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Management and outcome of bronchial trauma due to blunt versus penetrating injuries

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World Journal of Clinical Cases 2022年第16期10卷 5185-5195页

作者： Jin-Mou Gao Hui Li Ding-Yuan Du Jun Yang Ling-Wen Kong Jian-Bai Wang Ping He Gong-Bin Wei department of traumatology Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China department of Cardiothoracic Surgery Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China

BACKGROUND The number of patients with bronchial trauma(BT)who survived to hospital admission has increased with the improvement of prehospital care;early diagnosis and treatment should be considered,especially among blunt trauma patients,whose diagnosis is frequently *** To describe the early recognition and surgical management considerations of blunt and penetrating BTs,and to elaborate the differences between *** All patients with BTs during the past 15 years were reviewed,and data were retrospectively analyzed regarding the mechanism of injury,diagnostic and therapeutic procedures,and *** to the injury mechanisms,the patients were divided into two groups:Blunt BT(BBT)group and penetrating BT(PBT)*** injury severity,treatment procedures,and prognoses of the two groups were *** A total of 73 patients with BT were admitted during the study *** proportion of BTs among the entire cohort with chest trauma was 2.4%(73/3018),and all 73 underwent *** patients accounted for 81.6% in the BBT group and 22.9%in the PBT group,and the mean Injury Severity Score was 38.22±8.13 and 21.33±6.12,*** three-dimensional spiral computed tomography(CT)and/or fiberoptic bronchoscopy(FB)were performed in 92.1% of cases in the BBT group(n=38)and 34.3% in the PBT group(n=35).In the BBT group,a delay in diagnosis for over 48 h occurred in 55.3% of *** the PBT group,31 patients underwent emergency thoracotomy due to massive hemothorax,and BT was confirmed during the *** them,22 underwent pulmo-tractotomy for hemostasis,avoiding partial *** this series,the overall mortality rate was 6.9%(5/73),and it was 7.9%(3/38)and 5.7%(2/35)in the BBT group and PBT group,respectively(P>0.05).All 68 survivors were followed for 6 to 42(23±6.4)mo,and CT,FB,and pulmonary function examinations were performed as *** patients exhibited normal lung function and healthy conditi

关键词： Bronchial trauma Bronchial repair Blunt Penetrating Atelectasis Pneumonectomy

Management of severe pelvic fracture associated with injuries of adjacent viscera

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Chinese Journal of traumatology 2005年第1期8卷 13-16页

作者：高劲谋田显扬胡平李昌华王建柏曾剑波 department of traumatology Chongqing Emergency Medical Center Chongqing 400014 China

Objective: To investigate the approach of emergency management for severe pelvic fracture associated with injuries of adjacent viscera and evaluate the therapeutic effect. Methods: The data of 79 patients with severe pelvic fracture associated with injuries of adjacent viscera were retrospectively studied, and the study covered a period of 14 years. Results: To cease massive bleeding due to pelvic fracture, ligation of internal iliac arteries was performed on 33 cases, and angioembolization on 8. Of 42 patients with cystic or/and urethral injury, 35 underwent cystostomy and delayed reconstruction, and 7 received a primary realignment. All of 17 patients with injury of retroperitoneal rectum underwent diverting colostomy of the proximal end of sigmoid with presacral drainage, but 4 received primary repair without colostomy. In 22 patients with intraperitoneal colorectal injury, 19 were managed with primary repair or anastomosis while 3 received a colostomy. The overall mortality rate was 8.86% (7/79); the main causes were hemorrhagic shock and associated injury. The complications included urethro-rectal fistula in 4 cases, thrombosis of right common iliac artery in 1, ARDS following chest trauma in 1, and paraplegia in 1. Except the patient with paraplegia, all of them were cured. Conclusions: Prompt diagnosis and proper treatment are the key to success. Devascularization of internal iliac arteries with external fixation cage of the pelvis, cystostomy and proximal sigmoidostomy are effective procedures in emergency treatment of the critical patients.

