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钳夹辅助复位治疗高位股骨转子下骨折手术技术

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中华骨科杂志 2011年第3期31卷 I0036-I0044页

作者： Alan Afsari, MD Frank Liporace, MD Eric Lindvall, DO Anthony Infante Jr., DO Henry C. Sagi, MD George J. Haidukewych, MD 杨雷(译) Investigation performed at the Orthopedic trauma Service Florida Orthopedic Institute Tampa General Hospital Tampa Florida and the Department of Orthopaedics University of Medicine and Dentistry of New Jersey Newark New Jersey 温州医学院附属第二医院骨科 325027

背景：股骨转子下骨折的治疗具有复杂性。由于该部位具有较大的（肌肉）牵拉应力而使得近端骨折块较易移位以致于使骨折端的精确复位及内固定物放置困难。本研究的目的是评价一组高位股骨转子下骨折患者采取钳夹辅助复位及髓内钉内固定... 详细信息

背景：股骨转子下骨折的治疗具有复杂性。由于该部位具有较大的（肌肉）牵拉应力而使得近端骨折块较易移位以致于使骨折端的精确复位及内固定物放置困难。本研究的目的是评价一组高位股骨转子下骨折患者采取钳夹辅助复位及髓内钉内固定对于骨折愈合率及骨折复位质量的影响。方法：自2003年12月到2007年1月，来自于两个一级创伤中心共55例移位型高位股骨转子下骨折患者，其中2例死亡，9例失访。剩余44例患者均得到随访至术后6个月或至骨性愈合；男27例，女17例，平均年龄55岁。均采用扩髓型顺行静态锁定髓内钉内固定系统，同时通过外侧小切口使用钳夹辅助复位，其中9例患者加用线缆环扎骨折端。术后常规X线检查，评价骨折复位质量及骨折愈合情况。结果：随访44例患者中，43例患者达到骨性愈合，骨折复位后冠状面及矢状面成角均不大于5°。38例（86％）达到解剖复位，6例患者骨折端发生轻微的内翻畸形（2°-5°），所有的患者均无并发症发生。结论：使用钳夹辅助复位髓内钉固定适时加用线缆环扎骨折端治疗股骨转子下骨折可达到满意的骨折复位和较高的术后骨折愈合率。手术成功要点是操作细微，尽量减少对软组织的剥离。可信水平：治疗性研究Ⅳ级。关于证据等级的完整描述详见投稿须知。

关键词：股骨转子下骨折复位治疗手术技术钳夹骨折患者骨折愈合率骨折复位髓内钉内固定

A novel tissue engineered nerve graft constructed with autologous vein and nerve microtissue repairs a longsegment sciatic nerve defect

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Neural Regeneration Research 2021年第1期16卷 143-149页

作者： Jing Wang Ya-Qiong Zhu Yu Wang Hong-Guang Xu Wen-Jing Xu Yue-Xiang Wang Xiao-Qing Cheng Qi Quan Yong-Qiang Hu Chang-Feng Lu Yan-Xu Zhao Wen Jiang Chen Liu Liang Xiao Wei Lu Chen Zhu Ai-Yuan Wang Spine Research Center of Wannan Medical College Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution(Wannan Medical College)Department of Spine SurgeryYijishan HospitalThe First Affiliated Hospital of Wannan Medical CollegeWuhuAnhui ProvinceChina Department of Ultrasound Chinese PLA General HospitalBeijingChina Department of Orthopedic Surgery Key Laboratory of Musculoskeletal Trauma&War Injuries PLABeijing Key Lab of Regenerative Medicine in OrthopedicsChinese PLA General HospitalBeijingChina Medical College of Nankai University TianjinChina The Neural Regeneration Co-Innovation Center of Jiangsu Province NantongJiangsu ProvinceChina Department of Anesthesiology the Second Affiliated Hospital of Inner Mongolia Medical UniversityHuhhotInner Mongolia Autonomous RegionChina Department of Orthopedic Surgery Yan’an University Affiliated HospitalYan’anShaanxi ProvinceChina Department of Orthopedic Surgery the First Affiliated Hospital of Medical CollegeShihezi UniversityShiheziXinjiang Uygur Autonomous RegionChina Department of Orthopedic Surgery The First Peoples’Hospital of Yunnan ProvinceKunmingYunnan ProvinceChina Department of Orthopedic Surgery Anhui Provincial HospitalThe First Affiliated Hospital of University of Science and Technology of ChinaHeifeiAnhui ProvinceChina

