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Analysis of incidence of traumatic brain injury in blunt trauma patients with Glasgow Coma Scale of 12 or less

Chinese Journal of traumatology 2018年第3期21卷 152-155页

作者： Alexander Becket Kobi Peleg Oded Olsha Adi Givon Boris Kessel Israeli Trauma Group Department of Surgery A Emek Medical Center Afula Israel National Center for Trauma and Emergency Medicine Research Germer Institute for Epidemiology and Health Policy Research Tel Hashomer Israel Surgery Department Shaare Zedek Medical Center Jerusalem Israel Trauma Unit Hillel Yaffe Medical Center Hadera Israel Disaster Medicine Department School of Public Health Faculty of Medicine TelAviv University Israel Rappoport Medical School. Technion. Haifa Israel 不详

Purpose： Early diagnosis of traumatic brain injury （TBI） is important for improving survival and neurologic outcome in trauma victims. The purpose of this study was to assess whether Glasgow Coma Scale （GCS） of 12 or less can predict the presence of TBl and the severity of associated injuries in blunt trauma patients. Methods： A retrospective cohort study including 303,435 blunt trauma patients who were transferred from the scene to hospital from 1998 to 2013. The data was obtained from the records of the National Trauma Registry maintained by Israel＇s National Center for Trauma and Emergency Medicine Research, in the Gertner institute for Epidemiology and Health Policy Research. All blunt trauma patients with GCS 12 or less were included in this study. Data collected in the registry include age, gender, mechanism of injury, GCS, initial blood pressure, presence of TBI and incidence of associated injuries. Patients younger than 14 years old and trauma victims with GCS 13-15 were excluded from the study. Statistical analysis was performed by using Statistical Analysis Software Version 9.2. Statistical tests performed included Chi-square tests. A p-value less than 0.05 was considered statistically significant. Results： There were 303,435 blunt trauma patients, 8731 （2.9%） of them with GCS of 3-12 that including 6351 （72%） patients with GCS of 3-8 and 2380 （28%） patient with GCS of 9--12. In these 8731 patients with GCS of 3-12, 5372 （61.5%） patients had TBI. There were total 1404 unstable patients in all the blunt trauma patients with GCS of 3-12,1256 （89%） patients with GCS 3-8, 148 （11%） patients with GCS 9-12. In the 5095 stable blunt trauma patients with GCS 3-8, 32.4% of them had no TB1. The rate in the 2232 stable blunt trauma patients with GCS 9-12 was 50.1%. In the unstable patients with GCS 3-8, 60.5% of them had TBI, and in subgroup of patients with GCS 9-12, only 37.2% suffered from TBI. Conclusion： The utility of a GCS 12 and less is limited in prediction

关键词： Multiple trauma Transfer Glasgow Coma Scale

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Erratum to:Double-edged effects caused by magnesium ions and alkaline environment regulate bioactivities of magnesiumincorporated silicocarnotite in vitro

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Regenerative Biomaterials 2021年第6期8卷 318-318页

作者： Qiang Wu Shunxiang Xu Fei Wang Bo He Xin Wang Ye Sun Congqin Ning Kerong Dai Shanghai Key Laboratory of Orthopedic Implant Department of Orthopaedic SurgeryShanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineNo.639Zhizaoju RoadShanghaiHuangpu District 200011China The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials Shanghai Normal UniversityNo.100Guilin RoadShanghaiXuhui District 200234China Department of orthopedics Trauma and Microsurgery Zhongnan Hospital of Wuhan UniversityNo.169East Lake RoadWuchang DistrictWuhan 430071China Department of Orthopaedics The First Affiliated Hospital of Nanjing Medical UniversityNo.300Guangzhou RoadDrum-tower DistrictNanjing210029China State Key Laboratory of High Performance Ceramics and Superfine Microstructure Shanghai Institute of CeramicsChinese Academy of SciencesNo.1295Dingxi RoadChangning DistrictShanghai 200050China

[This corrects the article DOI: 10.1093/rb/rbab016.].

