Long non-coding RNA H19 regulates neurogenesis of induced neural stem cells in a mouse model of closed head injury

Stem cell-based therapies have been proposed as a potential treatment for neural regeneration following closed head injury.We previously reported that induced neural stem cells exert beneficial effects on neural regeneration via cell replacement.However,the neural regeneration efficiency of induced neural stem cells remains limited.In this study,we explored differentially expressed genes and long non-coding RNAs to clarify the mechanism underlying the neurogenesis of induced neural stem cells.We found that H19 was the most downregulated neurogenesis-associated lnc RNA in induced neural stem cells compared with induced pluripotent stem cells.Additionally,we demonstrated that H19 levels in induced neural stem cells were markedly lower than those in induced pluripotent stem cells and were substantially higher than those in induced neural stem cell-derived neurons.We predicted the target genes of H19 and discovered that H19 directly interacts with mi R-325-3p,which directly interacts with Ctbp2 in induced pluripotent stem cells and induced neural stem cells.Silencing H19 or Ctbp2 impaired induced neural stem cell proliferation,and mi R-325-3p suppression restored the effect of H19 inhibition but not the effect of Ctbp2 inhibition.Furthermore,H19 silencing substantially promoted the neural differentiation of induced neural stem cells and did not induce apoptosis of induced neural stem cells.Notably,silencing H19 in induced neural stem cell grafts markedly accelerated the neurological recovery of closed head injury mice.Our results reveal that H19 regulates the neurogenesis of induced neural stem cells.H19 inhibition may promote the neural differentiation of induced neural stem cells,which is closely associated with neurological recovery following closed head injury.

Induced neural stem cells regulate microglial activation through Akt-mediated upregulation of CXCR4 and Crry in a mouse model of closed head injury

Microglial activation that occurs rapidly after closed head injury may play important and complex roles in neuroinflammation-associated neuronal damage and repair.We previously reported that induced neural stem cells can modulate the behavior of activated microglia via CXCL12/CXCR4 signaling,influencing their activation such that they can promote neurological recovery.However,the mechanism of CXCR4 upregulation in induced neural stem cells remains unclear.In this study,we found that nuclear factor-κB activation induced by closed head injury mouse serum in microglia promoted CXCL12 and tumor necrosis factor-αexpression but suppressed insulin-like growth factor-1 expression.However,recombinant complement receptor 2-conjugated Crry(CR2-Crry)reduced the effects of closed head injury mouse serum-induced nuclear factor-κB activation in microglia and the levels of activated microglia,CXCL12,and tumor necrosis factor-α.Additionally,we observed that,in response to stimulation(including stimulation by CXCL12 secreted by activated microglia),CXCR4 and Crry levels can be upregulated in induced neural stem cells via the interplay among CXCL12/CXCR4,Crry,and Akt signaling to modulate microglial activation.In agreement with these in vitro experimental results,we found that Akt activation enhanced the immunoregulatory effects of induced neural stem cell grafts on microglial activation,leading to the promotion of neurological recovery via insulin-like growth factor-1 secretion and the neuroprotective effects of induced neural stem cell grafts through CXCR4 and Crry upregulation in the injured cortices of closed head injury mice.Notably,these beneficial effects of Akt activation in induced neural stem cells were positively correlated with the therapeutic effects of induced neural stem cells on neuronal injury,cerebral edema,and neurological disorders post–closed head injury.In conclusion,our findings reveal that Akt activation may enhance the immunoregulatory effects of induced neural stem cells on microglial activation via upregulation of CXCR4 and Crry,thereby promoting induced neural stem cell–mediated improvement of neuronal injury,cerebral edema,and neurological disorders following closed head injury.