Veins are easy to obtain,have low immunogenicity,and induce a relatively weak inflammatory ***,veins have the potential to be used as conduits for nerve ***,because of the presence of venous valves and the great elasticity of the venous wall,the vein is not conducive to nerve *** this study,a novel tissue engineered nerve graft was constructed by combining normal dissected nerve microtissue with an autologous vein graft for repairing 10-mm peripheral nerve defects in *** with rats given the vein graft alone,rats given the tissue engineered nerve graft had an improved sciatic static index,and a higher amplitude and shorter latency of compound muscle action ***,rats implanted with the microtissue graft had a higher density and thickness of myelinated nerve fibers and reduced gastrocnemius muscle atrophy compared with rats implanted with the vein ***,the tissue engineered nerve graft had a lower ability to repair the defect than autogenous nerve *** summary,although the tissue engineered nerve graft constructed with autologous vein and nerve microtissue is not as effective as autologous nerve transplantation for repairing long-segment sciatic nerve defects,it may nonetheless have therapeutic potential for the clinical repair of long sciatic nerve *** study was approved by the Experimental Animal Ethics Committee of Chinese PLA General Hospital(approval No.2016-x9-07)on September 7,2016.

关键词： in vivo injury motor neurological function peripheral nerve injury rat recovery regeneration repair

Ventricular Fibrillation Caused by traumatic Coronary Artery Dissection

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Case Reports in Clinical Medicine 2015年第4期4卷 119-123页

作者： Jun-ya Ishikawa Naoto Morimura Eri Nagai Kyota Nakamura Makoto Shimizu Keiji Uchida Department of Emergency Medicine Yokohama Municipal Citizen’s Hospital Yokohama Japan Advanced Critical care and Emergency Medical Center Yokohama City University Medical Center Yokohama Japan Department of Anesthesiology Kanagawa Cancer Center Yokohama Japan Department of Cardiology International Goodwill Hospital Yokohama Japan Cardiovascular Center Yokohama City University Medical Center Yokohama Japan

Coronary artery dissection due to blunt chest trauma (traumatic coronary artery dissection [TCAD]) may heal spontaneously, and some surgeons believe that conservative or elective treat-ments are sufficient, provided that there are no progressing ischemic symptoms. However, we report a patient who experienced sudden ventricular fibrillation (VF) during initial medical care for trauma injuries. The 32-year-old woman was riding in a passenger car when an accident occurred, and was subsequently transported to our emergency department. Twelve-lead electrocardiography revealed ST segment elevation in leads II, III, and aVF, although her vital signs remained stable. Therefore, we prioritized assessing the trauma at other sites, and VF suddenly occurred. Coronary angiography was performed with repeated defibrillation and chest compressions, which resulted in recovery of spontaneous circulation. Occlusion was observed in the right coronary artery, which we treated with balloon angioplasty. However, intravascular ultrasonography (IVUS) subsequently revealed coronary artery dissection, a stent was placed, and the patient successfully recovered. Therefore, IVUS may be useful for diagnosing TCAD, and swift intervention is needed if TCAD is detected.

关键词： Coronary Artery Dissection Blunt Chest trauma Ventricular Fibrillation Acute Myocardial Infarction Intravascular Ultrasonography

血浆游离DNA水平增高可作为预测重型颅脑损伤患者死亡率的独立指标(英文)

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中华神经外科疾病研究杂志 2014年第3期13卷 258-258页

作者： Rodrigues Filho EM1 Simon D Ikuta N Klovan C Dannebrock F de Oliveira CO Regner A 1ULBRA Laboratório de Biomarcadores do TraumaCanoasRSBrazil

trauma is the leading cause of death under 45 years worldwide and up to 50% of trauma fatalities are due to brain *** of outcome is one of the major problems associated with severe TBI and research efforts have focused on the investigation of biomarkers with prognostic value following TBI. Therefore,our aim was to investigate whether cell-free DNA concentrations correlated to short-term primary outcome( survivor or death) and GCS scores following severe TBI. A total of 188 victims of severe TBI were enrolled in this prospective study,outcome variables comprised: survival and neurological assessment using the GCS at ICU discharge. Control blood samples were obtained from 25 healthy volunteers. Peripheral venous blood was collected at admission in the ICU. Plasma DNA was measured using a real-time quantitative PCR assay for the β-globin gene. There was correlation between higher DNA levels and both fatal outcome and lower hospital admission GCS scores. Plasma DNA concentrations at the chosen cut- off point( ≥171,381 kilogenomesequivalents /L) predicted mortality with a specificity of 90% and a sensitivity of 43%. Logistic regression analysis showed that elevated plasma DNA levels were independently associated with death( P < 0. 001). In conclusion,high cell-free DNA concentration was a predictor of short-term mortality following severe TBI.