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Study on the Effect of the Intervention on Traditional Chinese Medicine Negative Heel Shoes in Geriatric orthopedics Patients

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Journal of Clinical and Nursing Research 2018年第6期2卷 5-7页

作者： Jiabin Zhai Lianjun Ren Qirong Wang Inner Mongolia Medical University Medical College Hohhot Inner Mongolia 010110 Shenzhen Yikang Shou Culture Research institute Shenzhen Guangdong 518125

In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden *** can result in poor survival rate and adverse final clinical ***,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic *** is of great significance to support and guarantee patients to obtain the best clinical *** article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.

关键词： orthopedics geriatric bedridden patient Chinese medicine negative heel shoes health care effects

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Pattern of injury in Shiraz

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Chinese Journal of traumatology 2008年第1期11卷 8-12页

作者： Ahmad-Reza Soroush Shahram Ghahri-Saremi Mehdi Rambod Seyed-Ali Malek-Hosseini Saman Nick-Eghbal Ali Khaji Department of Surgery Shariati General Hospital Tehran University of Medical Sciences Tehran 14114 Iran Obesity Research Center Research Institute for Endocrine Sciences Shaheed Beheshti University of Medical Sciences Tehran 14114 Iran Department of Surgery Nemazi General Hospital Shiraz University of Medical Sciences Shiraz 71937 Iran Sina Trauma Research Center Sina General Hospital Tehran University of Medical Sciences Tehran 11364 Iran

Objective： Injury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate the current status of trauma admissions to hospitals in Shiraz, as a major city of Iran. Methods： A hospital-based study was conducted in 2002. All injured patients admitted during 6 months in emergency departments of two general hospitals of Shiraz, Nemazi and Chamran were included. Results： A total of 1 765 injured patients were registered during the study period, with mean age of 33 years. Manual workers were the most vulnerable group among occupational categories. Inner-city roads were the most common place of injury and traffic accident was the major cause of injury. Overally, falling injury was the second common cause of injury in males and the first cause in females （ especially at the age of over 60）. Conclusion： As other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.

关键词： Trauma Iran Traffic accident Shiraz

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Changes of balance between proteinase and their inhibitors in blood of pigs with high-velocity missile wounds

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Chinese Journal of traumatology 2003年第4期6卷 222-225页

作者：周元国朱佩芳周继红李晓炎 Molecular Biology Center Research Institute of Surgery & Daping HospitalThird Military Medical UniversityChongqing 400042China then increased gradually and was higher than the baseline value at 12 hours after injury.Conclusions: Imbalance between lysosomal enzymes and proteinase inhibitors occurs soon after injury which might result in continuous tissue damage and play an important role in the disturbance of general reaction after injury.

Objective: To study the effect of imbalance between lysosomal enzymes and their inhibitors in blood on disturbance of the local and whole body after trauma.Methods: The dynamic changes of lysosomal enzymes and proteinase inhibitors were studied in 12 pigs with femoral comminuted fractures in both hind limbs caused by high velocity missiles. Four normal pigs served as controls.Results: After injury, the activity of Cathepsin D in arterial plasma increased gradually and reached the highest level at 8 hours, acid phosphatase in serum began to increase at 12 hours and the value of serum elastase did not change significantly. The level of αl-antitrypsin, a proteinase inhibitor in plasma, decreased significantly in the early stage after injury [ 73.5% ±6.4% and 81.0% ±5.1% of the baseline value (1.67 μmol · ml-1 · min-1 ± 0.29 μmol · ml-1 · min-1) at 1 and 2 hours after injury, respectively, P < 0.05 ], then increased gradually and was higher than the baseline value at 12 hours after injury.Conclusions: Imbalance between lysosomal enzymes and proteinase inhibitors occurs soon after injury, which might result in continuous tissue damage and play an important role in the disturbance of general reaction after injury.