Fetal Head Compression: Its Possible Role in Neurologic Injury

It is widely assumed that fetal ischemic brain injury during labor derives almost exclusively from severe, systemic hypoxemia with marked neonatal depression and acidemia. Severe asphyxia, however, is one of several causes of perinatal neurological injury and may not be the most common;most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of severe asphyxia. Sepsis, direct brain trauma, and drug or toxin exposure account for some cases, while mechanical forces of labor and delivery that increase fetal intracranial pressure sufficiently to impair brain perfusion may also contribute. Because of bony compliance and mobile suture lines, the fetal skull changes shape and redistributes cerebrospinal fluid during labor according to constraints imposed by contractions, and bony and soft tissue elements of the birth canal as the head descends. These accommodations, including the increase in intracranial pressure, are adaptive and necessary for efficient descent of the head while safeguarding cerebral blood flow. Autonomic reflexes mediated through central receptors normally provide ample protection of the brain from the considerable pressure exerted on the skull. On occasion, those forces, which are transmitted intracranially, may overcome the various adaptive anatomical, cardiovascular, metabolic, and neurological mechanisms that maintain cerebral perfusion and oxygen availability, resulting in ischemic brain injury. Accepting the notion of a potentially adverse impact of fetal head compression suggests that avoidance of excessive uterine activity and of relentless pushing without steady progress in descent may offer protection for the fetal brain during parturition. Excessive head compression should be considered in the differential diagnosis of ischemic encephalopathy.

Knowledge, Attitude, and Practice of Using Helmets in Children amongst Parents to Prevent Head Injuries: A Cross-Sectional Study in Riyadh, Saudi Arabia

Objectives: The primary objective was to characterize the range of Knowledge, Attitude, and Practice (KAP) of Helmet use in children amongst parents to prevent head injuries and death. Methods: This is a cross-sectional study, done by online survey using a snowball sampling technique, the number of included responses were 386 parents (Male and female) living in Riyadh Aged 21 - 60 years old or above. Results: The study showed that there is a difference in Parents’ belief in the importance of helmet use while riding a Bicycle vs Motorcycle/Quad bike and that was affected by parents’ education level, almost all the people who answered the survey (76.7%) agree that it is important for their children to wear a helmet when riding both a Bicycle and a Motorcycle or Quadbike with a cumulative percentage of (93.8%). And almost all agreed on multiple approaches to help increase helmet use be it by forcing rental shops to give out helmets, forcing sellers to recommend the use of helmets, increasing awareness campaigns, and imposing fines for not wearing helmets. Conclusions: This study is the first to explore Family helmet use while riding Bicycles and Motorcycles/Quad bikes. Although Parent’s belief in the importance of helmet use for their children was high, it is clear that the level of practice is low. With that the risk of head injuries might be high, our findings suggest that safety interventions for increasing pediatric helmet use are needed to increase helmet use and reduce the risk of head injury and hospitalization.

The usefulness of diffusion tensor imaging in detection of diffuse axonal injury in a patient with head trauma

Diffuse axonal injury is the predominant mechanism of injuries in patients with traumatic brain injury. Neither conventional brain computed tomography nor magnetic resonance imaging has shown sufficient sensitivity in the diagnosis of diffuse axonal injury. In the current study, we attempted to demonstrate the usefulness of diffusion tensor imaging in the detection of lesion sites of diffuse axonal injury in a patient with head trauma who had been misdiagnosed as having a stroke. A 44-year-old man fell from a height of about 2 m. Brain magnetic resonance imaging （32 months after onset） showed leukomalactic lesions in the isthmus of the corpus callosum and the left temporal lobe. He presented with mild quadriparesis, intentional tremor of both hands, and trunkal ataxia. From diffusion tensor imaging results of 33 months after traumatic brain injury onset, we found diffuse axonal injury in the right corticospinal tract （centrum semiovale, pons）, both fomices （columns and crus）, and both inferior cerebellar peduncles （cerebellar portions）. We think that diffusion tensor imaging could be a useful tool in the detection of lesion sites of diffuse axonal injury in patients with head trauma.

