The series of Harry Potter and the series of The Hunger Games are the most frequently mentioned children's and youngster's stories after The Adventures of Tom Sawyer. Both of them are children's and youngster's fa...The series of Harry Potter and the series of The Hunger Games are the most frequently mentioned children's and youngster's stories after The Adventures of Tom Sawyer. Both of them are children's and youngster's favorite stories. All of them are about children's adventures. But because of the time and history, they represent different themes of the time. This research paper aims at analyzing the Game Spirits in the first two. The suspense and surprise, fantastic adventures and time interweaving are shown in Harry Potter and the Prisoner of Azkaban. And the unbelievable background, the lucky number, image of gamble, and the game against humanity are the Game Spirits in The Hunger Games. The purpose of this thesis is to help people better understand Harry Potter and The Hunger Games in the aspect of Game Spirit. Harry Potter is the full of fantastic adventure while The Hunger Game is a story full of survival.展开更多
Homeless Bird is a 2000 National Book Award novel for young adults by Gloria Whelan. By employing the fairy tale Cinderella as an archetype, Gloria Whelan successfully blends fantasy with realism, building an image of...Homeless Bird is a 2000 National Book Award novel for young adults by Gloria Whelan. By employing the fairy tale Cinderella as an archetype, Gloria Whelan successfully blends fantasy with realism, building an image of new Cinderella, who is independent, courageous, and full of rebelling spirits in a patriarchal society, thus presenting young readers a more familiar and more acceptable access to the harsh reality. With the theme of female initiation, Koly's initiation journey is allegorical which needs to be read as an extended metaphor to exhibit the power of courage and hope in people who determine to take the fate in their own hands.展开更多
Katherine Mansfield is a world famous woman master of short stories in English literature. Her stories are sensitive revelations of human behaiour in quite ordinary situations, through which we can glimpse a powerful,...Katherine Mansfield is a world famous woman master of short stories in English literature. Her stories are sensitive revelations of human behaiour in quite ordinary situations, through which we can glimpse a powerful, and sometimes cruelly pessimistic view of life. A Dill Pickle is one of her short stories published in 1917, describing the encounter between a young woman and a young man who have been lovers six years ago and their lost love and changes over the years. Short as it is, it is really worth our earful analysis and appreciation. This paper will comment on this short story from the following two aspects: a commont on the theme of the story; a comment on the writing technique of the story. The paper conludes that romantic love is dependent upon circumstances and the convergence of certain character traits at a particular time.展开更多
Turkish people display deep consideration for the concept of hierarchy. Historically, they had been always calculating and measuring the relative positions of authority symbols with respect to one another; because the...Turkish people display deep consideration for the concept of hierarchy. Historically, they had been always calculating and measuring the relative positions of authority symbols with respect to one another; because they had their own dealings with those who held political power. Should they render their young sons to the service of the feudal lords or the state? Should they consent to the say of the local forces or that of the central state power, when it comes to fixing the amounts and/or the kinds of taxes? Sometimes, the ordinary subjects of the Ottoman state were even openly torn apart in dilemmas whereby local powers were revolting against the central government of the Sultan placed at the capitol. Even the anoymous folk tales, which reflect people's opinions and mentalities in a manner very close to the truth, involve comparisons among the levels of power represented by certain officials/figures. When confronted with authority, the usual feeling contains a tint of respect, even though it is mainly a kind of resignition mixed with acceptance, leading to obedience in the end. A true, internalized respect itself is solely that which is directed toward the elderly people of the society. On the other hand, traditionally and conventionally, old age was closely associated with official or informal power and authority, anyhow. However, nowadays, in a very confusing manner, this former social understanding is undergoing rather fast changes with the advent of younger contemporary political figures.展开更多
The namesake channel point selection is a method adopted in acupuncture treatment, in which the points on the six pairs of channels on the upper and lower extremities with same names are selected and needled. Clinical...The namesake channel point selection is a method adopted in acupuncture treatment, in which the points on the six pairs of channels on the upper and lower extremities with same names are selected and needled. Clinically, this method is mainly used for some acute soft tissue injuries, for instance, needling point Yangchi (TE 4) with reducing method for sprain of external malleolus, needling Qiuxu (GB 40) with reducing method for sprain of dorsal carpus, and needling Tiaokou (ST 38) for lateral shoulder pain. The therapeutic effect given by this point selection method is often superior to that given by the conventional needling method. In clinical practice, the author has found some typical cases, which respond well to this method, and reports them below.展开更多