关键词： Lysosomes Protease inhibitors Wounds and injuries Pigs

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Publishing clinical prActice GuidelinEs(PAGE):Recommendations from editors and reviewers

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Chinese Journal of traumatology 2022年第6期25卷 312-316页

作者： Nan Yang Wei Zhao Wen-An Qi Chen Yao Chong-Ya Dong Zhen-Guo Zhai Tong Chen En-Mei Liu Guo-Bao Li You-Lin Long Xin-Yi Wang Zi-Jun Wang Ruo-Bing Lei Qi Zhou Yao-Long Chen Liang Du on behalf of TERM working group Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou730000China Editor-in-Chief Office Chinese Medical Association Publishing HouseBeijing100052China Editorial Department British Medical Journal(Chinese Edition)Chinese Medical Association Publishing HouseBeijing100052China Department of Biostatistics Peking University First HospitalBeijing100034China Clinical Research institute Peking UniversityBeijing100191China Department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing100029China institute of Respiratory Medicine Chinese Academy of Medical SciencesBeijing100029China National Clinical Research Center for Respiratory Diseases Beijing100029China Department of Hematology Huashan HospitalFudan UniversityShanghai200040China institute of Medicine Huashan HospitalFudan UniversityShanghai200040China Department of Respiratory Medicine Children's Hospital of Chongqing Medical UniversityChongqing400014China National Clinical Research Center for Child Health and Disorders Ministry of Education Key Laboratory of Child Development and Disorders Chongqing400014China Chongqing Key Laboratory of Pediatrics Chongqing400014China National Clinical Research Center for Infectious Disease The Third People's Hospital of ShenzhenShenzhen518112China Medical Device Regulatory Research and Evaluation Center West China HospitalSichuan UniversityChengdu610041China Chinese Evidence-Based Medicine Center West China HospitalSichuan UniversityChengdu610041China Chevidence Lab of Child&Adolescent Health Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqing400014China Research Unit of Evidence-Based Evaluation and Guidelines(2021RU017) Chinese Academy of Medical SciencesSchool of Basic Medical SciencesLanzhou UniversityLanzhou730000China Guidelines and Standards Research Center Chinese Medical Association Publishing HouseBeijing100052China W

Transparency Ecosystem for Research and Journals in Medicine(TERM)working group summarized the essential recommendations that should be considered to review and publish a high-quality *** recommendations from editors and reviewers included 10 components of essential requirements:systematic review of existing relevant guidelines,guideline registration,guideline protocol,stakeholders,conflicts of interest,clinical questions,systematic reviews,recommendation consensus,guideline reporting and external *** working group abbreviates them as PAGE(essential requirements for Publishing clinical prActice GuidelinEs),and recommends guideline authors,editors,and peer reviewers to use them for high-quality guidelines.

关键词： Guidelines Recommendations Editor Peer review Transparency

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Strategy for prevention of hip fractures in patients with Parkinson's disease

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World Journal of orthopedics 2012年第9期3卷 137-141页

作者： Jun Iwamoto Yoshihiro Sato Tsuyoshi Takeda Hideo Matsumoto institute for Integrated Sports Medicine Keio University School of Medicine Tokyo 160-8582 Japan Department of Neurology Mitate Hospital Fukuoka 826-0041 Japan

Hypovitaminosis D and K due to malnutrition or sunlight deprivation,increased bone resorption due to immobilization,low bone mineral density(BMD)and an increased risk of falls may contribute to an increased risk of hip fractures in patients with Parkinson’s *** purpose of the present study was to clarify the efficacy of interventions intended to prevent hip fractures in elderly patients with Parkinson’s *** Med was used to search the literature for randomized controlled trials(RCTs)regarding Parkinson’s disease and hip *** inclusion criteria were 50 or more subjects per group and a study period of 1 year or *** RCTs were identified and the relative risk and95%confidence interval were calculated for individual *** exposure increased serum hydroxyvitamin D[25(OH)D]concentration,improved motor function,decreased bone resorption and increased *** or risedronate with vitamin D supplementation increased serum 25(OH)D concentration,strongly decreased bone resorption and increased ***(vitamin K2)decreased serum undercarboxylated osteocalcin concentration,decreased bone resorption and increased *** exposure(men and women),menatetrenone(women),alendronate and risedronate with vitamin D supplementation(women)significantly reduced the incidence of hip *** respective RRs(95%confidence intervals)according to the intention-to-treat analysis were 0.27(0.08,0.96),0.13(0.02,0.97),0.29(0.10,0.85)and 0.20(0.06,0.68).Interventions,including sunlight exposure,menatetrenone and oral bisphosphonates with vitamin D supplementation,have a protective effect against hip fractures elderly patients with Parkinson’s disease.