Changes of Nitric Oxide and Its Relationship with Clinical Features,Intracranial Pressure and Outcome in Acute Head Injury

To investigate the content and dynamics of nitric oxide (NO) in the cerebrospinal fluid (CSF) of patients with acute head injury and to clarify the relationship of NO with clinical features and intracranial pressure (ICP) as well as outcomes, 38 adults with acute head injury were studied. Glasgow Coma Scale (GCS) obtained at admission and Glasgow Outcome Scale (GOS) 3 months after injury was assessed. ICP was surveyed via intraventricular catheter and lumbar puncture and CSF samples were obtained simultaneously. NO was determined with Griess reagents. Results showed that NO peak content in the head injury group was significantly higher than that of the control group. During dynamic research, no peak content of mildly injured cases and severely injured ones appeared in different time windows respectively. The peak value of NO was distinctly higher in the severe group than in the mild group. NO peak value of the raised ICP group was remarkably higher than that of the normal ICP group. The peak value of NO was considerately higher in the poor outcome group than in the good outcome group. When the content of NO was over 6. 5 μmol/L, the rate of poor outcome was increased. There existed a correlation between NO and GCS, ICP and GOS. It is concluded that the content of NO was increased in patients with acute head injury and the changes of NO had different time windows in severely injured patients and mildly injured ones. The more sever the injury, the higher the NO content; and the more serious the secondary brain injury and brain edema, the worse the outcomes. When NO is combined with GCS, GOS and ICP, it increases the accuracy of judgement to the degree of head injury and outcome.

Early enteral nutrition supplemented with probiotics improved the clinical outcomesin patients with severe head injury： protocol for a meta-analysis of randomizedcontrolled trials

Objective： The aim of this systematic review of randomized controlled trials （RCTs） is to determine the effects of earlyenteral nutrition supplemented with probiotics on clinical outcomes in patients with SHI.Methods and analysis： A systematic search will be carried out in PubMed, Cochrane Central Register of ControlledTrials （CENTRAL）, China National Knowledge Infrastructure （CNKI）, WanFang database, and Chinese BiomedicalLiterature （CBM） in order to identify the randomized controlled trials （RCTs） investigated the potential of early enteralnutrition supplemented with probiotics on patients with severe head injury, as well as we will also manually check thebibliographies of eligible studies and topic-related reviews. We will assign two investigators to independently search allpotential citations, extracted data, and appraised risk of bias accordingly, and then STATA software version 12.0 will beused to statistically analyze all data.Ethics and dissemination： The ethics approval and patient written informed consent will not be required because allanalyses in the present study will be performed based on data from published studies. We will submit our systematicreview to a peer-reviewed scientific journal for publication.

Comparative numerical study on the child head injury under different child safety seat angles

It has been shown that annually around 1250 children younger than 15 years old die in traffic accident.The number of children who also injured as a consequence of car accidents is noticeably higher.According to the ECE-R44 regulation the safety of children in the cars,the use of a child safety seat(CSS)is highly recommended.Using a CSS would dramatically diminish the injuries of traffic accidents.However,the posture,especially the angle,of a child when seating on a seat may also affect the amount of injury occurs during the accident.It has been revealed that during the accident only few children remained seated in the standard position,and most of them whether slouched or slanted and turned their head to the side-support of the CSS.Extreme positions,such as leaning forward,escaping from the harness or holding feet were also observed.This study aimed to perform a finite element(FE)study to figure out what angle of seating would result in the least amount of injury to the child head in a typical car crash under the speed of 47 km/h.To do that,a 1.5 years old child dummy(a dummy representing the anthropometry of a 1.5 years old child)has been accommodated on a seat under the angles of 15°,30°,and 45°.The results revealed.The resulted displacements in the head after the accident were also calculated at X,Y,and Z directions.The results in this regard indicated a higher displacement at X direction whereas the lowest one was seen at Y direction.The results have implications not only for understanding the amount of injury to the child head after the accident under different seating angles,but also for giving an insight to the CSS industries and families to choose the right seating posture for the child in the car to reduce the severity of injury.

An experimental and clinical study on TXA_2 and PGI_2 content after head injury

The correlation of secondary brain injury with thromboxane A_2(TXA_2) and prostacy- clin (PGI_2) levels following head injury was studied in rats and patients.Thromboxane B_2 (TXB_2) and 6-keto-PGF_(1α) in rat brain homogenate and TXB_2 in cerebral spinal fluid (CSF) of patients with severe head injury were determined by RIA.The effects of ligustrazini hydrochlo- rioi were also tested.The results showed that the concentration of TXB_2 and 6-keto-PGF_(1α) in rat brain was progressively increased within 3h after injury (P<0.01),and the ratio between TXB_2 and 6-keto-PGF_(1α)(T/K value) increased during the early stage after injury,along with the tissue damage aggravation.After the use of ligustrazini hydrochlorioi,TXB_2 content in brain decreased sharply accompanied with a drop in T/K value.Moreover,TXB_2 content in CSF increased within 7 d after injury (P<0.01),and it reached its peak value on the 3rd day. This could indicate that the metabolic imbalance between TXA_2 and PGI_2 might be one of the important factors in the development of secondary brain injury,and ligustrazini hydrochlorioi proved to have a protective effect on the brain tissue by normalizing the metabolism of TXA_2 and PGI_2.In addition,the metabolic disorders of TXA_2 in the brain tissue of head injured pa- tients have much to do with the outcome of the patients.

Significance of computed tomography scans in head injury

Background: In view of the growing population and increased vehicle use, traumatic brain injury is becoming the most common and devastating problem especially in young healthy people. It has occupied second place next to cancer as leading cause of death. In this new era of radiology, computed tomography has become the primary modality of choice in the initial assessment of head injury patients as it is widely available, faster and highly accurate in detecting skull fractures and acute intracranial hemorrhage. Aim: It is to demonstrate the importance of ct scanning in the initial treatment planning, follow up and long term management of patients with acute head injury of varying severity. Patients: A retrospective study has been carried out of 100 cases of acute head trauma with positive CT scanning referred to Narayana medical college and hospital, Nellore, India between 30th April 2012 to 1st May 2013 [1 year retrospective study]. Results: The post traumatic intracranial consequences have been collected, reviewed and analyzed, where in 82% of cases males were involved , and most of the injured people belong to the first three decades of life, the main cause being road traffic accident which is growing in incidence in this 21st century. Most of the cases which were studied showed skull fractures, which indicates that there has been significant trauma and in a single case more than one pathology related to cranium has been seen. The most common post traumatic consequences found in the study of adults are contusions, brain edema and intracerebral hematomas, while other sequelae such as subarachnoid hematomas, subdural hematomas and extradural hematomas are encountered less. Diffuse and focal cerebral edema was being the most common pathology following trauma in children. Conclusion: CT scanning is the primary modality of choice in the diagnostic work up of patients with acute head trauma for identifying the various intracranial consequences following head injury especially within 48 hours which helps in the initial assessment, treatment planning, follow up and long term management of patients.

Effects of thyrotropin-releasing hormone on severe head injury:A preliminary clinical trial

Objective: To evaluate the effects of thyorotropin-releasing hormone (TRH ) on severe head injury.Methods: Eighty--seven severely head injured patients with a Glasgow Coma Scale (GCS ) score of & or less wererandomized into TRH--treated and saline control groups. In TRH treated group. the treatment was started with abolus injection of 0. 2 mg/kg followed by continuous infusion for 2 hours at 0. 2 mg/kg/h. Such treatment wasgiven once a day for 4 times. The patients in control group were given the equivalent normal saline with the samemethod. Results: TRH, administered intravenously after head injury. promoted the recovery of consciousness andGCS score, alleviated the traumatic brain edema, controlled and lowered the intracranial pressure. decreased thelevel of lipid superoxides, decreased the mortality rate. and improved the life quality of the survivals. Nocomplications or adverse and toxic effects were noted during the course of TRH treatment. Conclusion: TRH hasbeneficial effects on patients with severe head injury.

