Profile of ocular injury in pediatric age group

目的：研究北印度三级转诊中心儿童眼外伤的临床特征。

方法：基于医院的流行病学研究。包括所有年满16岁的眼外伤儿童。记录关于患者的社会经济状况,治疗手段和出院情况。随访3mo,记录初始和最终视力。眼部创伤分类指南和Birmingham眼部创伤术语用于眼外伤的定义和分类。社会经济地位是根据改良B.G. Prasad分类和Kuppuswamy社会经济级别分级的。

结果：在42例儿童中,男女比例为3.6：1。发生在11～16岁儿童眼外伤最多(50%)。大多数儿童(59.52%)属于较低的社会经济阶层,且均为农村背景。在家中发生眼外伤的儿童为20例(47.61%),其次在学校,游乐场和街道发生为6例(14.28%)。其中开放性眼外伤19例(45.24%),闭合性眼外伤23例(54.75%)。因木棍、石头、烟花、跌倒、玩具而受伤的儿童数量分别为12例(28.57%),5例(11.90%),3例(7.14%),3例(7.14%)和2例(4.76%)。 17例(40.47%)儿童需要药物治疗,25名(59.53%)需要手术治疗。

结论：农村地区和经济条件较差的男童更易患眼外伤。儿童在家里更易患眼外伤。木棍和石头是引起眼外伤最常见的因素。开放性眼外伤的患病率更高且视力不良增多。需要进一步的以人群为基础研究以补充本研究。基于此,人们可以计划在该地区实施一项长期的政策以预防儿童眼外伤。     

慢性硬膜下血肿一例临床病理报告

一67岁男性于死亡前二月余头部被击受轻伤,死亡后尸检病理证实为慢性硬膜下血肿。硬膜下出血来源考虑是桥静脉损伤,因尸检时掀去带囊血肿时,在前上额部留有一出血区。新膜中大量新生的毛细血管及其出血,可能造成血肿逐渐长大。     

围生期窒息患儿脐血血气分析与脑损伤的关系

围生期窒息是指胎儿窒息（宫内窘迫）、产程中和出生时的窒息，以神经系统并发症为主，并危及胎儿健康甚至生命。其原因是胎儿缺氧、缺血，无氧酵解增加，乳酸大量堆积，缓冲调节失常，导致二氧化碳分压（PC02）蓄积，血pH下降。围生期窒息患儿脐血血气分析与脑损伤有一定的相关性，是估价新生儿缺血缺氧和预后的较好方法。     

闭合性肾损伤56例临床报告

<正> 1992年10月～1999年10月共收治肾损伤病人59例,占泌尿系损伤病人的38％,其中开放性肾损病人3例,均在入院时死亡。现将泌外住院、有完整病历的闭合性肾损伤病人56例报告如下。 1 临床资料 本组56例,男41例,女15例。年龄6～74岁,平均34岁。其中左侧24例,右侧31例,双侧1例。合并休克9例,并1种或1种以上脏器损伤27例。合并伤有:骨折11例(颅骨除外),血气胸8例,颅脑伤5例,脾破裂5例,肝破裂3例,肠破裂2例,胰腺     

新生儿颅脑超声诊断学习班通知

<正>为提高对围产期脑损伤及其他中枢神经系统疾病的诊断水平,充分利用已有的医疗资源,推广颅脑超声检查诊断技术,北京大学第一医院儿科按计划于2012年4月上旬举办为期5天的新生儿颅脑超声学习班。本班属国家级教育     

脑损伤合并消化道出血65例临床分析

消化道出血为颅脑损伤多种并发症的一种,若处理不当可造成严重的后果,我院自1998-2002年共收治颅脑损伤合并消化道出血65例,其中死亡4例,行剖腹探查术1例,现报告如下:     

手腕部肌腱的闭合性损伤

报道２６例手腕部闭合性肌腱损伤的诊治经验。２６例中，由骨折脱位引起者１１例，类风湿性滑膜炎引起者８例，腱鞘滑膜结核引起者５例，其它原因２例。采用肌腱移位术治疗２３例，游离肌腱移植术３例。经６个月～４年随访，手握力和手指主、被动屈伸功能恢复正常或接近正常者１９例，达健侧功能７５％者５例，达健侧功能５０％者２例。有４例术后再次行肌腱松解术，１例修复术后再断裂，再次手术修复。总优良率为９２％。认为，对手腕部肌腱闭合性损伤应早期诊断，及时手术治疗，重建功能     