关键词：神经外科学疾病临床研究症状

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对我国西部地区创伤救治现状的考察及思考

中国急救复苏与灾害医学杂志 2023年第8期18卷 1008-1012页

作者：熊建黄博轩郎克 Henry Xiang 王天兵北京大学人民医院创伤骨科北京100044 国家创伤医学中心北京100044 青海省黄南藏族自治州人民医院青海省黄南藏族自治州811399 Center for Pediatric trauma Research&Center for Injury Research and Policy Nationwide Children's HospitalThe Ohio State College of MedicineColumbusOH 43210 北京大学人民医院创伤救治中心北京100044 创伤救治与神经再生教育部重点实验室北京100044

目的通过对青海省黄南藏族自治州的短期走访考察,探讨我国以青海省为代表的西部边远高原地区创伤救治体系及创伤中心建立的条件,设计及实施方法。方法2018年8月对青海省黄南藏族自治州所辖的4个县(尖扎县,河南蒙古族自治县,泽库县,同仁... 详细信息

目的通过对青海省黄南藏族自治州的短期走访考察,探讨我国以青海省为代表的西部边远高原地区创伤救治体系及创伤中心建立的条件,设计及实施方法。方法2018年8月对青海省黄南藏族自治州所辖的4个县(尖扎县,河南蒙古族自治县,泽库县,同仁县)进行了为期1个月的实地走访考察,初步调查了4个县人民医院的基本急诊急救情况,对各医疗机构的规模,科室设置,患者类型,地理、人文情况,以及医疗机构间的交通、路况等进行了实地的考察与座谈。结果4所县人民医院均为所在县最大的且唯一的二级甲等西医综合性医院,主要负责辖区内百姓的慢病治疗、公共卫生以及创伤患者的救治。创伤为各家医院急诊疾病谱中的第一位疾病。黄南藏族自治州为高原地区,4所州人民医院的平均海拔为2928.2 m,汽车为创伤急救及转运的唯一交通工具,4所医院之间的平均汽车时间为122.5 min,4所医院间的平均车程为110.2 km,4所医院距青海省创伤救治中心的平均车程为199.25 km,汽车时间平均为175 min。尖扎县、河南蒙古族自治县、泽库县3个县规模较小,只设有综合内科及综合外科。急诊科正在建设或建立不久,缺乏合理规范的救治分区,设备尚齐备,但人员缺乏系统规范培训。结论以青海省黄南藏族自治州为代表我国西部高原地区,自然气候条件恶劣,随着西部大开发及经济建设的高速发展,创伤发生率高,但相应的救治条件和水平有待提高,建立以省会医院为创伤医学中心,州人民医院为创伤救治中心,县人民医院为创伤救治点的符合地域特点的区域性创伤救治体系并大力开展创伤从业人员相关培训可以提高当地的创伤救治水平。

关键词：创伤西部地区转运急救体系交通民族

创伤患者急诊气管插管的成功分析：一个大型成年创伤转诊中心的10年经验

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麻醉与镇痛 2011年第4期7卷 35-40页

作者： Christopher T. Stephens, MD Stephanie Kahntroff, MD Richard P. Dutton, MD, MBA 段怡(译) 李士通(校) Division of trauma Anesthesiology Department of Anesthesiology University of Maryland School of Medicine Baltimore Maryland 不详

背景对于多数麻醉医师来讲急诊气道管理是必须掌握的一项重要技术，我们总结了一个一级创伤中心10年来的经验，评估创伤患者入院后24小时内气管插管的结果。方法通过该中心1996年7月至2006年6月的创伤登记、质量管理记录、收费系统记录... 详细信息

背景对于多数麻醉医师来讲急诊气道管理是必须掌握的一项重要技术，我们总结了一个一级创伤中心10年来的经验，评估创伤患者入院后24小时内气管插管的结果。方法通过该中心1996年7月至2006年6月的创伤登记、质量管理记录、收费系统记录，得出入院后1小时内、24小时内需要插管的患者人数，并且回顾每个气管切开患者的医疗记录，了解其特征和无法进行经口或经鼻插管的原因。结果所有插管都在一名处理创伤经验丰富的麻醉医师的指导下进行。研究期间，标准插管法为直接喉镜下快速诱导插管。入院后1小时内，6088名患者进行插管，其中21名患者（0．3％）最终行气管切开。入院后24小时内，累计32000名患者进行插管，共31名行气管切开。意外的困难气道是气管切开的主要因素。31名患者中有4名死于外伤，无人死于插管失败。结论由经验丰富的麻醉医师指导，直接喉镜下快速诱导气管插管是有效的急诊气道管理方法，以其为核心的急诊气道管理规则使得气道管理成功率很高。

关键词：急诊气管插管创伤患者气管切开患者气道管理转诊成年麻醉医师快速诱导插管

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1例罕见的儿童损伤:外伤性幽门前横断

世界核心医学期刊文摘（儿科学分册） 2006年第8期2卷 46-46页

作者： Whyte L.H. Soundappan S.V.S. Harvey J. Cass D.T. 朱新菊 Department of Academic Surgery and trauma Children's Hospital at WestmeadSydneyNSW 2145Australia

The diagnosis and management of a 14-year-old girl with isolated traumatic t ransection of the prepylorus after amotor vehicle accident are *** nal computed tomography was useful in the diagnosis of pneumoperitoneum associat ed with hollow viscous *** diagnosis and surgical repair of this unusu al injury resulted in an uncomplicated recovery.