Detection of the Severity of Brain Injury in Head Trauma Patients Using Biochemical Blood Markers and Its Correlation with Glasgow Coma Scale

Head trauma is one of common injury related mortality and morbidity. Blood biomarkers are valuable tools for the identification and characterization of initial injury and secondary pathological processes for traumatic brain injury (TBI). This study evaluated the performance of a recently developed visfatin and its correlation with other blood circulating biomarkers that reflect specific pathological mechanisms including neuro inflammatory, neuron injury and oxidative damage in moderate to severe TBI patients. Peripheral blood was taken from TBI patients (n = 78) at hospital admission, maximum 6 hours post-injury. Severity and neurological outcome were assessed using the Glasgow Coma Scale (GCS) and blood level of: visfatin, neuron specific enolase (NSE), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH). Concentrations of visfatin (28 ± 1.68 μg/L, 25 ± 2.09 μg/L) was significantly higher (p < 0.0001) in sever and moderate groups of TBI patients respectively compared to control group (7.62 ± 0.87 μg/L), NSE concentrations also were significantly higher (p < 0.0001) in both groups of TBI patients (20.47 ± 3 ng/ml, 13.49 ± 2.66 ng/ml) compared to control group (4.3 ± 0.52 ng/ml), MDA was significantly elevated (p < 0.001) in sever TBI patients group (6.88 ± 0.58 μmol/L) compared to control group (5.12 ± 0.76 μmol/L), while SOD (245.12 ± 24.2 U/L, 276.097 ± 30.8 U/L) and GSH (112.07 ± 2.09 μmol/L, 119.26 ± 2.7 μmol/L) were highly significantly decreased (p < 0.0001) in TBI patients compared to control group (304.17 ± 27.17 U/L and 151.64 ± 9.9 μmol/L) respectively. Visfatin was positively correlated with NSE and MDA, while there was negative correlation with SOD and GSH. In conclusion blood level of visfatin in correlation with other blood biomarkers can be used for prediction of severity of TBI cases.

Risk factors of posttraumatic cerebral infarction in patients with severe and extremely severe head injury

Objective To explore pathogenesis and risk factors for posttraumatic cerebral infarction (PTCI) in patients with severe and extremely severe head injuries for the purpose of providing clues for reducing occurrence of PTCI and case-fatality. Methods Gender,age,Glasgow coma scale (GCS) ,the presence or absence of basicranial fracture,cerebral hernia or infection,surgical modality,hypotension,and the use of diuretics

有限元方法在脑震荡领域的热点:脑损伤模型、测试方法与防护装备的改进

背景:由身体接触性运动或交通事故造成的脑震荡远比人们想象的更为严重与常见,近年来引起了媒体、医学界及体育界的广泛关注与高度重视。目的:采用文献计量学方法对有限元方法在脑震荡领域的研究热点与趋势进行可视化分析,从而为中国在该领域的研究提供一定的参考。方法:基于Web of Science核心集数据库进行文献检索,检索主题词策略为(TS=(Concussion)) AND TS=(Finite element),利用CiteSpace 6.2.R4可视化工具对纳入文献的作者、国家、机构、关键词及被引文献等进行可视化分析。结果与结论:(1)共计纳入215篇文献,发文量与被引量总体上呈上升趋势;学科分布涉及生物医学工程、生物物理学、运动科学、临床神经学及神经科学等学科,呈现多学科交叉融合的趋势;发文量最多的作者是来自爱尔兰都柏林大学的Gilchrist M,发文量最多的机构是渥太华大学,发文量最多的国家是美国。(2)通过关键词分析发现研究的热点聚焦于脑损伤模型的建立用来模拟和预测脑震荡的损伤;脑震荡损伤机制的解析;防护设备和装置的优化设计。(3)通过文献共被引分析发现脑损伤的预测与评估是该领域的知识基础亦是研究热点。(4)有限元方法运用在脑震荡领域的研究热点主要围绕头部损伤预测为主题展开,结合探索大脑损伤机制以及防护装备的设计与改进。(5)随着人工智能与材料学的进步,未来有限元方法在脑震荡损伤领域的研究热点将集中于脑损伤模型、测试方法与防护装备的改进。

