糖尿病足溃疡的外部创伤因素及发病位置研究进展

糖尿病足溃疡(DFU)是糖尿病的一种常见、严重且具有挑战性的慢性并发症,具有较高的感染风险和下肢截肢风险。DFU是多种病理因素共同作用的结果,目前其发病机制仍未阐明。多种多样的外部创伤因素(如鞋袜相关的损伤、意外创伤、足部护理行为不当)是DFU发生发展的重要外因,不同发病位置具有不同的病理机制和外部创伤条件。正确认识这些外部创伤因素、了解不同发病位置的病变特点是探索DFU发病机制的关键,同时可为临床医师进行糖尿病足防治工作提供合理的参考意见。

创伤性因素对脊柱外科病人围手术期相关凝血指标及深静脉血栓形成发生率的影响

目的探讨创伤性因素对脊柱外科病人围手术期相关凝血指标及深静脉血栓(DVT)形成发生率的影响。方法以45例因脊柱外伤入院的患者为观察组,以同期非外伤性脊柱手术治疗的45例患者为对照组。对比两组患者术后DVT的发生率及凝血指标水平。结果观察组DVT的发生率为35.56%,高于对照组(15.56%)(P<0.05)。观察组D二聚体、纤维蛋白降解产物(FDP)水平高于对照组,活化部分凝血酶原时间(aPTT)、凝血酶原时间(PT)水平低于对照组(P<0.05)。结论创伤因素可引起患者D二聚体、FDP水平升高,同时aPTT、PT水平降低,此外创伤引起脊柱损伤患者术后DVT的发生率较高。

儿童口腔急症的分析

目的 分析儿童口腔急症的发病特点及防治策略.方法 选取我院2015年10月～2016年1月收治的急症患儿200例作为研究对象,对患儿性别与急症之间的关系、年龄与病因之间的关系以及患儿心理行为特点进行分析.结果 本组200例患儿,创伤因素致病占46.0%,多见于软组织挫裂伤和牙齿挫伤,以〈3岁患儿为主,男患儿多于女患儿;非创伤因素致病占54.0%,多见于根尖周炎和急性牙髓炎,以7～9岁患儿为主,女患儿〉男患儿.结论 儿童口腔急症的处理和防治应考虑到患儿的性别、年龄及心理行为特点,加强宣教和看护尤为重要.

Current status and influencing factors of post-traumatic growth in maintenance hemodialysis

Objective:To study the post-traumatic growth level and influencing factors in patients with maintenance hemodialysis.Methods:A total of 179 patients receiving maintenance hemodialysis from a third-level grade A hospital in Tianjin,China were investigated using Post-traumatic Growth Inventory(PTGI),Perceived Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score for the PTGI was 53.73±16.45.Multiple linear regression analysis showed that social support,coping style,marital status,and family income significantly influenced the post-traumatic growth level in patients undergoing maintenance hemodialysis.These factors explained 41.4%of the variance.Conclusion:Medical staff should help patients under maintenance hemodialysis to fulfill their potentials by boosting the level of social support and to effectively cope with internal conflicts.In addition,nursing staff should provide relevant psychological health education to patients to improve their post-traumatic growth.

Relationship between abdominal trauma or surgery and mesenteric panniculitis

Mesenteric panniculitis is a rare disease characterized by chronic non-specific inflammation of mesenteric fat tissue.Several etiologic and/or associated factors have been reported in the literature so far.Although trauma or surgery is one of the potential etiologic factors for mesenteric panniculitis,to the best of our knowledge,no strong correlation has been shown in the literature until now.

Risk Factors Analysis on Traumatic Brain Injury Prognosis

Objective To investigate the independent risk factors of traumatic brain injury （TBI） prognosis. Methods A retrospective analysis was performed in 885 hospitalized TBI patients from January 1, 2003 to January 1, 2010 in the First Affiliated Hospital of Medical College of Xi＇an Jiaotong LIniversity. Sin- gle-factor and logistic regression analysis were conducted to evaluate the association of different variables with TBI outcome. Results The single-factor analysis revealed outcome, including age （P=0.044 for the age group （P〈0.O01）, cerebrospinal fluid leakage （P〈0.001）, reflex （P〈0.001）, shock （P〈0.001）, associated （P〈0.001）, cerebral contusion （P〈0.001）, diffuse significant association between several variables and TB1 40-60, P〈0.00l for the age group ≥60）, complications Glasgow Coma Scale （GCS） （P〈0.001）, pupillary light extra-cranial lesions （P=0.01）, subdural hematoma axonal injury （P〈0.001）, and subarachnoid hemorrhage （P〈0.001）, suggesting the influence of those factors on the prognosis of TBI. Furthermore, logistic regression analysis identified age, GCS score, pupillary light reflex, subdural hematoma, and subarachnoid hemorrhage as independent risk factors of TB1 prognosis. Conclusion Age, GCS score, papillary light reflex, subdural hematoma, and subarachnoid hemorrhage may be risk factors influencing the prognosis of TBI. Paying attention to those factors might improve the outcome of TBI in clinical treatment.