Objective: To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods: We prospecti...Objective: To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods: We prospectively followed 52 children who presented with Gartland type 3 displaced supraeondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing (n=23), followed by fall from height (n=20), road traffic accidents (n-5) and fall from standing height (n=2). In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria. Results: Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn's criteria, 90.4% patients showed satisfactory results. Conclusion: Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup.展开更多
Objective: To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005. Methods: The data of road crash in 2003-2005 were collected to study the characteristics including total vehic...Objective: To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005. Methods: The data of road crash in 2003-2005 were collected to study the characteristics including total vehicle number, occurrence rates of traffic accidents and serious traffic accidents so as to discuss the causes and characteristics of road crash in China. Results: From 2003 to 2005, the numbers of traffic accidents, injuries and deaths as well as the mortality rates per 100 000 persons and per 10 000 vehicles declined in China. Until 2005, the total number of traffic accidents decreased to 450 000 and deaths to 99 000, with the mortality rate per 10 000 vehicles being 7.6 persons. While the drivers and passengers accounted for 33.2 % and 26.6 % of death casualties respectively in 2005. Most traffic accidents were caused by drivers, especially those with driving experience less than 3 years. Traffic accidents occurred on suburban roads accounted for 60%. The mortality rate of the traffic accidents per 100 km on the first grade road ranked the highest. The mortality rate of the traffic accidents on expressways ranked the highest, with continual increase of death and injury. Conclusions. At present, the increase trend of traffic accidents and casualties in China has been slowed down to some extent and shows a declining tendency, but the situation is far away from being optimistic. In order to cut down the number of traffic accidents and casualties, we should pay more attention to training and managing drivers with less than three driving years and those driving buses. Strict prevention measures should be laid on traffic accidents on first grade roads, expressways and suburban roads as well as the enhancement on improving first-aid system.展开更多
Objective: This research analyzes data on road traffic accidents (RTA) in Fars province, whose roads are among the highly dangerous ones in Iran. It inves- tigates educational level and age involved in RTA in order...Objective: This research analyzes data on road traffic accidents (RTA) in Fars province, whose roads are among the highly dangerous ones in Iran. It inves- tigates educational level and age involved in RTA in order to discover patterns that can prevent or decrease accidents. Methods: This research made use of data visualization techniques to find hidden patterns. The data included mor- tality rate related to RTA in Fars province and were obtained from Fars Forensic Medicine Registry covering a period of 1 year from March 21, 2010 to March 21, 2011. All data were analyzed using SPSS 11.5. The results were reported as de- scriptive indices such as frequency (percentage). The Chi- square test was applied to the data concerning educational level and age. P value less than 0.05 was considered significant. Results: In the mentioned period, 1 831 people were killed, out of whom un/lowly educated people (69.6%) ac- counted for the highest mortality rate. The significant rela- tionship between educational level and mortality rate was found (X2=275.98, P〈0.0001). Also three was a significant association between age and mortality rate (X2=371.20, P〈0.0001). Young people (age between 20 and 29 years) contribute to higher RTA mortality rate compared with other age groups. Conclusion: The educational level and age are signifi- cantly correlated to mortality rate. The youth and un/lowly educated people suffer more fatal RTA.展开更多