基于精神情感状况导向的照护模式在重症颅脑损伤术后恢复期患者中的应用

目的 探讨基于精神情感状况导向的照护模式在重症颅脑损伤术后恢复期患者中的应用效果。方法 选取2020年2月至2023年2月湖南中医药高等专科学校附属第一医院100例重症颅脑损伤恢复期患者,以奇偶数法分为对照组和干预组,各50例。对照组于术后恢复期给予常规护理干预,干预组在对照组的基础上给予基于精神情感状况导向的照护模式干预,干预1个月。比较两组干预前后负面情绪[焦虑自评量表(SAS)及抑郁自评量表(SDS)]、日常生活活动能力[改良Barthel指数(MBI)]及认知功能[蒙特利尔认知评估量表(Mo CA)]。结果 干预后,两组SAS、SDS评分低于干预前,且干预组低于对照组(P<0.05);两组MBI、Mo CA评分高于干预前,且干预组高于对照组(P<0.05)。结论 基于精神情感状况导向的照护模式可改善重症颅脑损伤术后恢复期患者的负面情绪,提高日常生活活动能力和认知功能。

平头车变长头车以保护行人头部损伤的方法及效能研究

为提升平头车保护人体头部损伤的能力和法规上的接受水平,通过推导车头伸出长度公式而给出一种使平头车变长头车的方法,随后通过理论和仿真分析研究所提方法的损伤防护效果及摩擦因数、车速和行人身高等因素对防护效果的影响规律。结果显示:所提方法能极显著降低行人头部损伤,且在低速、低摩擦、矮行人身高下防护效果更佳。分析发现伸出可变车头长度优于固定车头长度,而在获得更高精度行人损伤风险曲线后可进一步优化所提方法。该研究将为M类、N类等大型平头车辆保护行人提供新思路,为它们利用长头车智能安全技术以更好地保护行人提供支持。

两轮电动车骑车人头部损伤的生物力学分析

两轮电动车(powered two-wheeler,PTW)骑车人头部损伤是我国道路交通事故中一种常见的伤害类型,完善骑车人头部损伤评价标准对制定两轮电动车骑车人安全法规以降低碰撞损伤风险具有重要意义。本文采用头部具有详细解剖学结构的人体数值模型进行骑车人-车辆碰撞仿真,对头部进行生物力学分析和损伤评估,并与行人-车辆碰撞中行人头部损伤进行对比分析。研究发现行人和骑车人在车辆碰撞事故中运动学响应较为相似,但头部生物力学响应存在差异,骑车人头部损伤风险高于行人。同时发现骑车人握力因素影响头部的运动学响应,应考虑其在两轮电动车骑车人头部损伤评估中的影响。