关键词：外伤性横断幽门损伤罕见儿童腹部CT扫描快速诊断治疗经过交通事故

Regulation of extracellular bioactive cations in bone tissue microenvironment induces favorable osteoimmune conditions to accelerate in situ bone regeneration

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Bioactive Materials 2021年第8期6卷 2315-2330页

作者： Zhengjie Lin Danni Shen Weixiao Zhou Yufeng Zheng Tiantian Kong Xuanyong Liu Shuilin Wu Paul K.Chu Ying Zhao Jun Wu Kenneth M.C.Cheung Kelvin W.K.Yeung College of Chemistry and Environmental Engineering Shenzhen UniversityShenzhen518060China Department of Orthopaedics and traumatology The University of Hong KongHong KongChina Department of Materials Science and Engineering College of EngineeringPeking UniversityBeijing100871China Shenzhen Key Laboratory for Innovative Technology in Orthopaedic trauma The University of Hong Kong Shenzhen Hospital1 Haiyuan 1st RoadFutian DistrictShenzhenChina Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging Department of Biomedical EngineeringSchool of MedicineShenzhen UniversityShenzhen518060China State Key Laboratory of High Performance Ceramics and Superfine Microstructure Shanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China School of Materials Science&Engineering the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of ChinaTianjin UniversityTianjin300072China Department of Physics Department of Materials Science and EngineeringCity University of Hong KongTat Chee AvenueKowloonHong KongChina Centre for Human Tissues and Organs Degeneration Shenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen518055China State Key Laboratory of Bioelectronics School of Biological Science and Medical EngineeringSoutheast UniversityNanjing210096China

The design of orthopedic biomaterials has gradually shifted from“immune-friendly”to“immunomodulatory,”in which the biomaterials are able to modulate the inflammatory response via macrophage polarization in a local immune microenvironment that favors osteogenesis and implant-to-bone *** the well-known effects of bioactive metallic ions on osteogenesis,how extracellular metallic ions manipulate immune cells in bone tissue microenvironments toward osteogenesis and subsequent bone formation has rarely been ***,we investigate the osteoimmunomodulatory effect of an extracellular bioactive cation(Mg^(2+))in the bone tissue microenvironment using custom-made poly lactic-co-glycolic acid(PLGA)/MgO-alendronate microspheres that endow controllable release of magnesium *** results suggest that the Mg^(2+)-controlled tissue microenvironment can effectively induce macrophage polarization from the M0 to M2 phenotype via the enhancement of anti-inflammatory(IL-10)and pro-osteogenic(BMP-2 and TGF-β1)cytokines *** also generates a favorable osteoimmune microenvironment that facilitates the proliferation and osteogenic differentiation of bone marrow mesenchymal stem *** in vivo results further verify that a large amount of bony tissue,with comparable bone mineral density and mechanical properties,has been generated at an early post-surgical stage in rat intramedullary bone defect *** study demonstrates that the concept of in situ immunomodulated osteogenesis can be realized in a controlled magnesium tissue microenvironment.

关键词： Bone regeneration Osteoimmunomodulatory property Osteoimmune environment Macrophage polarization Magnesium ions

Magnetic resonance imaging in glenohumeral instability

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World Journal of Radiology 2011年第9期3卷 224-232页

作者： Manisha Jana Shivanand Gamanagatti Department of Radiodiagnosis All India Institute of Medical SciencesAnsari Nagar110029 New DelhiIndia Department of Radiology JPNA Trauma CentreAll India Institute of Medical SciencesAnsari Nagar 110029 New DelhiIndia

The glenohumeral joint is the most commonly dislocated joint of the body and anterior instability is the most common type of shoulder *** resonance (MR) imaging,and more recently,MR arthrography,have become the essential investigation modalities of glenohumeral instability,especially for pre-procedure evaluation before arthroscopic *** associated with glenohumeral instability are variable,and can involve the bones,the labor-ligamentous components,or the rotator *** instability is associated with injuries of the anterior labrum and the anterior band of the inferior glenohumeral ligament,in the form of Bankart lesion and its variants;whereas posterior instability is associated with reverse Bankart and reverse Hill-Sachs *** instability often has no labral pathology on imaging but shows specific osseous changes such as increased chondrolabral *** article reviews the relevant anatomy in brief,the MR imaging technique and the arthrographic technique,and describes the MR findings in each type of instability as well as common imaging pitfalls.

关键词： Shoulder joint Instability Magnetic resonance imaging Magnetic resonance arthrogram