对群众急性运动损伤与意外伤害急救能力的调查

调查显示,群众对发生急性运动损伤与意外伤害事故的急救知识相对缺乏,意识较差,不能有效地处理体育锻炼中的突发事件。为了群众的身体健康,提出了群众要掌握一些基本的医疗常识,体育锻炼中出现意外时要有自我保护和救治能力。

探讨如何在体育训练中防止伤害

在体育训练过程中,由于学生动作不规律或安全措施不充分等多种原因,导致运动损伤的发生,从而对学生的身体产生不利影响。它不仅影响学生的健康,而且影响体育课程的顺利进行。本篇文章分析了体育训练中运动损伤的因素并提出预防措施,有效降低运动损伤风险,保证体育课程的顺利进行。本文围绕着探讨如何在体育训练中的防止伤害进行研究讨论。

Effects of temperature and strain rate on critical damage value of AZ80 magnesium alloy

A series of AZ80 billets were compressed with 60%height reduction on hot process simulator at 250,300,350,400℃ under strain rates of 0.01,0.1,1 and 10 s- 1.In order to predict the occurrence of surface fracture,the values of the Cockcroft-Latham equation were calculated by the corresponding finite element numerical algorithm developed.A concept about damage incremental ratio in plastic deformation was defined as the ratio of damage increment at one step to the accumulated value.A method of finding the intersection of incremental ratio varying curve and simulation step axis was brought forward to make the fracture step certain. Then,the effects of temperature and strain rate on critical damage value were achieved.The results show that the critical damage value is not a constant but changes in a range of 0.021 8-0.378 0.It decreases significantly with the increase of strain rate at a certain temperature.While under a certain strain rate,the critical damage value has little change with the increase of temperature.

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

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 of brain injury in multiple trauma patients. Significant proportion of trauma victims with low GCS had no TBI and their impaired neurological status is related to severe extra-cranial injuries. The findings of this study showed that using of GCS in initial triage and decision making processes in blunt trauma patients needs to be re-evaluated.

Negative pressure wound therapy： An update

Purpose： To get the maximum benefit of vacuum-assisted closure （VAC） in the management of acute and chronic wounds without abuse or misuse. Methods： Fourty one patients were included in the study. Among them, 9 patients had chronic wounds and the rest 32 patients had acute wounds. In acute wounds, 19 patients had co-morbid conditions. Seven patients had gaped wounds, 4 patients had necrotizing fasciitis and 2 patients had enter- ocutaneous fistula. Results： The hospitalization period varied from 1 to 6 weeks. The follow-up period was up to 6 months. No mortality was recorded during this study. All skin grafts showed complete healing. Necrotizing fas- ciitis was managed with good outcome. Wounds with enterocutaneous fistula have improved. In chronic wounds, good healing and excellent outcome were obtained. Conclusion： The VAC therapy is an essential element for the management of problematic acute and chronic wounds.

Epidemiological features of I 281 patients with head injuries arising from the 2008 Wenchuan earthquake

Objective： To analyze the epidemiological features of patients with head injuries in the 2008 Wenchuan earthquake. Methods： Medical records of patients with head injuries who were admitted to 14 hospitals in Deyang, Mianyang and Chengdu cities after the earthquake were retrospectively analyzed. The patients＇ age, gender, cause of injury, diagnosis, and outcome were analyzed retrospectively. Results： A total of 1 281 patients with 807 males and 474 females were included. According to Glasgow Coma Scale score at admission, 1 029 patients presented with mild injury, 161 moderate injury and 91 severe injury. The major cause of injuries （83%） was bruise by collapsed buildings.Open head injuries accounted for 60.8%. A total of 720 patients underwent surgical treatment. Good recovery was achieved in 1 056 patients, moderate disability in 106, se- vere disability in 71, coma in 29 and death in 19. Conclusions： In this series, male patients were more than female patients. The main cause of injury was hit by falling objects due to building collapse. Minor and open craniocerebral injuries were most common. The epidemiological features of head injuries in Wenchuan earthquake may be helpful to preparation for future rescue.

Strengthening Injury Surveillance System in Iran

Objective： To strengthen the current Injury Surveillance System （IS System） in order to better monitor injury conditions, improve protection ways and promote safety. Methods： At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder＇s consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results： The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts.Conclusions： Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire： identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches.

Multiple bilateral lower limb fractures in a 2-year-old child： previously unreported injury with a unique mechanism

Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.

Civilian casualties of Iraqi ballistic missile attack to Tehran, capital of Iran

Objective： To determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war. Methods： Data were extracted from the Army Staff Headquarters based on daily reports of Iranian army units during the war. Results： During 52 days, Tehran was stroked by 118 A1-Hussein missiles （a modified version of Scud missile）. Eighty-six missiles landed in populated areas. During Iraqi missile attacks, 422 civilians died and 1 579 injured （4.9 deaths and 18.3 injuries per missile）. During 52 days, 8.1 of the civilians died and 30.4 injured daily. Of the cases that died, 101 persons （24%） were excluded due to the lack of information. Among the remainders, 179 （55.8%） were maleand 142 （44.2%） were female. The mean age of the victims was 25.3 years＋19.9 years. Our results show that the high accuracy of modified Scud missiles landed in crowded areas is the major cause of high mortality in Tehran. The presence of suitable warning system and shelters could reduce civilian casualties. Conclusion： The awareness and readiness of civilian defense forces, rescue services and all medical facilities for dealing with mass casualties caused by ballistic missile at- tacks are necessary.

Neglected reverse Essex-Lopresti injury with ulnar nerve compression

A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on fight forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnarnerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes.