Epidemiology of eye injuries sustained by military personnel in China

Objective:To investigate the epidemiological characteristcs of eye injuries sustained by military personnel in Chinese army.Methods:Eleven military evacuation hospitals located in different regions were selected for this study.We reviewed all the medical records of eye injuries sustained by military personnel between January 2005 and December 2009.Patients' information was collected.All data were put into database and analyzed statistically.Results:Totally there were 415 inpatients with eye injuries (442 eyes) and their mean age was 24.40 years.Eye injury accounts for 13.51％ of all eye diseases in this study.From 2006 to 2009,the number of eye injury increased gradually.Among them,175 (42.17％) were injured in leisure time,and 145 (34.94％) in working time.Twenty-two (5.30％)patients had an eye surgery or history of eye disease before injury.In all,246 patients (59.28％) were sent to evacuation hospital within 24 hours and 64 (56.64％) underwent surgeries in 24 hours after injury.There were 389 patients (93.73％)hospitalized for 1 time.Visual acuities of 187 eyes (42.31％)were grade 1 (≥ 20/40) after injury.When discharge,349eyes (78.96％) obtained a visual acuity of grade 1.Conclusion:Eye injury has a very frequent incidence in Chinese army and much more attention should be paid to prevent it.     

对抗演习阶段肩关节训练伤的影响因素分析

目的探讨对抗演习阶段肩关节训练伤的发生情况及致伤的影响因素,为制定有效的干预措施提供科学的依据。方法采用完全随机抽样的方法,对演习结束后1个月内的官兵进行问卷调查,分析演习阶段肩关节训练伤发生情况、致伤原因及损伤类型。根据肩关节训练伤的发生情况分为受伤组和未受伤组,首先对2组进行单因素分析,然后采用Logistic回归分析肩关节训练的危险因素和保护因素。结果回收有效问卷1 922份,其中受伤组255例,肩关节训练伤发生率为13.3%。单因素分析结果显示,受伤组和未受伤组在热身及准备活动、身体情况、紧张、烦躁方面差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,演练时心情烦躁是造成肩关节训练伤的危险因素,热身及准备活动充足、身体状况良好是肩关节训练伤的保护因素。结论对抗演习阶段肩关节训练伤发生率较高,而充足的热身及准备活动、良好的身体状况及自我心理调节能力是避免肩关节损伤的有效方法。     

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

Purpose

Trauma-related injuries are the leading cause of death worldwide. Some risk factors make traumatic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hospitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran.

Risk factors for urban road traffic injuries in Hangzhou,China

Objective  To investigate factors that most influence urban road traffic injuries (RTI) mortality and morbidity. Methods  The study used linked police and hospital records of RTI patients in the city of Hangzhou during the 3-year period 2004–2006. Three RTI outcome groups were included: (1) fatally injured; (2) severely injured; and (3) mildly injured persons. Results  High risks for fatal road traffic accidents (RTA) were found on urban links, over weekend, during night hours, in male drivers who drove old vehicles without using seat belts, and at exceeding speeds, or with night time accidents and bad weather condition. In case of higher risk for all urban road users on urban junctions, the numbers on mildly injury cases were increasing. The highest combined risk for dying or being severely injured was found in male drivers driving at excessive speed, on urban links, and with night time accidents. Conclusions  Intensifying safety education of motor vehicle drivers, enhancing traffic management and keeping balance of “person–vehicle–road” system will greatly reduce the urban traffic accidents and casualties.     

某特种兵大队新兵下肢军事训练伤情况调查

[目的]了解某特种兵部队新兵在入伍基础军事训练中发生的各种下肢训练伤的特点,为部队制定相应的预防措施提供科学依据。[方法]调查了该部队2006年度281名新兵的入伍训练情况(1~3个月),设计训练伤调查表,通过问卷调查了解训练伤发病情况,并进行分类调查统计。[结果]该部队2006年度入伍新兵在基础军事训练中发生下肢损伤75人,发生率为26.69%,发生下肢伤75人中,以小腿部位损伤最多,共35例,占下肢损伤的46.67%。踝关节损伤17例,占22.67%。足部损伤11例,占14.67%。下肢伤中急性损伤为20例,占26.67%,过劳性损伤55例,占73.33%。下肢损伤中骨与关节损伤38例,占50.67%,软组织损伤37例,占49.33%。损伤的原因:场地等外部环境因素18人次,训练负荷过大61人次,损伤所发生的训练项目:大部分为3 km跑,达64人次。[结论]下肢运动损伤是军事训练的常见病和多发病,其发病特点和发生规律各不相同且相当复杂。在该调查中,训练负荷过大所导致的软组织过劳性损伤最为重要。因此,在平常的军事训练中,应该加强健康宣教工作,在新兵训练过程中要注意战士的身体承受情况,循序渐进,减少下肢训练伤的发生。     