Objective: To make an epidemiological analysis of the effect of environment on extremely severe road traffic crashes (RTCs). Methods: Epidemiologic data of extremely severe RTCs associated with environmental factors, ...Objective: To make an epidemiological analysis of the effect of environment on extremely severe road traffic crashes (RTCs). Methods: Epidemiologic data of extremely severe RTCs associated with environmental factors, including weather, topography, road conditions and other traffic conditions in China's Mainland during 2000-2001, were collected and analyzed. Results: (1) During 2000-2001, there were (3 365) extremely severe RTCs with (13 666) deaths, (12 204) injuries and a direct economical loss of 136 million RMB. (2) Most extremely severe RTCs occurred in fine weather days and in the daytime. The high occurrence sites were plain areas, horizontal and straight roads, Grade B and C roads, ordinary road segment, and asphalt, smooth and mixed roads. (3) Compared with other RTCs, extremely severe RTCs were more likely to happen under following conditions: on cloudy, snowing, misty and blustering days; in hill and mountainous areas; on crooked and sloping roads; on freeway, Grade A, B, and C roads; mixed roads; ordinary, bridge, narrow and transitional roads; sand and dirt-roads; without traffic control measures; night without lighting. (4) Extremely severe RTCs of mountainous area or crooked and sloping roads were most severe in terms of deaths and injures per crash. Conclusions: Extremely severe RTCs are closely related with environmental factors. Rational road programming, enhancing road establishment and improving road conditions are probably effective measures to reduce the road traffic injuries.展开更多
Objective: The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving. This study attempts to revisit and compare extramedullary vs. intramedullary devices...Objective: The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving. This study attempts to revisit and compare extramedullary vs. intramedullary devices in relatively young population. Methods: Thirty patients with subtrochanteric fractures were enrolled and treated with extramedullary or intramedullary devices and follow-up continued one year for clinico-radiological assessment. Results: The mean age of patients was 37,53 years. Most were males between 21-40 years. The dominant mode of injury was traffic accidents (66%). Fractures were classified according to Russell-Taylor classification. Forty percent were Russell-Taylor type IA, 37% type IB and 23% type IIA. Average time to surgery was 3.6 days from the time of admission to hospital. Mean duration of surgery was 45 minutes for intramedullary device (group A) and 105 minutes for extramedullary device (group B). Average blood loss was 100 ml in group A and 200 ml in group B. Mean duration of radiation exposure was 130 seconds and 140 seconds for groups A and B, while average duration of hospital stay was 12 days and 16 days respectively. Excellent results were seen in 47% of cases in group A and 33% of cases in group B. Conclusion: Intramedullary device is a reliable implant for subtrochanteric fractures. It has high rates of union with minimal soft-tissue damage. Intramedullary fixation has biological and biomechanical advantages, but surgery is technically demanding. Gradual learning and patience is needed to make this method truly rewarding.展开更多
Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30...Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30- year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 1 l0 (right) degrees and 100 (left)degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.展开更多
Purpose: Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of o...Purpose: Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. Methods: This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-lfi software by means of means _+ standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level ofp 〈 0.05. Results: In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male (65 patients, 79.3%). Their mean age was (25.4 ± 21.4) years, with an age range of 20-40 years (30 patients, 36.6%). Hyphema was the most common injury (26 patients, 25.5%), home was the most frequent incident location (32 patients, 39%), and knife or other cutting tools were mostly responsible for injuries (18 patients, 21.9%). Patients were hospitalized for 1-6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. Conclusion: The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.展开更多
:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding s...:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods:Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results:Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan' an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district(27.49/100 000,7.13/100 000,P〈0.01).However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan'an district(10.00%,P〈0.01).Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions:The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.展开更多
Purpose: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being chall...Purpose: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC). Methods: A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients (age 〉 16 years) sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Results: Two hundred and ninety-three patients were identified, with a mean injury severity score (ISS) of 28.9 (range 9-75), average age of 56.1 years (range of 16-100), and a male predominance (78%). Road traffic accidents accounted for 45% (n = 132) of injuries, whilst 44% were fall or jump from height (n = 129). Associated lung contusion was present in 133 patients (45%) while 76% of patients were found to have 5 or more ribs involved in the flail segment (n = 223) with 96% (n = 281 ) having a unilateral FC. Inpatient treatment was required 19.9 days (range 0-150 days) with 59% of patients (n = 173) requiring intensive care unit (ICU) level care for 8.4 days (range 1-63) with 61.8% requiring mechanical ventilation (n = 107) for 10.5 days (range 1-54), and Z8g underwent rib fixation with rib plates (n = 23). The mortality rate was found to be 14% (n = 42). A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days (6.94 vs 10.06, p = 0.18) intensive treatment unit (ITU) length of stay (LOS) (12.56 vs 15.53, p = 0.28) and hospital LOS (32.62 vs 35.24, p = 0.69). Conclusion: This study has successfully described the natural history of flail chest injuries, and has found a nonsignificant trend towards better outcomes with conservative management. With the cohort and management challenges now defined, work on outcome improvement can be targeted. In addition the comnarahility of results to other studies makes collaboration with other MTCs a realistic vrovosal.展开更多
