Worsening head bleeds in elderly blunt head trauma patients taking antithrombotics: Delayed CT head fails to change management

Background

Most elderly trauma patients suffer blunt head injury and many utilize antithrombotic (AT) medications. The utility of delayed CT-head (D-CTH) in neurologically intact elderly patients using AT who have an intracranial hemorrhage (ICH) on presentation is unknown. We hypothesized that D-CTH would not alter clinical management and aimed to evaluate the role of D-CTH in this population.

《少林寺伤科秘方》及其方药特点分析

《少林寺伤科秘方》之"少林寺经验损伤方"中载有方剂共41首,其中9首为专治相应部位之跌打损伤,5首为外用方剂。其所载方药基本符合跌打损伤"气血不流行"的病机特点。"祛瘀不伤正"是贯穿于伤科整个治疗过程,对于体弱之人时刻要顾护正气。纵观书中方剂,所有药物的用量均不大,应该考虑到了祛邪不伤正的原则。所以此书中的方药剂型虽多,但不循常规。《少林寺伤科秘方》用药以活血行气化瘀为主,兼以补养正气。通过对药物使用频率的分析,当归、桃仁、红花、乳香、没药、炙甲片、香附、枳壳、苏木使用的频率相对较高,尤其是当归,当之无愧的成为治疗伤科疾病的要药。     

创伤骨科急救药品存放管理的改进措施分析

对于创伤骨科患者来说,急救药品与物品事在急救过程中必不可少的物品。急救药品的管理和存放,也是直接影响急救效果的重要因素。因此现代医疗机构为了进一步提高医疗的安全度,必须要加强对急救药品和急救物品的规范管理,但是在这个过程当中仍然出现了许多问题,整体效果提升度不高。     

医护晨间查房模式在创伤外科优质护理服务中的应用效果

目的：探讨医护晨间查房模式在创伤外科优质护理服务中的应用效果。方法将本科2012年1～12月的住院患者设为对照组,实行医护分别晨间查房模式。将2013年1～12月的住院患者设为观察组,实行医护晨间共同查房模式,即责任护士与经管医生一起晨间查房,共同讨论,交流患者病情,探讨下一步的治疗护理计划。患者出院前1天,发放健康教育效果和患者满意度调查表,比较两组的调查结果。结果观察组的健康宣教知识知晓率、护理满意度均明显高于对照组（P＜0.05）。结论医护晨间查房模式比传统模式更深化了优质护理服务的内涵,提高了护理质量,提高了健康宣教效果和患者的满意度。     

Epidemiological analysis of deaths caused by burns in Osaka, Japan

By referring to all of the death cards recorded for the year of 1978 in the whole area of Osaka Prefecture, we examined deaths due to burn injuries, electric injury and heatstroke, and obtained the following results.

1. 1. Of the total 41 737 deaths, externally induced death took place in 3207 cases (8 per cent), and death due to burn injuries including electric shock and heatstroke took place in 215 cases (2–60 cases against 100 000 population), accounting for 6.7 per cent of all externally induced deaths. In those aged under 40 years, externally induced death ranked highest as the cause of death, and burn injury was one of the chief causes.

2. 2. The sex ratio of burn-induced death was 3: I for males and females, respectively. However, if burn injuries resulting from social factors and suicide were excluded, the sex ratio was not significantly different at 1-3:1. The causes of injury were work accidents, suicide and other accidents at a rate of I: 2: 3.

3. 3. The monthly incidence of injuries was larger in winter when there were many cases of on-the-spot death due to fire, but there was no significant difference in the monthly incidence of post-treatment death.

4. 4. Of the 215 cases, 158 (73–5 per cent) died on the spot, while only 57 cases died after treatment. There were apparent regional differences in the total casualties. Post-treatment death probably occurred in 30 per cent of the total deaths induced by burn injuries.

5. 5. Medical institutions receiving burn victims could be divided into private and public ones at a nearly equal ratio. Public institutions took a significantly larger proportion of this type of casualty than following road accidents.

6. 6. Supplementary investigations revealed that two to three times as many people died at the scene of the accident than died after treatment from severe burns, this amounted to 140 cases a year in the whole area of Osaka Prefecture.

     

Dynamic properties of the parasagittal bridging beins

Summary A method for investigating stretching of small blood vessels is presented. Stress and strain properties of the isolated parasagittal bridging veins were studied. These veins were stressed along their long axis and torn apart at various constant strainrates. The bridging vein's strain capacity was found to be dependent on strain rate, maximal strain was markedly reduced as the rate was increased. The maximal tension in the veins increases as the time to tearing decreases. The tearing tension was shown to be lower for bridging veins as compared to larger veins (femoral, popliteal, inferior vena cava).This work was supported by the Transport Research Delegation, Sweden.     

如何进行创伤外科见习教学实习

对创伤外科的见习教学经验进行总结：加强医德医风教育与心理学知识学习;认识创伤专科的特殊性与复杂性;遵循循证医学规律,建立临床思维;加强＂三基＂训练,为见习医生过渡到临床实习打下坚实基础。     

血小板源性生长因子及其受体在胎儿皮肤中的表达

目的：观察血小板源性生长因子（PDGF）两亚基（A，B）及其两种受体（PDGFR-α和PDGFR-β）在胎儿和成人皮肤组织中的表达持下征以及可能的生物学意义。方法 16例被测标本中包括不同胎龄的胎儿皮肤组织8例和成人皮肤组织8例。用免疫组化方法和病理技术研究这四种蛋白在胎儿和成人皮肤组织中的定位和表达量的变化规律。结果：在胎儿皮肤组织中，PDGF-A、PDGF-B、PDGFR-α和PDGFR-β的阳性细胞率较低，其中PDGF-A、B主要分布于表皮角质层细胞和血管内皮细胞内，PDGFR-α定位于表皮细胞和内皮细胞的细胞膜上，PDGFR-β则在内皮细胞的细胞膜上上有少量分布。在成人皮肤组织中，PDGF两种亚基和两种受体的阳性细胞率进一步增大，PDGF-A、B的阳性细胞主要为表皮基底层细胞和内皮细胞，PDGFR-α主要分布于表皮细胞、内皮细胞和部分成纤维细胞的细胞膜上，β-型受体在表皮基底层细胞和内皮细胞的质膜上有阳性表达。结论：PDGF及其受体可能对皮肤的发生、结构功能的维持以及伤后修复十分重要。在发育早期的胎儿皮肤组织中，四路蛋白低表达可能与胎儿无瘢痕愈合密切相关。