L,t=16.86,P<0.001);轻、中、重型患者同型半胱氨酸水平分别为16.76±6.37、20.41±6.01、24.48±6.29μmol/L,组间差异有统计学意义(P<0.05);不同病因和发病机制患者血清同型半胱氨酸水平差异无统计学意义(P>0.05)。结论血清同型半胱氨酸水平在脑梗死急性期升高,与脑梗死发生密切相关,可作为判断急性脑梗死病情严重程度的检测指标,但在不同病因和发病机制患者血清同型半胱氨酸水平无显著差异。     

GDM患者血清25-羟维生素D3变化及其与炎症因子、血脂指标的相关性研究

目的检测妊娠期糖尿病(GDM)患者血清25-羟维生素D3[25-(OH)2-VitD3]水平,评估其水平与机体炎症因子、血脂的相关关系。方法选取2018年2~9月在中国医科大学航空总医院产检并确诊为GDM的孕妇178例作为GDM组,同期在本院进行产检且糖耐量检查正常的孕妇100例作为正常对照组。对比两组孕妇血清中25-(OH)2-VitD3、炎症因子及血脂指标水平的差异,采用Pearson检验评估GDM患者血清25-(OH)2-VitD3水平与机体炎症因子、血脂指标的相关关系。结果GDM组血清中25-(OH)2-VitD3的含量显著低于正常对照组(P<0.05)。GDM组血清中炎症因子白介素-1β(IL-1β)、IL-6、IL-18和肿瘤坏死因子α(TNF-α)水平显著高于正常对照组(P均<0.05);血脂指标总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo-B)和载脂蛋白CⅢ(Apo-CⅢ)的水平显著高于正常对照组,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)的水平显著低于正常对照组(P均<0.05)。相关性分析发现,GDM孕妇血清中25-(OH)2-VitD3水平与炎症因子、血脂指标均相关(P均<0.05)。结论GDM患者血清25-(OH)2-VitD3水平明显降低,且其水平与机体炎症因子、血脂指标相关,这在GDM发生及病情评估中具有重要意义。