Risk factors for low back pain and sciatica: an umbrella review

Background

Low back pain (LBP) is a highly prevalent condition and it is associated with significant disability and work absenteeism worldwide. A variety of environmental and individual characteristics have been reported to increase the risk of LBP. To our knowledge, there has been no previous attempt to summarize the evidence from existing systematic reviews of risk factors for LBP or sciatica.

Analysis of injuries and treatment of 3,401 inpatients in 2008 Wenchuan earthquake--based on Chinese Trauma Databank

Objective： A catastrophic earthquake struck Wenchuan region of West China on May 12, 2008 and caused more than 69 225 deaths. This study was to analyze injury characteristics and treatment of the seismic patients based on Chinese Trauma Databank, which will be helpful for improvement of future medical rescue in potential disasters. Methods： Based on inpatients＇ medical records of seismic patients admitted into 11 hospitals, data were registered with Trauma Database System Version 3.0. Patients＇ general information, causes, clinical characteristics and treatment of injuries were studied. Results： Main causes for seismic injuries were blunt strike （68.2%）, crush/burying 08.7%） and slip/falling （11.5%）. Slip/falling was the main cause for spinal injuries and accounted for 19. 1%, which was higher than the percentage for other body part. Extremity injuries accounted for 54.8% of all injuries. Fractures accounted for 53.1%. Lower extrem-ity fracture accounted for 70.1% of lower extremity injury and spinal fracture accounted for 85.9% of spinal injury. The proportion of spinal injuries with AIS ≥4 was higher than that of other injured locations except for the abdomen. Debridement and suturation for single injury and multiple injury patients accounted for 64.7% and 42.9% of their operations respectively. Conclusions： Blunt strike, crush/burying and slip/ falling are the main causes for seismic injuries. The most frequently injured site is extremity. The main injury type is fracture, especially for the lower extremities and the spine. Multiple injury patients were mainly treated by operation, including debridement and suturation, closed reduction and external fixation, etc.     

Clinical retrospective and comparative study on diaphragm injuries in 46 cases

ａｕｍａｔｉｃｄｉａｐｈｒａｇｍｒｕｐｔｕｒｅｉｓｎｏｔｃｏｍｍｏｎｉｎｃｌｉｎｉｃａｌｗｏｒｋ ,ａｎｄｔｈｅｉｎｊｕｒｙｉｓｖｅｒｙｓｅｒｉｏｕｓａｎｄｔｈｅｍｏｒｔａｌｉｔｙｉｓｈｉｇｈ .Ｔｈｅａｉｍｏｆｐｒｅｓｅｎｔｓｔｕｄｙｗａｓｔｏｅｌｕｃｉｄａｔｅｔｈｅｃｌｉｎｉｃａｌｃｈａｒａｃｔｅｒｉｓｔｉｃｓｏｆｂｌｕｎｔａｎｄｐｅｎｅｔｒａｔｉｎｇｄｉａｐｈｒａｇｍｉｎｊｕｒｉｅｓａｎｄｔｏｑｕａｎｔｉｔａｔｉｖｅｌｙｃｏｍｐａｒｅｔｈｅｓｅｖｅｒｉｔｙｏｆｄｉｆｆｅｒｅｎｔｄｉａｐｈｒａｇ…     

Paediatric admissions to the British military hospital at Camp Bastion, Afghanistan

INTRODUCTION

International humanitarian law requires emergency medical support for both military personnel and civilians, including children. Here we present a detailed review of paediatric admissions with the pattern of injury and the resources they consume.

METHODS

All paediatric admissions to the hospital at Camp Bastion between 1 January and 29 April 2011 were analysed prospectively. Data collected included time and date of admission, patient age and weight, mechanism of injury, extent of wounding, treatment, length of hospital stay and discharge destination.