文摘The series of Harry Potter and the series of The Hunger Games are the most frequently mentioned children's and youngster's stories after The Adventures of Tom Sawyer. Both of them are children's and youngster's favorite stories. All of them are about children's adventures. But because of the time and history, they represent different themes of the time. This research paper aims at analyzing the Game Spirits in the first two. The suspense and surprise, fantastic adventures and time interweaving are shown in Harry Potter and the Prisoner of Azkaban. And the unbelievable background, the lucky number, image of gamble, and the game against humanity are the Game Spirits in The Hunger Games. The purpose of this thesis is to help people better understand Harry Potter and The Hunger Games in the aspect of Game Spirit. Harry Potter is the full of fantastic adventure while The Hunger Game is a story full of survival.
文摘Homeless Bird is a 2000 National Book Award novel for young adults by Gloria Whelan. By employing the fairy tale Cinderella as an archetype, Gloria Whelan successfully blends fantasy with realism, building an image of new Cinderella, who is independent, courageous, and full of rebelling spirits in a patriarchal society, thus presenting young readers a more familiar and more acceptable access to the harsh reality. With the theme of female initiation, Koly's initiation journey is allegorical which needs to be read as an extended metaphor to exhibit the power of courage and hope in people who determine to take the fate in their own hands.
文摘Katherine Mansfield is a world famous woman master of short stories in English literature. Her stories are sensitive revelations of human behaiour in quite ordinary situations, through which we can glimpse a powerful, and sometimes cruelly pessimistic view of life. A Dill Pickle is one of her short stories published in 1917, describing the encounter between a young woman and a young man who have been lovers six years ago and their lost love and changes over the years. Short as it is, it is really worth our earful analysis and appreciation. This paper will comment on this short story from the following two aspects: a commont on the theme of the story; a comment on the writing technique of the story. The paper conludes that romantic love is dependent upon circumstances and the convergence of certain character traits at a particular time.
文摘Turkish people display deep consideration for the concept of hierarchy. Historically, they had been always calculating and measuring the relative positions of authority symbols with respect to one another; because they had their own dealings with those who held political power. Should they render their young sons to the service of the feudal lords or the state? Should they consent to the say of the local forces or that of the central state power, when it comes to fixing the amounts and/or the kinds of taxes? Sometimes, the ordinary subjects of the Ottoman state were even openly torn apart in dilemmas whereby local powers were revolting against the central government of the Sultan placed at the capitol. Even the anoymous folk tales, which reflect people's opinions and mentalities in a manner very close to the truth, involve comparisons among the levels of power represented by certain officials/figures. When confronted with authority, the usual feeling contains a tint of respect, even though it is mainly a kind of resignition mixed with acceptance, leading to obedience in the end. A true, internalized respect itself is solely that which is directed toward the elderly people of the society. On the other hand, traditionally and conventionally, old age was closely associated with official or informal power and authority, anyhow. However, nowadays, in a very confusing manner, this former social understanding is undergoing rather fast changes with the advent of younger contemporary political figures.
文摘The namesake channel point selection is a method adopted in acupuncture treatment, in which the points on the six pairs of channels on the upper and lower extremities with same names are selected and needled. Clinically, this method is mainly used for some acute soft tissue injuries, for instance, needling point Yangchi (TE 4) with reducing method for sprain of external malleolus, needling Qiuxu (GB 40) with reducing method for sprain of dorsal carpus, and needling Tiaokou (ST 38) for lateral shoulder pain. The therapeutic effect given by this point selection method is often superior to that given by the conventional needling method. In clinical practice, the author has found some typical cases, which respond well to this method, and reports them below.