关键词： Wounds and injuries Pelvis Fractures Abdominal injuries Surgery

Hemoglobin integrated red blood cell membrane-coated metalorganic framework nano-platform for improving the self-adaptive blood glucose management

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Nano Research 2025年第1期18卷 618-627页

作者： Shuai Wu Li Zhu Sheng Ni Xiong Zhao Meng Yan Yuan Zhong Karissa Kusuma Yi Liang Kaiwen Bao Kai Qu Xian Qin Kun Zhang Wuquan Deng Da Sun Wei Wu Key Laboratory of Biorheological Science and Technology Ministry of EducationCollege of BioengineeringChongqing UniversityChongqing 400044China chongqing University Three Gorges Hospital Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic DiseasesChongqing 404000China Institute of Life Sciences&Biomedical Collaborative Innovation center of Zhejiang Province Wenzhou UniversityWenzhou 325035China department of Endocrinology School of MedicineChongqing Emergency Medical CenterChongqing University Central HospitalChongqing 400014China

Diabetes,a prevalent chronic metabolic disorder,often leads to severe ***,existing treatment methods may pose life-threatening risks due to poor patient compliance and inaccurate dosing of subcutaneous insulin ***,a biomimetic red blood cell(RBC)membrane-coated glucose-responsive nanoplatform is developed for controlling insulin *** nanoplatforms with RBC membrane can prolong the half-life of nano-formulation in vivo mediated by the biomimetic immune ***,the cascade catalytic effect of glucose oxidase(GOx)encapsulated in metal-organic frameworks(MOFs)and hemoglobin(Hb)in the RBC membrane are able to not only facilitate glucose-responsive insulin release,but also eliminate the detrimental by-product hydrogen peroxide(H_(2)O_(2))resulting from the Hb mediated H_(2)O_(2)*** in vitro and in vivo studies have demonstrated the favorable glucose-responsive performances of this advanced nano-platform with a single intravenous injection maintaining blood glucose balance in Type 1 Diabetes(T1D)mice for an extended duration without the hypoglycemia ***,this biomimetic insulin delivery system is poised to function as a strategy for the intravenous insulin administration,offering a promising drug candidate for the self-adaptive long-term T1D treatment.

关键词： glucose-responsive metal-organic frameworks red blood cell membrane insulin delivery glucose oxidase hemoglobin

Intervertebral bridging ossification after kyphoplasty in a Parkinson’s patient with Kummell’s disease:A case report

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World Journal of Clinical Cases 2022年第2期10卷 677-684页

作者： Jie Li Yun Liu Lei Peng Jian Liu Zhi-Dong Cao Miao He department of Orthopaedic Surgery Chongqing Emergency Medical Center(Chongqing University Central Hospital)Chongqing 400010China department of Radiology Chongqing Emergency Medical Center(Chongqing University Central Hospital)Chongqing 400010China

BACKGROUND The short-term therapeutic efficacy of kyphoplasty on Kummell’s disease is ***,postoperative refracture and adjacent vertebral fracture occur occasionally and are difficult to ***'s disease(PD)is a pathological disorder associated with heterotopic *** a patient with PD,an intervertebral bridge was formed in a short period of time after postoperative refracture and adjacent vertebral fracture,providing new *** SUMMARY A 78-year-old woman had been suffering from PD for more than 10 *** months before operation,she developed lower back pain and *** visual analog scale(VAS)score was 9 *** magnetic resonance imaging indicated collapse of the L2 *** was performed and significantly decreased the severity of intractable *** patient’s VAS score for pain improved from 9 to *** days postoperatively,the patient suddenly developed severe back pain,and the VAS score was 9 points.X-ray showed L2 vertebral body collapse,slight forward bone cement displacement,L1 vertebral compression fracture,and severe L1 *** patient was given calcium acetate capsules 0.6 g po qd and alfacalcidol 0.5ug po qd,and bed rest and brace protection were *** conservative treatment for 2 mo,the patient's back pain was alleviated,and the VAS score improved from 9 to *** tomography at the 7-mo follow-up indicated extensive callus formation around the T12-L2 vertebrae and intervertebral bridging ossification,providing new *** Kyphoplasty is currently a conventional treatment for Kummell's disease,with definite short-term ***,complications still occur in the long term,and these complications are difficult to address;thus,the treatment needs to be selected *** avoid refracture,an interlaced structure of bone cement with trabeculae should be created to the greatest extent possible during the injection of bone *** interven