新生儿窒息后阴离子间隙状态与脑损伤

目的　 了解窒息新生儿血液AG状态及其与脑损伤关系。 方法 　对 5 9例出生时窒息并经复苏处理后的新生儿作动脉血气、血电解质检查、测定AG值。 结果 　高AG 3 0例 ,正常AG 2 1例 ,低AG 8倒。轻、重度窒息组高AB发生率分别为5 5 0 %、42 1% ;代酸发生率分别为 72 5 %、63 2 % ;HIE发生率分别为 82 5 %、89 5 % ;其差异均无显著性。轻、中、重度HIE组高AG发生率分别为 19 0 %、80 0 %、88 9% ;代酸发生率分别为 4 3 %、90 0 %、10 0 0 % ,轻度HIE组与中、重度HIE组比较均有非常显著性差异。 结论 　脑损伤的发生与出生时窒息程度不一致 ,与高AG状态及其代酸的发生关系密切。对中、重度HIE纠正酸碱紊乱应以改善通气、加强供氧、增加循环灌注为主。     

A pilot study on the effects of early use of valproate sodium on neuroinflammation after traumatic brain injury北大核心CSCD

Objective To study the effect of early use of sodium valproate on neuroinflammation after traumatic brain injury (TBI). Methods A total of 45 children who visited in Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from August 2021 to August 2022 were enrolled in this prospective study, among whom 15 healthy children served as the healthy control group, and 30 children with TBI were divided into a sodium valproate treatment group and a conventional treatment group using a random number table (n=15 each). The children in the sodium valproate treatment group were given sodium valproate in addition to conventional treatment, and those in the conventional group were given an equal volume of 5% glucose solution in addition to conventional treatment. The serum concentrations of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3), high-mobility group box 1 (HMGB1), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were measured in the healthy control group on the day of physical examination and in the children with TBI on days 1, 3, and 5 after admission. Glasgow Outcome Scale-Extended (GOS-E) score was evaluated for the children with TBI 2 months after discharge. Results Compared with the healthy control group, the children with TBI had significantly higher serum concentrations of NLRP3, HMGB1, TNF- α, and IL-1β on day 1 after admission (P<0.017). The concentration of NLRP3 on day 5 after admission was significantly higher than that on days 1 and 3 after admission in the children with TBI (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of NLRP3 than the conventional treatment group (P<0.05). For the conventional treatment group, there was no significant difference in the concentration of HMGB1 on days 1, 3, and 5 after admission (P>0.017), while for the sodium valproate treatment group, the concentration of HMGB1 on day 5 after admission was significantly lower than that on days 1 and 3 after admission (P<0.017). On day 5 after admission, the sodium valproate treatment group had a significantly lower concentration of HMGB1 than the conventional treatment group (P<0.05). For the children with TBI, the concentration of TNF-α on day 1 after admission was significantly lower than that on days 3 and 5 after admission (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of TNF-α than the conventional treatment group (P<0.05). The concentration of IL-1β on day 3 after admission was significantly lower than that on days 1 and 5 after admission (P<0.017) in the children with TBI. On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of IL-1β than the conventional treatment group (P<0.05). The GOS-E score was significantly higher in the sodium valproate treatment group than that in the conventional treatment group 2 months after discharge (P<0.05). Conclusions Early use of sodium valproate can reduce the release of neuroinflammatory factors and improve the prognosis of children with TBI. © 2023 Xiangya Hospital of CSU. All rights reserved.     

内源性神经干细胞治疗新生儿脑损伤的研究进展

新生儿脑损伤是指围生期阶段各种因素引起的脑组织病理性损伤, 常见于新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy, HIE)、脑室周围-脑室内出血和脑室周围白质软化等疾病。严重脑损伤后, 中枢神经系统(central nervous system, CNS)的修复与重建对其功能恢复至关重要。研究表明, 神经干细胞(neural stem cells, NSC)是一类具有多向分化和自我更新能力的细胞群。内源性NSC(endogenous neural stem cells, eNSC)能在体内增殖、迁移至受损区域, 并分化为星形胶质细胞、少突胶质细胞和神经元, 为神经再生治疗策略开辟了新的研究方向。该文旨在对eNSC治疗新生儿脑损伤中的研究进展进行综述。