The Roots of Psychological Trauma and Post-TraumaticStress Reaction/Disorders and the Intervention

Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and the improper coping of these events will lead to a post-traumatic stress disorder. In this paper, the author makes an exploration on the roots of psychological trauma and of post-traumatic stress reaction or disorders, which were caused by natural traumatic event, such as floods, snowstorms, earthquakes and other man-made factors such as wars, accidents from a psychological point of view. Finally, some suggestions of intervention are provided for the relevant departments to make relevant rebuilding policies.

The Study on the Sports Injuries and Psychological Stress of Chinese Elite Players

Through national gymnastics to 30 active athletes and 30 national women＇s handball training athletes, which results in the paper are as follows： outstanding gymnastics. The main part of injury is elbow, ankle, and the degree of damage to elbow as the worst. Women＇s handball player injury occurred campaign main pan is knees joint, ankle, with the most serious level of knee injuries. Outstanding women athletes in gymnastics and handball injury occurred campaign＇s state anxiety level is higher, were reached 49.37 ± 94 and 49. 00 ±61.3, excellent gymnast sports injury of the main source of stress for coach criticism, leading opponent table Now when the good. Good men＇s gymnastics athlete sports injury of main source of stress for physical or psychological made a mistake, coach criticism, suffered severe pain or injury After. Outstanding female handball player of the main source of the sports injury stress for the referee injustice, not the bad climate space equipment and error, etc. 4, excellent gymnastics The main way to deal with the players face for attributed to the outside world not controllable factors, focus your attention on the action or distracting, excellent handball in the athletes to diversify To strengthen the way to deal with the game for faith, quickly forget unhappy experience and experience of stress take more carefully way. The abstract should summarize the contents of the paper and should contain at least 70 and at most 150 words. It should be set in 9-point font size and should be inset 1.0 cm from the fight and left margins. There should be two blank （10-point） lines before and aiter the abstract. This document is in the required format.

Quality of life and its influencing factors in patients with post-traumatic epilepsy

Objective： To observe the quality of life in patients with post-traumatic epilepsy and discuss the infuencing factors. Methods： We assessed 105 patients with post-traumatic epilepsy and 100 healthy people as control using Quality of Life Scale-31 （QOL-31）, Self-rating Depressing Scale （SDS） and Self-rating Anxiety Scale （SAS）, and conducted retrospective analysis on the depression, anxiety, site of trauma, control of seizure, EEG and therapeutic compliance. Results： Patients with post-traumatic epilepsy scored much lower than the control group on QOL-31 （P〈0.01）, but higher than the control group on SDS and SAS （P〈0.01）. Multiple regression analysis indicated that major influencing factors on the quality of life were anxiety, therapeutic compliance, depression, poor control of epileptic seizure and site of trauma. Conclusions： The quality of life in patients with posttraumatic epilepsy has significantly declined. Doctors should pay attention to psychological and mental problems of patients with epilepsy, such as depression and anxiety, enhancing therapeutic compliance and controlling epileptic seizure, which are the keys to improving prognosis.

Current understanding of neuroinflammation after traumatic brain injury and cell-based therapeutic opportunities

Traumatic brain injury （TBI） remains a major cause of death and disability worldwide, Increasing evidence indicates that TBI is an important risk factor for neurodegenerative diseases including Alzheimer＇s disease, Parkinson＇s disease, and chronic traumatic encephalopathy. Despite improved supportive and rehabilitative care of TBI patients, unfortunately, all late phase clinical trials in TBI have yet to yield a safe and effective neuroprotective treatment. The disappointing clinical trials may be attributed to variability in treatment approaches and heterogeneity of the population of TBI patients as well as a race against time to prevent or reduce inexorable cell death. TBI is not just an acute event but a chronic disease. Among many mechanisms involved in secondary injury after TBI, emerging preclinical studies indicate that posttraumatic prolonged and progressive neuroinflammation is associated with neurodegeneration which may be treatable long after the initiating brain injury. This review provides an overview of recent understanding of neuroinflammation in TBI and preclinical cell-based therapies that target neuroinflammation and promote functional recovery after TBI.

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. Methods： This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveil- lance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score （ISS）, surgical intervention, length of hospitalization, intensive care unit （ICU） admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 （SPSS Inc., Chicago） and p 〈 0.05 is considered to be statistically significant. Results： The incidence of nosocomial infection was 7.2% （p 〈 0.001）. Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients （p 〈 O.001 ）. Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.