文摘Objective: To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods: We prospectively followed 52 children who presented with Gartland type 3 displaced supraeondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing (n=23), followed by fall from height (n=20), road traffic accidents (n-5) and fall from standing height (n=2). In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria. Results: Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn's criteria, 90.4% patients showed satisfactory results. Conclusion: Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup.
基金This work was supported by the National Natural Science Foundation of China (No. 30522201). Acknowledgements: We give special thanks to Traffic Management Bureau of Ministry of Public Security and Traffic Management Bureau of Chongqing for their assistance in collecting corresponding data.
文摘Objective: To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005. Methods: The data of road crash in 2003-2005 were collected to study the characteristics including total vehicle number, occurrence rates of traffic accidents and serious traffic accidents so as to discuss the causes and characteristics of road crash in China. Results: From 2003 to 2005, the numbers of traffic accidents, injuries and deaths as well as the mortality rates per 100 000 persons and per 10 000 vehicles declined in China. Until 2005, the total number of traffic accidents decreased to 450 000 and deaths to 99 000, with the mortality rate per 10 000 vehicles being 7.6 persons. While the drivers and passengers accounted for 33.2 % and 26.6 % of death casualties respectively in 2005. Most traffic accidents were caused by drivers, especially those with driving experience less than 3 years. Traffic accidents occurred on suburban roads accounted for 60%. The mortality rate of the traffic accidents per 100 km on the first grade road ranked the highest. The mortality rate of the traffic accidents on expressways ranked the highest, with continual increase of death and injury. Conclusions. At present, the increase trend of traffic accidents and casualties in China has been slowed down to some extent and shows a declining tendency, but the situation is far away from being optimistic. In order to cut down the number of traffic accidents and casualties, we should pay more attention to training and managing drivers with less than three driving years and those driving buses. Strict prevention measures should be laid on traffic accidents on first grade roads, expressways and suburban roads as well as the enhancement on improving first-aid system.
文摘Objective: This research analyzes data on road traffic accidents (RTA) in Fars province, whose roads are among the highly dangerous ones in Iran. It inves- tigates educational level and age involved in RTA in order to discover patterns that can prevent or decrease accidents. Methods: This research made use of data visualization techniques to find hidden patterns. The data included mor- tality rate related to RTA in Fars province and were obtained from Fars Forensic Medicine Registry covering a period of 1 year from March 21, 2010 to March 21, 2011. All data were analyzed using SPSS 11.5. The results were reported as de- scriptive indices such as frequency (percentage). The Chi- square test was applied to the data concerning educational level and age. P value less than 0.05 was considered significant. Results: In the mentioned period, 1 831 people were killed, out of whom un/lowly educated people (69.6%) ac- counted for the highest mortality rate. The significant rela- tionship between educational level and mortality rate was found (X2=275.98, P〈0.0001). Also three was a significant association between age and mortality rate (X2=371.20, P〈0.0001). Young people (age between 20 and 29 years) contribute to higher RTA mortality rate compared with other age groups. Conclusion: The educational level and age are signifi- cantly correlated to mortality rate. The youth and un/lowly educated people suffer more fatal RTA.
文摘Objective: To make an epidemiological analysis of the effect of environment on extremely severe road traffic crashes (RTCs). Methods: Epidemiologic data of extremely severe RTCs associated with environmental factors, including weather, topography, road conditions and other traffic conditions in China's Mainland during 2000-2001, were collected and analyzed. Results: (1) During 2000-2001, there were (3 365) extremely severe RTCs with (13 666) deaths, (12 204) injuries and a direct economical loss of 136 million RMB. (2) Most extremely severe RTCs occurred in fine weather days and in the daytime. The high occurrence sites were plain areas, horizontal and straight roads, Grade B and C roads, ordinary road segment, and asphalt, smooth and mixed roads. (3) Compared with other RTCs, extremely severe RTCs were more likely to happen under following conditions: on cloudy, snowing, misty and blustering days; in hill and mountainous areas; on crooked and sloping roads; on freeway, Grade A, B, and C roads; mixed roads; ordinary, bridge, narrow and transitional roads; sand and dirt-roads; without traffic control measures; night without lighting. (4) Extremely severe RTCs of mountainous area or crooked and sloping roads were most severe in terms of deaths and injures per crash. Conclusions: Extremely severe RTCs are closely related with environmental factors. Rational road programming, enhancing road establishment and improving road conditions are probably effective measures to reduce the road traffic injuries.