关键词： Kummell's disease Parkinson's disease Kyphoplasty Refracture Heterotopic ossification Case report

Low-grade slightly elevated and polypoid colorectal adenomas display differential β-catenin-TCF/LEF activity, c-Myc, and cyclin D1 expression

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World Journal of Gastroenterology 2017年第17期23卷 3066-3076页

作者： Tian-wen Yang Yun-han Gao Sha-Ying Ma Qiang wu Zhong-fu Li department of Gastroenterology Yongchuan Hospital Chongqing Medical University department of General Surgery Chongqing Emergency Medical Center

AIM To comparatively investigate the cellular and molecular characteristics of low-grade slightly elevated adenomas and polypoid *** Colorectal tumors were collected from 24 patients with slightly elevated adenomas and 23 patients with polypoid adenomas. five commonly mutated genes(APC, BRAf, KRAS, NRAS, and PIK3CA) were selected for mutational analysis. Paraffin-embedded tumor sections were used to calculate the apoptotic index(AI) and Ki-67 labeling index(KLI). Two pure colorectal epithelial cell lines were created by pooling the slightly elevated and polypoid tumors. western blots, luciferase assays for β-catenin-T-cell factor protein/β-cateninlymphoid enhancer factor(β-catenin-TCf/LEf)-driven transcriptional activity, and caspase activity assays were conducted on the two cell *** Slightly elevated lesions showed a significantly lower APC mutational frequency and a significantly higher KRAS mutational frequency(both P < 0.05). Slightly elevated lesions showed a significantly lower AI(P < 0.05). β-catenin and β-catenin-TCf/LEf-driven transcriptional activity was significantly upregulated in slightly elevated lesions(both P < 0.05). In slightly elevated lesions, c-Myc was significantly downregulated, while cyclin D1 was significantly upregulated(both P < 0.05). β-catenin-TCf/LEf-driven transcriptional activity was negatively correlated with c-Myc(ρ =-0.78). Slightly elevated lesions displayed significant Bcl-2 and Bcl-x L upregulation(both P < 0.05) along with significant decreases in caspase-9 and caspase-3 activity(both P < 0.05). c-Myc was negatively correlated with Bcl-2 and Bcl-x L(ρ =-0.74 and-0.78, respectively).CONCLUSION The lower apoptotic activity of low-grade slightly elevated adenomas can be partly attributed to upregulated β-catenin pathway activity and downregulated c-Myc expression.

关键词： Cancer Carcinoma Colorectal Adenoma β-catenin Non-polypoid

Short-term prone positioning for severe acute respiratory distress syndrome after cardiopulmonary bypass:A case report and literature review

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World Journal of Clinical Cases 2022年第36期10卷 13435-13442页

作者： Jian-Hua Yang Shu Wang Yuan-Xiu Gan Xuan-Yun Feng Bai-Lin Niu department of Intensive Care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing Key Laboratory of Emergency MedicineChongqing 400016China department of Intensive Care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400016China

BACKGROUND Aortic dissection is a complex and dangerous cardiovascular disease,with many complications in the perioperative period,including severe acute respiratory distress syndrome(ARDS),which affects prognosis and increases *** the effect of prone positioning(PP)in improving oxygenation in patients with severe ARDS,reports about PP early after cardiac surgery are few and such an opt-ion may be an issue in cardiac surgery patients because of the recent *** SUMMARY A 40-year-old male patient diagnosed with acute type A aortic dissection on October 22,2021 underwent ascending artery replacement plus total aortic arch replacement plus stent elephant trunk implantation under cardiopulmonary ***,he developed ARDS on postoperative day *** comprehensive treatment with aggressive pulmonary protective ventilation,fluid management with continuous renal replacement therapy,the condition continued to deteriorate and rapidly progressed to severe ARDS with a minimum oxygenation index of *** are ready to implement salvage therapy,including PP and extracorporeal membrane oxygenation(ECMO).Due to the large amount of pericardial mediastinal and thoracic drainage after thoracotomy,ECMO may result in massive postoperative *** prone ventilation is often inappropriate after ***,we chose short-term PP for<6 ***,the oxygenation index greatly improved and the diffuse exudation in both lungs of the patient was significantly reduced with short-term prone *** Intermittent short-term PP can improve early postoperative severe ARDS after acute aortic dissection.

