Objective: An accurate scoring system for intra-abdominal injury (IAI) based on clinical manifesta- tion and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is de- s...Objective: An accurate scoring system for intra-abdominal injury (IAI) based on clinical manifesta- tion and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is de- signed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT) admitted to the emergency department (ED) of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chi- square test and logistic regression were done. Factors with significant relationship with CT scan were imported in multi- variate regression models, where a coefficient (13) was given based on the contribution of each of them. Scoring systemwas developed based on the obtained total [3 of each factor. Results: Altogether 261 patients (80.1% male) were enrolled (48 cases of IAI). A 24-point blunt abdominal trauma scoring system (BATSS) was developed. Patients were di- vided into three groups including low (score〈8), moderate (8≤score〈12) and high risk (score≥ 12). In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%). Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%). The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%). Conclusion: The present scoring system furnishes a high precision and reproducible diagnostic tool for BAT detection and has the potential to reduce unnecessary CT scan and cut unnecessary costs.展开更多
Since the late 20th century owing to the improvement of spinal surgery techniques, the diagnosis and treatment of thoracolumbar fracture have been perfected more and more. Although the advent of modern spinal surgery ...Since the late 20th century owing to the improvement of spinal surgery techniques, the diagnosis and treatment of thoracolumbar fracture have been perfected more and more. Although the advent of modern spinal surgery in China was late, we have gained some advanced achievements owing to various international communications benefited from the open policy. Therefore, it is essential to evaluate the current status and perspective of diagnosis and treatment of thoracolumbar fracture. There are several issues we would like to discuss here.展开更多
Current states of traumatic eye injury are reviewed in terms of epidemiology in the developing countries and developed countries, causes of the trauma, eye injury types, traumatic eye injury diagnostic methods and tre...Current states of traumatic eye injury are reviewed in terms of epidemiology in the developing countries and developed countries, causes of the trauma, eye injury types, traumatic eye injury diagnostic methods and treatments. Trauma-caused vision-threatening conditions such as open global injury, traumatic optic neuropathy and proliferative vitreoretinopathy are particularly discussed. Also the most updated clinic research in China as Eye Injury Vitrectomy Study is discussed. At the end, the current achievements and research in traumatic eye injury in the world are summerized.展开更多
文摘Objective: An accurate scoring system for intra-abdominal injury (IAI) based on clinical manifesta- tion and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is de- signed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT) admitted to the emergency department (ED) of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chi- square test and logistic regression were done. Factors with significant relationship with CT scan were imported in multi- variate regression models, where a coefficient (13) was given based on the contribution of each of them. Scoring systemwas developed based on the obtained total [3 of each factor. Results: Altogether 261 patients (80.1% male) were enrolled (48 cases of IAI). A 24-point blunt abdominal trauma scoring system (BATSS) was developed. Patients were di- vided into three groups including low (score〈8), moderate (8≤score〈12) and high risk (score≥ 12). In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%). Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%). The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%). Conclusion: The present scoring system furnishes a high precision and reproducible diagnostic tool for BAT detection and has the potential to reduce unnecessary CT scan and cut unnecessary costs.
文摘Since the late 20th century owing to the improvement of spinal surgery techniques, the diagnosis and treatment of thoracolumbar fracture have been perfected more and more. Although the advent of modern spinal surgery in China was late, we have gained some advanced achievements owing to various international communications benefited from the open policy. Therefore, it is essential to evaluate the current status and perspective of diagnosis and treatment of thoracolumbar fracture. There are several issues we would like to discuss here.
文摘Current states of traumatic eye injury are reviewed in terms of epidemiology in the developing countries and developed countries, causes of the trauma, eye injury types, traumatic eye injury diagnostic methods and treatments. Trauma-caused vision-threatening conditions such as open global injury, traumatic optic neuropathy and proliferative vitreoretinopathy are particularly discussed. Also the most updated clinic research in China as Eye Injury Vitrectomy Study is discussed. At the end, the current achievements and research in traumatic eye injury in the world are summerized.