RESULTS

Eighty-five children (65 boys and 17 girls, median age: 8 years, median weight: 20kg) were admitted. In 63% of cases the indication for admission was battle related trauma and in 31% non-battle trauma. Of the blast injuries, 51% were due to improvised explosive devices. Non-battle emergencies were mainly due to domestic burns (46%) and road traffic accidents (29%). The most affected anatomical area was the extremities (44% of injuries). Over 30% of patients had critical injuries. Operative intervention was required in 74% of cases. The median time to theatre for all patients was 52 minutes; 3 patients with critical injuries went straight to theatre in a median of 7 minutes. A blood transfusion was required in 27 patients; 6 patients needed a massive transfusion. Computed tomography was performed on 62% of all trauma admissions and 40% of patients went to the intensive care unit. The mean length of stay was 2 days (range: 1–26 days) and there were 7 deaths.

CONCLUSIONS

Paediatric admissions make up a small but significant part of admissions to the hospital at Camp Bastion. The proportion of serious injuries is very high in comparison with admissions to a UK paediatric emergency department. The concentration of major injuries means that lessons learnt in terms of teamwork, the speed of transfer to theatre and massive transfusion protocols could be applied to UK paediatric practice.     

Spinal fractures resulting from traumatic injuries

Objective： To illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran. Methods： Data regarding spinal injuries including demographics, mechanism and level of spinal injury, abbreviated injury score, associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004. Results： A total of 619 patients with traumatic spine fractures were identified, of whom 68.5% were males. The peak frequency of these injuries occurred in the 21-40 year age-group. Accidental falls and road traffic crashes （RTCs） were the most common mechanisms of spinal fractures （47.2% and 44.1%, respectively）. RTCs tended to occur in younger patients compared with accidental falls. The most common spinal region for spinal fracture was the lumbar spine （53.63%）. Cervical spine fractures were significantly more common in RTCs, while lumbar spine fractures were more common in accidental falls （P〈0.001）. A total of 171 （27.6%）patients had associated non-spinal injuries, of whom 127 had associated extremity injuries, and 55 had head injuries. Thirty-six （5.6%） patients had spinal cord injury （SCI）.The injury severity score of the RTC group was significantly higher than that of accidental falls （P=-0.002）. Fifteen （4%） patients died of traumatic injuries. The rate of death was significantly higher in RTCs compared with accidental falls （5.1% vs 2.1%, P=0.039）. Conclusions： The patterns of spinal fractures are similar to those reported from developed countries. RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls. Therefore preventive strategies should be based on reduction of the number and severity of RTCs.     

肾脏损伤的诊断和治疗(附120例报告)

回顾分析１９７５～１９９５年间收治的肾损伤患者１２０例，其中血尿１１６例，行大剂量ＩＶＵ检查７８例，有异常发现４５例；Ⅱ～Ⅳ级肾损伤ＩＶＵ阳性率为９５％；ＣＴ检查２０例，其中９例诊断为Ⅲ类肾损伤并经手术探查证实。对８１例Ⅰ、Ⅱ类肾损伤者行保守治疗，除１例随访发现高血压外其他患者无并发症；２例Ⅲ类肾损伤行保守治疗失败行肾切除，８例Ⅲ类肾损伤经选择性肾动脉栓塞治疗而痊愈；手术探查２８例，肾脏仅为挫伤者１０例，肾深度裂伤６例修复成功，１２例伤情重者行了肾切除。１２０例中除１例死亡外，其他患者治疗效果满意。结合文献，对肾损伤的诊断和治疗进行了讨论     

腹部手术切口脂肪液化的临床分析

目的　探讨腹部手术切口脂肪液化的危险因素、诊断、治疗及预防措施。方法　采用回顾性调查方法从我院 2 0 0 0年～ 2 0 0 3年间腹部手术后发生切口脂肪液化的病例中随机抽样 30例作为实验组 ,同时、同期手术未发生切口脂肪液化的腹部手术病例中随机抽样 30例作为对照组进行对比分析。结果　综合性、易感性诱发因素均可造成切口脂肪液化。危险因素中除基础疾病因素无显著性差异外 (P >0 .0 5 ) ,其余体型、使用电刀、切口类型、切口长度、手术时间、手术类型、性别等危险因素有显著性差异 (P <0 .0 5 )。结论　充分做好腹部手术的围手术期准备工作 ,把好手术“进出关” ,加强病房及手术室的管理等综合性措施 ,可减少或避免腹部手术后切口脂肪液化的发生。     

Remission and remission-related factors in lupus nephritis patients: a cohort study