文摘Objective: The treatment of subtrochanteric fractures is challenging and treatment modalities and implants are constantly evolving. This study attempts to revisit and compare extramedullary vs. intramedullary devices in relatively young population. Methods: Thirty patients with subtrochanteric fractures were enrolled and treated with extramedullary or intramedullary devices and follow-up continued one year for clinico-radiological assessment. Results: The mean age of patients was 37,53 years. Most were males between 21-40 years. The dominant mode of injury was traffic accidents (66%). Fractures were classified according to Russell-Taylor classification. Forty percent were Russell-Taylor type IA, 37% type IB and 23% type IIA. Average time to surgery was 3.6 days from the time of admission to hospital. Mean duration of surgery was 45 minutes for intramedullary device (group A) and 105 minutes for extramedullary device (group B). Average blood loss was 100 ml in group A and 200 ml in group B. Mean duration of radiation exposure was 130 seconds and 140 seconds for groups A and B, while average duration of hospital stay was 12 days and 16 days respectively. Excellent results were seen in 47% of cases in group A and 33% of cases in group B. Conclusion: Intramedullary device is a reliable implant for subtrochanteric fractures. It has high rates of union with minimal soft-tissue damage. Intramedullary fixation has biological and biomechanical advantages, but surgery is technically demanding. Gradual learning and patience is needed to make this method truly rewarding.
文摘Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30- year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 1 l0 (right) degrees and 100 (left)degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.
文摘Purpose: Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. Methods: This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-lfi software by means of means _+ standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level ofp 〈 0.05. Results: In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male (65 patients, 79.3%). Their mean age was (25.4 ± 21.4) years, with an age range of 20-40 years (30 patients, 36.6%). Hyphema was the most common injury (26 patients, 25.5%), home was the most frequent incident location (32 patients, 39%), and knife or other cutting tools were mostly responsible for injuries (18 patients, 21.9%). Patients were hospitalized for 1-6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. Conclusion: The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.
文摘:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods:Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results:Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan' an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district(27.49/100 000,7.13/100 000,P〈0.01).However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan'an district(10.00%,P〈0.01).Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions:The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.
文摘Purpose: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC). Methods: A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients (age 〉 16 years) sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Results: Two hundred and ninety-three patients were identified, with a mean injury severity score (ISS) of 28.9 (range 9-75), average age of 56.1 years (range of 16-100), and a male predominance (78%). Road traffic accidents accounted for 45% (n = 132) of injuries, whilst 44% were fall or jump from height (n = 129). Associated lung contusion was present in 133 patients (45%) while 76% of patients were found to have 5 or more ribs involved in the flail segment (n = 223) with 96% (n = 281 ) having a unilateral FC. Inpatient treatment was required 19.9 days (range 0-150 days) with 59% of patients (n = 173) requiring intensive care unit (ICU) level care for 8.4 days (range 1-63) with 61.8% requiring mechanical ventilation (n = 107) for 10.5 days (range 1-54), and Z8g underwent rib fixation with rib plates (n = 23). The mortality rate was found to be 14% (n = 42). A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days (6.94 vs 10.06, p = 0.18) intensive treatment unit (ITU) length of stay (LOS) (12.56 vs 15.53, p = 0.28) and hospital LOS (32.62 vs 35.24, p = 0.69). Conclusion: This study has successfully described the natural history of flail chest injuries, and has found a nonsignificant trend towards better outcomes with conservative management. With the cohort and management challenges now defined, work on outcome improvement can be targeted. In addition the comnarahility of results to other studies makes collaboration with other MTCs a realistic vrovosal.