Progresses in understanding trauma-induced coagulopathy and the underlying mechanism

Trauma-induced coagulopathy （TIC） is a clinical syndrome caused by imbalance between clotting, anti- coagulation and fibrinolysis resulting from multiple pathological factors such as hemorrhage and tissue injury in the early stage of trauma, and is closely related to the outcome of trauma patients. It is proved in growing evidence that the endogenous coagulation disturbance in trauma itself is the activating factor of TIC, rather than dilution or other acquired coagulopathy. Therefore, a thorough understanding of the molecular mechanisms in the pathogenesis and progression is crucial for effective prevention and treatment in patients with TIC. This review focuses on transitions in the concept of TIC and mechanical progress.

Effect of retension sutures on abdominal pressure after abdominal surgery

To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients. Methods： This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the ＂U＂ type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure （IVP） was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded. Results： During the operation, the IVP decreased and then increased; it was at its lowest I h after the start of the operation （5.3 mmHg _＋ 3.2 mmHg） and peaked after tension-reducing （8.8 mmHg _＋ 4.0 mmHg）. The IVP values in the ＂U＂ type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation （p 〈 0.005）. The Visual Analogue Scale （VAS） pain scores were 3.9 ~ 2.2, 3.8 ~ 2.0, and 3.0 _＋ 1,0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the ＂U＂ type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group （p 〈 0,005）. Conclusion： Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.

Epidemiological investigation on Wenchuan earthquakestruck trauma patients admitted to two hospitals of Chongqing

Objective： To study epidemiological characteristics and influential factors of in-hospital patients struck by the Wenchuan earthquake disaster. Methods： The clinical data of 196 cases were collected from 2 hospitals of Chongqing city, including age, sex, occupation, injury site, dwelling and injury severity score. Results： In this series, 31.63% victims＇ age was over 60 years, and 54.08% were farmers. Multiple trauma accounted for 35.71%, and lower limb injury for 33.67%. There was no significant difference on injury severity score between city dwellers and rural ones （P〉0.05）. Conclusion： The earthquake injury is influenced by many factors. More attention should be paid to the treatment at first 5 days after injury and high risk population.

Analysis on the risk factors of intracranial infection secondary to traumatic brain injury

Objective： To discuss the characteristics and risk factors for intracranial infection post traumatic brain injury to prevent and better the clinical care. Methods： Retrospective study of 520 patients with traumatic brain injury were included, 308 male and 212 female. The risky factors of intracranial infection were identified. Results： Thirty two cases （6.54%, 321520） of intracranial infection were diagnosed, lntracranial infection most likely happened 4-10 days after injury. Cerebrospinal fluid leakage, drainage, multiple craniotomies were significant related to intracranial infection. Logistic regression predicted cerebrospinal fluid leakage and drainage as independent factors. Conclusion： Intracranial infection is a serious complication after traumatic brain injury, Patients with drainage or cerebrospinal fluid leakage are more risky for intracranial infection, Aggressive precaution should be taken to better outcome.

Relations of transcription expression of IL-2 with nuclear factor of activated T cells as well as changes of C-Fos and C-Jun after trauma

Objective: To observe the relations among expression of interleukin 2 (IL 2) in spleen lymphocytes, DNA binding activity of nuclear factor of activated T cells (NFAT) and expression of the partly family members C Fos, C Jun after trauma. Methods: A murine closed trauma model was used, animals were sacrificed 6, 12 hours and 1, 4, 7, 10, 14 days, respectively after injury. Spleen lymphocytes were isolated from injured mice and stimulated with concanavalin A. The culture supernatants were harvested and assayed for IL 2 activity. Total RNA was extracted from spleen lymphocytes and assayed for IL 2 mRNA. Nuclear protein was extracted, and the DNA binding activity of NFAT was measured using an electrophoretic mobility shift assay (EMSA), the expressions of C Fos, C Jun protein determined by Western blot analysis. Results: The expressions of IL 2 activity and IL 2 mRNA in spleen lymphocytes were decreased in injured mice compared with those in control mice, and the most obvious decrease appeared on the 4th day after injury. The DNA binding activity of NFAT decreased gradually and reached the minimum that was only 41% of the control on the 4th day after injury, which was closely associated with the decline of IL 2 activity and IL 2 mRNA. An decrease in the expression of C Fos on the 1st and 4th day after injury, trauma had no significant effect on the C Jun expression. Conclusions: These results suggest that the inhibition of IL 2 expression is partly due to the impairment in the activation of NFAT in injured mice; and the decline in the DNA binding activity of NFAT is partly due to trauma block in the C Fos expression.