股中间肌卫星细胞移植对大鼠骨骼肌钝挫伤的修复作用

目的:探讨体外培养的股中间肌卫星细胞对大鼠骨骼肌钝挫伤的修复作用,为提高对肌肉损伤的治疗提供参考依据。方法:分别取体外培养SD大鼠股中间肌卫星细胞悬液(实验组)与生理盐水(对照组),注入大鼠骨骼肌钝挫伤模型损伤部位,观察比较两组动物损伤修复进程及差异。结果:移植后实验组比对照组恢复效果好。(1)卫星细胞移植后5、10、15天,实验组肌肉组织内荧光标记的肌卫星细胞逐渐减少,形成肌管并最终融合成肌纤维参与损伤修复;(2)移植后5、10、15天大鼠肌电图的纤颤电位和正尖波均逐渐减少,而实验组大鼠异常自发活动的消失较对照组早,且损伤侧肌肉肌电强度振幅和波宽依次增大,逐渐接近正常侧,而对照组肌电强度振幅与波宽则增加缓慢;(3)随着损伤修复的进程,实验组肌肉湿重恢复率逐渐降低并接近1;(4)随着修复的进程,HE染色灰度值逐渐增加,且实验组灰度值大于对照组。结论:股中间肌卫星细胞移植对骨骼肌钝挫伤有明显修复作用。     

TreadScan步态分析系统在评价大鼠脊髓挫伤模型中的应用

目的：探讨TreadScan步态分析系统在评价大鼠脊髓挫伤（spinal cord injury,SCI）模型中的应用价值。方法：采用连有PinPoint™精密接触传感器的Benchmark^TM立体定位颅脑撞击器制备脊髓挫伤大鼠模型。利用Image J图像分析软件测定伤后30 min损伤中心及其邻近区域的初始损伤体积。应用TreadScan步态分析系统描述术前及伤后7,14,21,28 d大鼠的行为学特征。采用Harris氏HE染色结合Luxol固蓝染色技术观察伤后1,7,14,28 d损伤组织的形态学改变。结果：模型组脊髓初始损伤体积为（4.17 ± 0.1）mm³（X±s, n=5）,范围在4.02至4.32 mm³之间,呈近似正态分布。与术前比较,模型组术后各项行为学参数差异均具有显著性（P<0.05）。与假手术组比较,伤后模型组脚印面积、步长、瞬间跑速、正常步序比均下降显著（P<0.05）,而跨步时间、摆动时间、后脚脚间距、最小纵向偏差均显著上升（P<0.05）。伤后1 d除损伤中心外,邻近区域组织形态基本完好。但是随时间延长,模型组组织溃变和髓鞘脱失的严重程度显著高于假手术组,且有向周边蔓延趋势。结论：采用连有PinPoint™精密接触传感器的Benchmark^TM立体定位颅脑撞击器制备的脊髓挫伤大鼠模型具有良好的重复性。应用TreadScan步态分析系统能够客观准确的评价大鼠SCI后的运动功能。     

Bruising and Physical Child Abuse

Bruising is one of the earliest, most common, and easily recognizable signs of physical child abuse and can signal escalating interpersonal violence within a household. Early detection of abuse through recognition of bruising coupled with appropriate intervention may help to prevent future and potentially more severe physical assaults. This article provides an overview of precise terminology and definitions, contusion pathology, development and appearance of bruises, characteristics of bruises suspicious for abuse, photographic documentation, techniques to help visualize bruising, conditions that may be confused with abusive bruising, and the difficulties encountered when attempting to estimate the age of bruises.     

The incidence and severity of injury in children hospitalised for traumatic brain injury in Kashmir

A large number of people experience traumatic brain injury each year, often with severe consequences. This is a public health problem that requires ongoing surveillance to follow trends in the incidence, risk factors, causes, and outcomes of these injuries. In 2003, a prospective study of all children below 15 years admitted to hospitals with a diagnosis of head injury was conducted in the Accident & Emergency Department of Sher-e-Kashmir Institute of Medical Sciences, Srinagar (India) to determine the incidence and severity of accidental head injury among children and the circumstances of injury. The highest incidence of head injury was seen at ages 6-10 years. Head injury rates were higher in males than in females. The leading causes include falls and motor vehicle accidents. More than 50% falls occurred in the age group of 4-6 years. Ninety per cent patients, who recovered, were discharged within 16-24 h after admission. Lack of supervision, non-implementation of safety measures and poor implementation of traffic rules leads to many injuries. The ability of the health care system to deal with increasing trauma in Jammu & Kashmir is limited. Nevertheless, prevention can be low cost strategy to overcome this problem. The results of epidemiological studies are affected by factors like demography, geographic region and socioeconomic status. This study emphasizes the need for intensified effort for prevention, minimising risk factors, strict legislative measures, observing traffic rules, implementation of safety measures, establishing appropriate trauma care at district level, adult supervision, and creating awareness.     