Objective To explore prognosis and remission-related factors in lupus nephritis (LN) patients. Methods Patients diagnosed as LN by renal biopsy in Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology between Jan 1, 2011 and July 31, 2016 were enrolled. All related baseline clinical data was recorded and regular follow-up was performed. Kaplan-Meier curves was used to analyze partial remission and complete remission rates. Log-rank test was performed to compare remission rates of patients with nephrotic-range proteinuria (24-hour proteinuria≥3.5 g) and without nephrotic-range proteinuria (24-hour proteinuria＜3.5 g). Univariate and multivariate Cox regression analyses were performed to evaluate the remission-related factors in different periods. Results A total of 115 patients, with 88.7% female and (31.5±9.5) years mean age, were followed up for up to 5 years. During follow-up period 2 patients died and 1 dialyzed. The 6-, 12-, 24- and 36- and 48-month renal partial remission and complete remission rates were 33.3%, 58.2%, 71.5%, 84.0%, 89.6%, and 18.9%, 40.5%, 67.3%, 79.4%, 87.0%, respectively. Patients without nephrotic-range proteinuria had higher complete remission than patients with nephrotic-range proteinuria (HR=2.01, 95%CI 1.15-3.34, P=0.014), but there was no difference in their partial remission (HR=1.33, 95%CI 0.74-2.43, P=0.341). Multivariate Cox regression model indicated that every 1 g/L increase in baseline level of serum albumin was associated with increased 8% and 9% risk, respectively, in partial remission (HR=1.08, 95%CI 1.01-1.15, P=0.024) and complete remission (HR=1.09, 95%CI 1.01-1.07, P=0.038). Conclusions Around half of LN patients reach remission during 1 year. Patients without nephrotic-range proteinuria have higher complete remission, and serum albumin is a remission-related factors.     

血管损伤的介入治疗

目的 探讨血管损伤的介入治疗方法 及临床疗效.方法 2006年1月至2008年3月,采用介入方法 治疗血管损伤13例.损伤部位包括颈内静脉、锁骨下动脉、腋动脉、下腔静脉、腹主动脉、肠系膜上动脉、髂动静脉和股动脉,病变类型表现为刀刺伤后动静脉内瘘形成3例、血管裂伤伴周围血肿4例、外伤后假性动脉瘤3例、动脉损伤修复术后狭窄3例.行覆膜支架置入9例(10枚)、网状支架置入1例、球囊封堵2例、弹簧圈栓塞1例.结果 13例介入手术均取得成功,无围手术期死亡,无严重并发症.胸主动脉假性动脉瘤覆膜支架置入后有少量内漏、左锁骨上动脉-颈内静脉瘘患者覆膜支架置入后有少量造影剂从颈内静脉渗出,均未作进一步处理,患者痊愈.随访12例,随访时间1～26个月,平均9.3个月.胸主动脉假性动脉瘤患者术后12个月出现少量咯血,CTA检查无明显异常.未发现支架断裂、移位、变形或支架内狭窄,无病变复发.结论 介入治疗血管损伤具有创伤小、手术时间短、操作简单、术后恢复快的优点,但需严格掌握手术适应证以确保操作安全有效.     

活血化瘀法在泥石流伤员救治中作用的病例对照研究

目的：观察活血化瘀中药对泥石流损伤患者血清肿瘤坏死因子-α、白细胞介素-6的影响,探讨活血化瘀中药在灾害救治中的作用机制。方法：以2010年8月12日起由甘肃舟曲和成县转运至兰州的泥石流伤员为研究对象,分为2组。A组25例,男15例,女10例;平均年龄（39.0±3.9）岁;AIS评分1分2例,2分3例,3分17例,4分3例,无5分患者;ISS评分〈16分16例,16～25分7例,〉25分2例。B组25例,男11例,女14例;平均年龄（40.1±3.6）岁;AIS评分1分3例,2分4例,3分16例,4分2例,无5分患者;ISS评分〈16分15例,16～25分9例,〉25分1例。2组患者入院后完善全身检查,A组8例手术治疗,其中3例行切开复位钢板内固定术,4例行扩创引流术,1例行异物取除术;B组6例手术治疗,其中颅脑手术1例,胸部手术2例,软组织清创术3例。2组患者均常规预防感染、预防并发症、支持及消肿治疗,A组在此基础上另内服消肿止痛合剂,每次50ml,每日2次;外用伤科洁肤液外敷患部,每次20ml,每日4次,每次外敷20～30min。2组患者均以7d为1个疗程,共治疗2个疗程,分别于入院第2、7、14天运用免疫度量法测定促炎症细胞因子TNF-α、IL-6于血清中的含量,所测TNF-α、IL-6不同时间点的数据采用SPSS16.0统计学软件进行处理。结果：入院第2天,2组患者血清TNF-α、IL-6的含量比较,差异无统计学意义;第7、14天2组血清TNF-α、IL-6的含量比较,差异有统计学意义。入院第7、14天与入院第2天血清TNF-α、IL-6含量比较,差异有统计学意义。结论：活血化瘀中药能抑制创伤后致炎症因子释放。     