关键词： Vitamin D Vitamin K Hip fractures Parkinson’s disease Mortality

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Trochanteric area pain,the result of a quartet of bursal inflammation

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World Journal of orthopedics 2013年第3期4卷 100-102页

作者： Bruce Rothschild Department of Medicine Northeast Ohio Medical UniversityRootstownOH 44272United States Biodiversity institute University of KansasLawrenceKS 66045United States

Bursitis is quite responsive to therapeutic intervention, once the afflicted area is accurately identified. This is especially notable for some hip complaints. Patients' use of the term "hip" can relate to anything from the low back to groin to lateral thigh pain. Trochanteric area surface localization of "hip" pain may afford an opportunity for immediate cure. Effectiveness of therapeutic intervention is predicated upon injection of not one or two, but all four peri-trochanteric bursa with a depot(minimally water-soluble) corticosteroid. The term trochanteric bursitis suggests that the inflammation is more focal than what is clinically observed. While easier to express, perhaps it is time to refer to inflammation in this area, naming all four affected bursae.

关键词： Trochanter Bursitis Bursa Hip Injection Corticosteroids Dexamethasone Triamcinolone

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Mechanical solution for a mechanical problem:Tennis elbow

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World Journal of orthopedics 2013年第3期4卷 103-106页

作者： Bruce Rothschild Department of Medicine Northeast Ohio Medical UniversityRootstownOH 44272United States Biodiversity institute University of KansasLawrenceKS 66045United States

Lateral epicondylitis is a relatively common clinical prob lem, easily recognized on palpation of the lateral protu berance on the elbow. Despite the "itis" suffix, it is no an inflammatory process. Therapeutic approaches with topical non-steroidal anti-inflammatory drugs, cortico steroids and anesthetics have limited benefit, as would be expected if inflammation is not involved. Other ap proaches have included provision of healing cytokine from blood products or stem cells, based on the recog nition that this repetitive effort-derived disorder repre sents injury. Noting calcification/ossification of tendon attachments to the lateral epicondyle(enthesitis), dry needling, radiofrequency, shock wave treatments and surgical approaches have also been pursued. Physi ologic approaches, including manipulation, therapeuti ultrasound, phonophoresis, iontophoresis, acupuncture and exposure of the area to low level laser light, ha also had limited success. This contrasts with the benefi of a simple mechanical intervention, reducing the stres on the attachment area. This is based on displacemen of the stress by use of a thin(3/4-1 inch) band applied just distal to the epicondyle. Thin bands are required as thick bands(e.g., 2-3 inch wide) simply reduce mus cle strength, without significantly reducing stress. Thi approach appears to be associated with a failure rateless than 1%, assuming the afflicted individual modifies the activity that repeatedly stresses the epicondylar attachments.

关键词： Epicondylitis Tennis elbow Adaptive equipment Mechanical overload Elbow Inflammation

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Management of postoperative spinal infections

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World Journal of orthopedics 2012年第11期3卷 182-189页

作者： Vishal Hegde Dennis S Meredith Christopher K Kepler Russel C Huang Department of Orthopedic Surgery Weill Cornell Medical CollegeNew YorkNY 10021United States Department of Orthopedic Surgery Spine and Scoliosis ServiceHospital for Special SurgeryWeill Cornell Medical CenterNew YorkNY 10021United States Department of Orthopedic Surgery Rothman InstituteThomas Jefferson UniversityPhiladelphiaPA 19107United States

Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories:(1) microbiological factors;(2) factors related to the patient and their spinal pathology; and(3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique,prophylactic antibiotics,avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinalinstrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure.

关键词： Surgical site infection Spine surgery Discitis Postoperative infection

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