新型经鼻气管插管固定器在头颈外科手术中的应用评价

目的探讨一种新型经鼻气管插管固定装置在头颈外科手术中的应用效果。方法选取2020年6月~2021年4月在我院中心手术室经鼻气管插管全身麻醉手术的成年患者180例,采用随机数字表法分成观察组和对照组,每组90例。观察组采用自主研发的新型经鼻气管插管固定装置固(获得国家新型实用专利授权,专利号:ZL 202020903995.3),对照组采用常规方法结合水胶体敷料固定。比较两组鼻部压力性损伤、呼吸管路松动的发生率,以及通过视觉模拟量表方法比较麻醉医生和手术室护士对两种固定方法的满意度。结果观察组患者鼻翼压力性损伤的发生率为3.33%(3/90),对照组为12.2%(11/90),观察组发生率明显低于对照组,差异有统计学意义(χ^(2)=5.149,P<0.05)。观察组患者中无一例发生因术中转变头位导致的呼吸通路过滤器与气管插管衔接口松动或脱落,对照组中共发生7次。麻醉科医护人员对两种固定方式的满意度调查,观察组医护人员平均得分为(8.0160.673),对照组平均得分(3.1731.006),观察组满意度高于对照组,得分有显著性统计学差异(t=6.245,P<0.05)。结论使用新型经鼻气管插管固定装置能显著降低鼻部压力性损伤的发生率,不增加其他部位的压力性损伤。并且能预防术中呼吸管路松动脱落,便于麻醉医护人员使用,值得在临床推广使用。

重型颅脑损伤患者胃肠功能衰竭风险预测模型的建立

目的建立重型颅脑损伤(sTBI)患者胃肠功能衰竭风险预测模型,并进行验证。方法选择2019年1月至2023年3月达州市中西医结合医院神经外科接诊的147例sTBI患者资料进行分析。收集可能影响sTBI患者胃肠功能衰竭的相关因素,根据急性胃肠道损伤(AGI)分级将患者分为胃肠功能衰竭组与非胃肠功能衰竭组,以LASSO筛选出潜在影响因素后行多因素Logistic回归分析,根据多因素分析结果建立列线图模型并进行验证。结果本研究模型组102例sTBI患者中共有33例(32.35%)出现胃肠功能衰竭,多因素Logistic回归分析结果显示:机械通气情况、休克、通便措施、肺部感染情况、血钠、人肠脂肪酸结合蛋白(iFABP)、D-乳酸及二胺氧化酶(DAO)为sTBI患者胃肠功能衰竭的独立性影响因素(P<0.05)。ROC分析显示模型组曲线下面积(AUC)为0.942,95%CI为0.896~0.988;验证组AUC为0.908,95%CI为0.849~0.966。校准曲线结果显示,预测曲线与标准曲线基本拟合。决策曲线分析结果显示,当列线图模型预测sTBI患者胃肠功能衰竭风险的概率阈值为0.10~0.90时,患者的净收益率大于0。结论sTBI患者胃肠功能衰竭主要受机械通气情况、休克、通便措施等相关因素的影响,本研究基于上述因素建立的列线图预测模型用于预测sTBI患者胃肠功能衰竭具有较高的准确度与区分度。

急诊入院整形美容技术修复146例头面部软组织损伤患者的护理体会

目的总结急诊入院整形美容技术修复146例头面部软组织损伤患者的护理经验。方法选择2023年4月至2023年12月焦作市第二人民医院急诊科收治的146例头面部软组织损伤患者作为研究对象;创面类型为单处线性118例,单处缺损15例,多处创伤11例,贯穿伤2例。患者入院时做好评估,给予个性化心理护理缓解其不良情绪,术前向患者介绍整形美容技术的特点、费用,术中做好配合,术后做好创面护理和皮瓣护理,院外延续性护理对患者饮食和创面护理进行指导。结果单处线性创伤118例患者,均一期愈合,术后9例遗留瘢痕,切口长度均≥5 cm;单处缺损15例,2例患者缺损面积较大,需进行二期肉芽创面植皮,为二期愈合;其余13例均为1期愈合,3例患者遗留瘢痕。多处创伤11例,均一期愈合,未见遗留明显瘢痕。贯穿伤2例患者均一期愈合,未遗留瘢痕。结论整形美容技术是急诊科修复头面部软组织损伤的主要方式,对术前评估和针对性的心理护理、术前沟通,可促进患者对整形美容技术的理解和应用,术后护理和延续性护理,可保证术后修复美容效果。