Clinical features of snowboarding injuries

A retrospective study of 3102 injured snowboarders from 1992 to 1999 was undertaken using the medical records and questionnaires the patients had been asked to complete at the time of consultation. These cases represent all the injuries with medical treatment that occurred in five skiing and snowboarding resorts in the Nagano area. The total number of the injuries was 3243. The number of patients each year rapidly increased over the eight seasons. In descending order, the injuries were seen in the head and face, left upper extremity, spine, chest and abdomen, left lower extremity, right upper extremity, and right lower extremity. The number of head and face injuries was 829 (25%) followed by 768 (24%) left upper extremity injuries. With regard to the type of injury, fracture was the most frequent injury. There were 998 fractures, of which 625 were fractures of the upper extremity. Contusions were frequent on the head, face, chest, abdomen, and pelvis. Lacerations were frequent on the head and face. Sprains were frequent in the lower extremities, and dislocations were seen frequently in the upper extremities. The sharp increase in the number of patients was thought to reflect the increase in the population of snowboarders in Japan. The reason for the high concentration of injuries to the head and upper extremity is thought to derive from the characteristic riding form of snowboarding, with both legs fixed to one short, wide board. To decrease the injuries and to develop snowboarding as a safe and exciting sport, snowboarders, instructors, slope managers, and equipment manufacturers must comprehend the patterns of snowboarding injuries and cooperate to devise preventive measures.     

Facial dog bite injuries in children: A case report

IntroductionDog bites are common and can affect victims of different ages, from children to the elderly. Injuries are usually located in different body regions, including head and face. The treatment of choice for injuries is the suture of the lesion, accompanied by antibiotic therapy and tetanus and anti-rabies vaccination.Presentation of caseAn 11-year-old male black patient was admitted to the Surgery and Maxillo-Facial Traumatology Service, on an urgent basis, victim of domestic animal aggression (dog biting). The child had multiple and extensive lesions on the face, trauma with laceration with loss of substance, involving the left genic region, lower and upper lip, and lower gingival-labial sulcus.DiscussionSmaller children are especially vulnerable to injuries in the craniofacial region due their low stature, propensity to crawl/play on the ground and exploratory behavior. The primary treatment of bites is by means of direct suture, grafting or local flaps, depending on the type of wound and the surgeon's decision, regardless of time elapsed from the attack.ConclusionThis case shows a case of a child patient victim of animal bite, with lesions limited to the region of the face. The patient was followed up for a month and showed good wound healing without any complications.     

膝关节损伤的诊断与治疗

<正>膝关节是人体最大且结构最复杂的屈戍关节,其功能精细、复杂。同时,由于膝关节位于下肢的中部和人体两大杠杆臂之间,需承受较大和较多的应力,并进行持久的三维运动,因而容易引     

Treatment of limb arterial in juries caused by traffic accidents

Objective:To analyze the features,diagonosis and treatment of limb arterial injuries caused by traffic accidents.Methods:A total of 43 patients with limb arterial injury admitted in our department over the past 30years(about50%of them happened during the last10 years)were analyzed retrospectively in this article.The popliteal,femoral and brachial arteries were mainly involved,accounting for 432%,20.5%and20.5%respectively of all the involvements.There were 35cases of open injury and9of close injury,The involved vessels were transected in 43.2%of the cases and contused in 40.9%,All the patients had various complications,such as fractures,dislocations and severe soft tissue injuries.The injured vessels were repaired by means of end-to-end anastomosis in 10cases,autogenous vein graft in 23cases and intraluminal hydraulic dilatation in 4cases.Results:Successful limb salvage was achieved in 34cases initially,whereas10amputations were carried out due to injuries to popliteal arteries in7,femoral arteries in2and humeral artery in 1and severe soft tissue damages in9 cases.Twenty-nine patients were followed up for 1-156months,with the averageof48.8months.There was good circulation in 22 cases and certain ischemia in 5cases.Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2cases.There was no death in this series.Conclusions:The limb arterial injuries caused by traffic accidents are severe and complicated.It is proposed that particulatr attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.