医院内意外烫伤的病因与预防

目的：回顾分析医院内意外烫伤的原因及治疗和预防措施。方法：1997年1月至2005年3月间共治疗院内烫伤33例，其中家属擅自给患者取暖烫伤18例（占54．5％），治疗过程中意外烫伤15例（占45．5％）。结果：19例应用MEBO（湿润烧伤膏）反复换药，创面完全愈合，无瘢痕及功能障碍；14例手术辅以MEBO治疗，均得到一期愈合，其中1例双足瘢痕挛缩畸形功能差，经二期手术修复后功能恢复，均未给病人造成不良影响。结论：对住院患者及其家属应常规进行烧伤知识的宣传与教育，医护人员严格执行各项技术操作常规，共同加强医患保护意识，是减少或杜绝医院内患者偶发烫伤的有效途径。     

949例作业渔民损伤原因分析

我科自１９９３年１月～１９９９年 １２月共收治作业渔民各种损伤９４９例,占同期各类外伤住院伤员总数的５６．７％。全部病例均有完整的住院病历,有准确的受伤原因及部位等资料。近年来随着海洋资源开发的不断发展,这类伤者将会有增加的趋势,现总结分析如下。 一、临床资料 １．对象：本组９４９例均为男性渔民,年龄１８～６７岁,平均（４１．７±７．９１）岁,其中２５～４５岁７２３例,占７６．２％。 ２．损伤原因：本组作业渔民的损伤以机器伤和非动力性器械伤为主,共５３５例,占５６．４％,其次为意外滑跌伤、压砸伤等,…     

282例儿童烧伤流行病学调查及预防措施

目的通过儿童烧伤的流行病学调查，探讨儿童烧伤的预防措施。方法对282例儿童烧伤病例进行资料分析。结果烧伤患儿中以1～3岁年龄组儿童最多，占总人数的53．90％，5岁以下占94．60％。其中烫伤225例，占儿童烧伤的79．78％，热液是儿童烧伤的主要原因，以6—9月份发病率较高，占全年的51．42％。烧伤程度以轻、中度烧伤为主，占87．58％。结论儿童烧伤具有可预防性，提高安全意识，加强儿童监护，改善生活条件能有效预防儿童烧伤的发生。     

吸入性损伤病死率与菌血症关系的探讨

1960～1995年，我院共收治烧伤15907例，合并吸入性损伤1539例，占9．7％。吸入性损伤后易致全身感染而致菌血症，甚至死亡。为此，我们对吸入性损伤病死率与菌血症的关系进行了探讨，以期为吸入性损伤菌血症的治疗提供参考。1对象和方法1．1对象1539例中，男1152例，女387例；年龄14～83岁，平均251岁。烧伤总面积38．6士25．3％，Ⅲ度烧伤面积174士21．2％。根据解剖位置分度法，诊断为轻度吸入性损伤1080例（70．2％），中度33O例（21．4％），重度129例（8．4％）。1．2方法（1）计算吸入性与非吸入性损伤菌血症的发生率，并进行比较；…     

231例面中部骨折的临床研究

目的 探讨面中部骨折的发生机制及治疗特点。方法 以我院口腔颌面外科1981－2000年资料完整的面中部骨折患者231例为研究对象，进行性别及年龄分布、致伤原因、骨折类型、合并伤、治疗方法等方面的分析研究。结果 231例中，男195例，女36例，男女之比为5．4：1。高峰年龄段为20－40岁，占63．6％（147／231）。交通伤占56．3％（130／231），为主要致伤原因。以上颌骨折最多，占全部骨折的42．2％（206／488）；在合并伤中以眼外伤的发生率最高（29．4％，68／231）；经切开复位内固定治疗125例，占54．1％（125／231）。结论 面中部骨折最常见致伤原因是交通伤；最好发人群是20－40岁男性；最好发部位是上颌骨；最常用的治疗方法是切开复位、坚固内固定。     

小儿烧伤的护理体会

儿童因各种意外发生烧伤的病例时有发生，在诊疗护理过程中，因儿童各系统发育尚不完善，若不及时进行抢救治疗，极易造成休克，甚至死亡，我院近年治疗护理儿童烧伤用例均治愈现报告如下：临床资料一般资料：我院1995年收治烧伤病人110例，其中儿童为30例（36．7％），男性17例，女性13例，年龄15个月一12岁．平均5岁。治疗经过：入院后立即清创，清除异物，清洁创面，常规注射破伤风抗毒素以及补液，全身应用抗生素，控制感染等对症治疗，以减轻病人痛苦，预防并发症的发生。烧伤原因：由于年龄和生活习惯不同发生原因亦不同。如婴幼儿活…     

陆路交通事故引起的重型颅脑伤

报告我院１９８６～１９９１年间收治的３６８例由陆路交通事故引起的重型颅脑损伤［１］。临床资料一般资料：本组病例占同期住院重型颅脑损伤（８５３例）的４３．１％。男２６０例，女１０８例；年龄１／１２～８０岁，平均３４．７岁。事故发生形成中车辆本身肇事占３...     

心脏直视手术中意外损伤的处理

心脏直视手术中意外损伤的处理张载高，刘欲团，史鉴运，褚衍林１９８０～１９９０年问，我院在施行心脏体外循环手术中遇到意外出血１０例，占同期心内直视手术的０．７６％（１０／１３１０例）。临床资料男６例，女４例；年龄６～３４岁。二尖瓣置换３例，房缺伴部分肺...     

不同术式治疗十二指肠损伤46例

目的：探讨十二指肠损伤的手术治疗方法。方法：总结1992年6月－2002年6月收治的46例十二指肠损伤的临床资料。本组男31例，女15例；年龄3－62岁，平均33．6岁。交通伤23例，刀刺伤15例，挤压伤6例，坠落伤2例。十二指肠第一段损伤2例，第二段24例，第三段13例，第四段4例，多处损伤3例。破裂伤44例，横断伤2例。按美国创伤外科学会（AAST）标准评定，I级2例，Ⅱ级16例，Ⅲ级22例，Ⅳ级6例。结果：46例均进行手术治疗，治愈37例（80．4％），死亡9例（19．6％）。术后并发症发生率23．9％（11／46）。结论：应根据十二指肠损伤的位置、严重程度以及是否合并其他脏器伤选择合理的手术方式。对血流动力学不稳定患者应根据损伤控制外科的要求简化手术，对Ⅲ级及Ⅲ级以上十二指肠损伤多采用十二指肠修补及十二指肠憩室化手术。     

长沙市儿童烧伤的流行病学特征与分析

目的：探讨长沙市儿童烧伤的流行病学特征,为制定有效烧伤预防措施提供依据。方法：采用分层随机整群抽样法。对2005年3月至2006年3月间长沙市3所医院烧伤门诊初诊患儿进行烧伤情况调查。结果：1～7岁男孩多于女孩,0～1岁和7岁及以上男女比例相近。热液烫伤是各年龄段儿童主要致伤原因。47．5％的烧伤发生在厨房,24．7％在客厅,68．3％的火焰烧伤、60．0％的电烧伤发生在户外。9时～12时、15时～18时为烧伤发生高峰期。冬夏季烧伤分别占32．1％和30．8％。78．4％的烧伤发生时有成人在旁,41.5％的火焰烧伤、100％电烧伤发生时无成人在旁。结论：男孩是危险因素,随着年龄增加男女差异减少。幼儿期和学龄前期是小儿烧伤高发期,应引起家长及抚教人员的重视。热液烫伤对儿童生活构成的威胁较其他类型烧伤大,应成为防治重点。家庭是烧伤发生主要场所,客厅环境复杂容易发生意外。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.