改良湿润密闭烧伤疗法治疗因飞溅钢水引起的面颈部烧伤

We present the case of a 35-year-old male foundry worker with painful burns after exposure to splashing 1500°C molten steel. This rare case involves a localized occupational-related molten steel burn on the cervicofacial region. The lesion was induced by hyperthermal contact of the skin with molten steel. This case report highlights a modified moist occluded burn therapy that is applied using a combination of modified chitin wound rehabilitating biogel (AmPoSa (?)) and sterile polyethylene film. The patient in our report achieved favourable aesthetic restoration without residual scars and hyperpigmented areas.

改良湿润封闭烧伤疗法:一种治疗热烧伤的新方法

Severe thermal burns usually result in complex facial problems such as contracture and formation of hyper/hypopigmentation,contracture,hypertrophic scars or deformity,with patients often requiring reconstructive surgery.Therefore,seeking a superior and reliable burn therapy remains a great challenge for plastic and burn surgeons.However,the optimal treatment of thermal injuries remains controversial.In the 1960s,a new therapeutic concept,that sterile polyethylene film might be used as a type of moist occlusive dressing,was successively proposed.Below we present a hypothesis that combined utilization of sterile polyethylene film and burn cream may be a novel and superior therapeutic approach for thermal burns.To distinguish this method from traditional moist burn therapy,this new therapy we proposed is named modified moist occlusive burn therapy(MMOBT).

Prognostic value of time to generalization in 71 Chinese patients with sporadic amyotrophic lateral sclerosis

Background:It is important to determine prognostic factors for the outcome of amyotrophic lateral sclerosis (ALS) at an early stage.The time taken for symptoms to spread from spinal or bulbar regions to both (time to generalization;TTG) is considered a strong predictor of survival;however,this has rarely been studied in Asian populations.The aim of this retrospective study was to evaluate potential factors affecting prognosis in Chinese patients with sporadic ALS,with a focus on the association between TTG and overall survival.Methods:Seventy-one patients with sporadic ALS who were hospitalized at Chinese PLA General Hospital from 2009 to 2016 were followed up until December 2017.Survival analysis was performed using univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards models.The clinical data of the patients were recorded and analyzed.Variables studied were age at symptom onset,sex,site of symptom onset,diagnostic latency,TTG,diagnostic category,ALS Functional Rating Scale-revised score,percent predicted forced vital capacity (FVC%),and disease progression rate (DPR) at diagnosis.Results:The mean age at onset was 54 (SD = 10.2) years,and the median survival time from symptom onset was 41 months (95% confidence interval:34–47).By univariate analysis,factors independently affecting survival were age at symptom onset (Log rank = 15.652,P<0.0001),TTG (Log rank = 14.728,P<0.0001),diagnostic latency (Log rank = 11.997,P = 0.001),and DPR (Log rank = 6.50,P = 0.011).In the Cox multivariate model,TTG had the strongest impact on survival time (hazard ratio = 0.926,P = 0.01).Conclusions:TTG can be used as an effective indicator of prognosis in patients with sporadic ALS.

Contact heat evoked potentials in knowledge workers and unskilled labors

Background:Whether occupation has an impact on contact heat evoked potential(CHEP)results has not been investigated.In this study,we investigated the difference of CHEP parameters between knowledge workers and unskilled labors.Methods:A total of 137 healthy participants were recruited between November 20,2014 and December 31,2016.All participants underwent neurologic examination,laboratory examination,and nerve conduction studies.CHEP was performed on four body sites:the upper border of the distal third of the volar forearm,the upper border of the distal third of the lateral leg,the spinous process of seventh cervical vertebrae(C7),and the spinous process of 12th thoracic vertebrae(T12).Independent t test and nonparametric test were performed using SPSS software to compare the difference of the CHEP parameters between knowledge workers and unskilled labors.Results:The“N2 latency/height”(Z=-2.290,P=0.022)and“P2 latency/height”(Z=-2.020,P=0.043)on the volar forearm of unskilled labors significantly increased than those of knowledge workers.The“N2 latency/height”(F=6.348,P=0.016)and“P2 latency/height”(F=5.920,P=0.018)in the distal leg of unskilled labors significantly prolonged than those of knowledge workers.The N2-P2 amplitude(F=5.797,P=0.020)in the distal leg of unskilled labors significantly decreased than those of knowledge workers.Conclusions:Our study found that significantly prolonged N2 latency and P2 latency and significantly decreased N2-P2 amplitude in the distal leg and the volar forearm in unskilled labors as to knowledge workers.