Sudden death from contusion of the right atrium after blunt chest trauma: case report and review of the literature

Occult cardiac injury following blunt trauma is more common than generally suspected. Myocardial lesions range from myocardial contusion to cardiac rupture. Myocardial contusion is not uncommon, it is usually a benign disorder which often remains undiagnosed. We report the case of a previously healthy 29-year-old man who was involved in a fight and suffered from blunt heart injury leading to contusion of the right atrium. The patient died soon after the injury and before admission to the Hospital. The diagnosis was made at autopsy. The present case is of special interest because of the unusual eliciting event and the rarity of the contusion site (right atrium). It is reported in order to raise the index of suspicion in physicians treating patients involved in a fight and aid in prompt diagnosis of myocardial contusion.     

Unilateral Post-Traumatic Pulmonary Contusion: Findings of a Review

Purpose There is still much controversy regarding the optimal treatment for pulmonary contusion. Therefore, we examined the variables affecting patient outcomes over a 10-year period.Methods We retrospectively reviewed 107 consecutive patients with a mean age of 28 years, who were treated for pulmonary contusion during a 10-year period. Pulmonary perfusion scans were obtained for 11 patients. We used a pulmonary contusion score (PCS) of one-third of a lung = 3 and the entire lung = 9.Results Overall mortality was 15%, which increased to 24.4% in patients with a PCS of 7–9. The time taken for contusions to resolve was longer based on scan results than chest X-rays (42.6 vs 15.5 days, respectively). Concomitant thoracic injures were present in 64.5% of patients, and 29% had a flail chest. The factors predictive of mortality were age 60 years, an injury severity score (ISS) 25, transfusion of 4 units of blood, a PaO₂/FIO₂ ratio of <300, concomitant flail chest, and a PCS of 7–9. The predictors for mechanical ventilation were age 60 years, concomitant flail chest, a PCS of 7–9, and an ISS 25. Mortality and the need for mechanical ventilation were higher in patients with nonisolated contusions than in those with isolated contusions.Conclusions Optimizing patient outcome requires prompt diagnosis, appropriate maintenance of fluid volume, and selective mechanical ventilation.     

Sprint car visual loss

A 16-year-old boy developed bilateral visual loss 24 hours after a sprint car accident. Bilateral central scotomas were demonstrated but were unexplained by a thorough eye examination and neuro-imaging. A diagnosis of commotio retinae was established by multi-focal ERG testing. This relatively new technique is discussed, including comparison to full-field ERG and clinical applications.     

眼球挫伤压陷三面镜检查69例分析

本文报道眼球挫伤后2周用三面镜检查追踪观察最长达十年,观察前房角、睫状体、玻璃体、和周边视网膜等改变,探讨其与青光眼、视网膜脱离的关系。     

Regional cerebral blood flow in the pig after a localized cerebral contusion treated with barbiturates

Summary Regional cerebral blood flow determined with microsphere technique in anaesthetized pigs was measured before and after a localized cerebral contusion as well as after treatment with pentobarbital.No overall reduction in intracranial pressure or perfusion pressure was observed. Flow reduction due to pentobarbital was different in different regions with a high percentage change in the highly perfused basal structures and cortical grey matter except in the centre of the contusion where the reduction was half compared to the rest of cortical grey matter. Changes in white matter were less than in cortical grey matter but more pronounced than in the very high flow areas (choroid plexus and pineal gland). The accumulated change was greatest in the damaged region. Contralateral to the contusion, where a significant increase in flow was noticed after the contusion, there was a very low accumulated change in flow. In white subcortical matter underlying the contusion a similar low flow change was observed but this was not accompanied by as large an accumulated change as in grey cortical matter. At each fraction of injected pentobarbital a short-lasting increase in intracranial pressure and a reduction in mean arterial blood pressure was observed. The amplitude and the height of the intracranial pressure change was reduced during the pentobarbital injections.     

视神经挫伤轴浆运输和超微结构变化的实验研究

目的 研究实验性视神经挫伤轴浆运输与超微结构的变化。方法采用自行设计的弹簧冲击器对家兔视神经进行定量损伤，术后1、3、7、14d应用辣根过氧化物酶(HRP)顺行标记和透射电镜观察视神经轴浆运输以及超微结构的变化。结果 不同时间实验组HRP反应产物较正常对照组明显降低，差异有显著性，HRP反应产物随观察时间延长逐渐增加，但至术后14d仍明显低于正常。电镜观察见损伤后1d大部分轴突颗粒状变性，线粒体肿胀，髓鞘松解，3d时损伤最重，14d部分轴突恢复正常。结论 视神经挫伤后局部轴浆运输发生障碍，同时轴突变性，14d部分轴突功能恢复。