关键词： Aortic dissection Short-term prone positioning Acute respiratory distress syndrome Oxygenation index Cardiopulmonary bypass Case report

Multilocular thymic cysts can be easily misdiagnosed as malignant tumor on computer tomography:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1474-1480页

作者： Jun Sun Qing-Ning Yang Yi Guo Ping Zeng Long-Yan Ma Ling-Wen Kong Bo-Ying Zhao Chuan-Ming Li department of Radiology Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China department of Pathology Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China department of Cardiothoracic Surgery Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400014China

BACKGROUND Multilocular thymic cyst(MTC)is a rare mediastinal lesion which is considered to occur in the process of acquired *** is usually characterized by well-defined cystic density and is filled with transparent *** SUMMARY We report on a 39-year-old male with a cystic-solid mass in the anterior *** tomography(CT)imaging showed that the mass was irregular with unclear *** injection of contrast agent,there was a slight enhancement of stripes and *** to CT findings,it was diagnosed as thymic *** After surgery,MTC accompanied by bleeding and infection was confirmed by pathological *** main lesson of this case was that malignant thymic tumor and MTC of the anterior mediastinum sometimes exhibit similar CT *** is necessary in clinical work to avoid misdiagnosis.

关键词： Multilocular thymic cyst Computer tomography Misdiagnosis Hemorrhage Infection Case report

Application effect for a care bundle in optimizing nursing of patients with severe craniocerebral injury

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World Journal of Clinical Cases 2021年第36期9卷 11265-11275页

作者： Ying Gao Li-Ping Liao Peng Chen Ke Wang Cui Huang Ying Chen Shao-Yu Mou department of Neurosurgery Chongqing Emergency Medical CenterChongqing 400014China School of Nursing Chongqing Medical UniversityChongqing 400016China

BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the *** condition is complex and changeable,and disability and mortality rates are *** the life of STBI patients can be saved through treatment,the sequelae of consciousness,speech,cognitive impairment,stiffness,spasm,pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a *** the past,routine nursing was often used to treat/manage STBI;however,problems,such as improper cooperation and untimely communication,reduced therapeutic *** To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with *** From January 2019 to December 2020,126 STBI patients were admitted to the emergency department of chongqing emergency medical *** patients were retrospectively selected as the research participants in the current *** study participants were then divided into a control group(61 cases)and a study group(65 cases).The control group was treated with routine *** study group adopted the proposed care *** National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale(GCS)were used to evaluate neurological function before and after emergency *** 3 mo of rehabilitation,experimental outcomes were *** included the GCS,Barthel Index,complication rate,muscle strength grade and *** There was no significant difference in gender,age,cause of injury and GCS between the two *** emergency,the National Institutes of Health Stroke Scale/Score of the study group(10.23±3.26)was lower than that of the control group(14.79±3.14).The GCS score of the study group(12.48±2.38)was higher than that of the control group(9.32±2.01).The arrival time of consultation in the study group was 20.56±19.12,and the retention time in th

关键词： Severe craniocerebral injury Care bundle emergency treatment Early rehabilitation Clinical application

New method to remove tibial intramedullary nail through original suprapatellar incision:A case report

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World Journal of Clinical Cases 2022年第3期10卷 1116-1121页

作者： Miao He Jie Li department of Orthopaedic Surgery Chongqing Emergency Medical Center(Chongqing University Central Hospital)Chongqing 400010China

BACKGROUND Since 2006,introducing a tibial intramedullary nail via the suprapatellar approach has been established;however,nail removal must be carried out using classic infrapatellar access,which can lead to ***,we report a new method to remove the intramedullary nail through the original suprapatellar *** SUMMARY A 39-year-old man was hit by a vehicle in *** was immobilized with a 10-mm×330-mm tibial intramedullary nail via the suprapatellar approach due to left middle tibial *** years later,the patient requested for the implant to be *** used a new method to remove the tibial intramedullary nail through the original suprapatellar incision,and the operation went *** This case report indicates that suprapatellar access can be used to remove the intramedullary nail via the original incision without infrapatellar access,thus avoiding surgical complications.

关键词： Suprapatellar approach Nail removal Infrapatellar access Case report