Objective: To identify how hospital discharge data could discriminate the distribution patterns of high-risk trauma children in mandated and non-mandated trauma systems. Methods: Hospital discharge data of pediatric t...Objective: To identify how hospital discharge data could discriminate the distribution patterns of high-risk trauma children in mandated and non-mandated trauma systems. Methods: Hospital discharge data of pediatric trauma patients 1 - 15 years of age in Florida (FL), USA—[a mature mandated trauma system with certified trauma centers (TCs)] and in Indiana (IN), USA—(an immature non-mandated trauma system) admitted both to trauma center (TC) and non-TC healthcare facilities were analyzed. The injury severity score (ISS) measurement was used to verify injury severities. Results: Analysis showed that the majority of admissions were mild injuries (ISS = 1 - 8), [FL 70%, IN 66%, odds ratio (OR) 1.2, 95% confidence interval (CI) 1.1, 1.3]. Florida trauma children (all severities) generally receive TC care more frequently than Indiana’s (OR = 1.8, CI 1.6 - 1.9). Particularly admission to TCs with severe (ISS ≥ 25) pelvic injury was greater in Florida (OR 3.5, CI 1.6 - 7.4). Florida, encountered some other severe injury mechanisms (motor vehicle accidents, falls) more frequently than Indiana (ORs and CI: 2.2, 1.5 - 3.3 and 3.1, 1.1 - 8.7, respectively). Conclusions: Hospital discharge data can demonstrate the expected patient distribution difference when comparing a mature trauma system with a voluntary evolving system. The level of maturity of the adopted trauma system often influences such difference.展开更多
Background: There is growing evidence suggesting that those who suffer traumatic injury display high levels of perceived injustice which impedes their recovery, both physically and mentally. Aim: The aim of this syste...Background: There is growing evidence suggesting that those who suffer traumatic injury display high levels of perceived injustice which impedes their recovery, both physically and mentally. Aim: The aim of this systematic review was to examine the association between perceived injustice and pain-related, mental health and functional outcomes in patients who have suffered a traumatic injury. Methods: In May 2023, a systematic review of the literature was performed on the electronic databases of PubMed, Google Scholar, Embase, and the Cochrane Database of Systemic Reviews. Papers were collected and analysed as per PRISMA guidelines for systematic reviews. The outcomes of interest were pain intensity, pain interference, disability, depression, anxiety, and quality of life. The initial search identified 59 papers. Of these papers, five studies met the inclusion criteria and were subsequently analysed (N = 1172). Each of the papers was published in peer-reviewed journals in the English language. Individuals with pain or pathology prior to the trauma and those who were not hospitalised following the trauma were excluded from the study. Results: Of the papers reviewed, each study indicated significant associations between perceived injustice and pain, disability, depression, anxiety, post-traumatic stress disorder, as well as reduced return to work status. Conclusion: This systematic review investigated the relationship between perceived injustice and pain-related, mental health, and functional outcomes in trauma patients. The results highlight the negative role that perceived injustice has on recovery following traumatic injury. Further, it provokes the need for future research regarding the implementation of therapeutic interventions and the development of predictive models of injustice.展开更多
Although Canada has a universal health care program that provides free in-hospital services to all citizens,its vast landmass and nonstandardized prehospital and posthospital systems make delivering quality trauma car...Although Canada has a universal health care program that provides free in-hospital services to all citizens,its vast landmass and nonstandardized prehospital and posthospital systems make delivering quality trauma care challenging,particularly to resource-limited rural regions.This article summarizes the strengths of the prehospital system,facility-based care,trauma network,trauma registry,rehabilitation,and governance/financing/quality assurance components of Canada’s trauma system.Future directions,including the use of telemedicine,standardization of practices,and resource optimization,are also explored.Canada’s trauma system is well developed,yet geography impedes equitable access.More standardization and resource optimization are needed.展开更多
Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve ...Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.展开更多
BACKGROUND The increase in severe traumatic brain injury(sTBI)incidence is a worldwide phenomenon,resulting in a heavy disease burden in the public health systems,specifically in emerging countries.The shock index(SI)...BACKGROUND The increase in severe traumatic brain injury(sTBI)incidence is a worldwide phenomenon,resulting in a heavy disease burden in the public health systems,specifically in emerging countries.The shock index(SI)is a physiological parameter that indicates cardiovascular status and has been used as a tool to assess the presence and severity of shock,which is increased in sTBI.Considering the high mortality of sTBI,scrutinizing the predictive potential of SI and its variants is vital.AIM To describe the predictive potential of SI and its variants in sTBI.METHODS This study included 71 patients(61 men and 10 women)divided into two groups:Survival(S;n=49)and Non-survival(NS;n=22).The responses of blood pressure and heart rate(HR)were collected at admission and 48 h after admission.The SI,reverse SI(rSI),rSI multiplied by the Glasgow Coma Score(rSIG),and Age multiplied SI(AgeSI)were calculated.Group comparisons included Shapiro-Wilk tests,and independent samples t-tests.For predictive analysis,logistic regression,receiver operator curves(ROC)curves,and area under the curve(AUC)measurements were performed.RESULTS No significant differences between groups were identified for SI,rSI,or rSIG.The AgeSI was significantly higher in NS patients at 48 h following admission(S:26.32±14.2,and NS:37.27±17.8;P=0.016).Both the logistic regression and the AUC following ROC curve analysis showed that only AgeSI at 48 h was capable of predicting sTBI outcomes.CONCLUSION Although an altered balance between HR and blood pressure can provide insights into the adequacy of oxygen delivery to tissues and the overall cardiac function,only the AgeSI was a viable outcome-predictive tool in sTBI,warranting future research in different cohorts.展开更多
BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present f...BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.METHODS Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of procedures.Review of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected.Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay.Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.CONCLUSION Dental complications occur in approximately 1 in 300 of upper endoscopy cases.These are easily preventable by pre-endoscopy screening.Protocols to mitigate dental injury are also suggested.展开更多
We read with interest the recent systematic reviewaArtificial intelligence and machine learning for hemorrhagic trauma careoby Peng et al.[1],which evaluated literature on machine learning(ML)in the management of trau...We read with interest the recent systematic reviewaArtificial intelligence and machine learning for hemorrhagic trauma careoby Peng et al.[1],which evaluated literature on machine learning(ML)in the management of traumatic haemorrhage.We thank the authors for their contribution to the role of ML in trauma.展开更多
Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects an...Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.展开更多
Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient procedure.Colonoscopy is associated with di...Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient procedure.Colonoscopy is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used,the sedatives used,but to the procedure related as well including bleeding and perforation.Injuries to the extra-luminal abdominal organs during colonoscopy are uncommon,however,serious complications related to the procedure have been reported infrequently in the literature.Life threatening injuries to the spleen,liver,pancreas,mesentery,and urinary bladder have been reported as early as in mid-1970s.These injuries should not be overlooked by clinicians and endoscopists.Steadily increasing abdominal pain,abdominal distension,and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ injury.Splenic and hepatic injury following colonoscopy are usually serious and may be life threatening.Although conservative management may help,yet they usually need interventional radiology or surgical intervention.Acute pancreatitis following colonoscopy is usually mild and is mostly managed conservatively.The mechanism of abdominal organ injuries during colonoscopy is not fully understood,however many risk factors have been identified,which can be classified as-organ related,procedure related,and local abdominal factors.Difficult colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these injuries.Left lateral position,avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.展开更多
Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by ...Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by a manually operated force pump was reported in 1904.[1]Colorectal injuries have the potential to progress to high-mortality complications,such as abdominal infection,peritonitis,and septic shock.[2,3]Herein,we report a case of trans-anal barotrauma in a man who presented with pneumoperitoneum,pneumomediastinum,and pneumoscrotum.We performed laparoscopic exploration and loop ileostomy on this patient.展开更多
Severe trauma is one of the main causes of premature death,posing a significant challenge to public health systems.[1]At present,there is a lack of universally accepted guidelines for rapid detection of life-threateni...Severe trauma is one of the main causes of premature death,posing a significant challenge to public health systems.[1]At present,there is a lack of universally accepted guidelines for rapid detection of life-threatening severe trauma,[2]and the accuracy of existing prognostic models in predicting early death is limited.[3,4]Severe non-brain-injured trauma(SNT)patients account for approximately 70%of all trauma-related deaths.Moreover,there is a lack of studies on early death in SNT patients.[5]This study aims to identify risk factors associated with early death(≤72 h post-admission)in SNT patients.展开更多
BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference ...BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference in optic nerve sheath diameter(ONSD)between patients with and without a cervical collar using computed tomography(CT).METHODS:This was a single-center,retrospective study examining trauma patients who presented to the emergency department between January 1,2021,and December 31,2021.The ONSD on brain CT of the trauma patients was measured and analyzed to determine whether there was a difference between the ONSD with and without the cervical collar.RESULTS:The study population consisted of 169 patients.On CT imaging of patients with(n=66)and without(n=103)cervical collars,the mean ONSD in the axial plane were 5.43±0.50 mm and 5.04±0.46 mm respectively for the right eye and 5.50±0.52 mm and 5.11±0.46 mm respectively for the left eye.The results revealed an association between the presence of a cervical collar and the mean ONSD,which was statistically significant(P<0.001)for both the right and left eyes.CONCLUSION:A cervical collar may be associated with increased ONSD.The effect of this increase in the ONSD on clinical outcomes needs to be investigated,and the actual need for cervical collar in the emergency department should be evaluated on a case-by-case basis.展开更多
BACKGROUND The continuous development of social and economic progress and ongoing enhancement of infrastructure construction has led to drastic changes in the occurrence of trauma.AIM To analyze the epidemiological ch...BACKGROUND The continuous development of social and economic progress and ongoing enhancement of infrastructure construction has led to drastic changes in the occurrence of trauma.AIM To analyze the epidemiological characteristics of trauma in Lanzhou City to provide theoretical references for improving quality of trauma care.METHODS A retrospective analysis of clinical data from 16585 trauma patients treated at the First Hospital of Lanzhou University Trauma Center from November 1,2021 to October 31,2023 was conducted.Data including age,sex,time of trauma,cause of trauma,and major injured body parts were statistically analyzed.RESULTS A total of 18235 patients were admitted,with complete data for 16585 cases.Of these,9793 were male and 6792 were female(male-to-female ratio of 1.44:1).The peak times for trauma occurrence were 10 AM-12 PM and 6-10 PM,and the peak months were from May to October.The leading causes of trauma were falls(45.32%),other trauma(15.88%),road traffic accidents(15.15%),violence(10.82%),cutting/stabbing(9.41%),mechanical injuries(2.65%),winter sports injuries(0.36%),animal bites(0.22%),burns(0.09%),and electrical injuries(0.02%).The distribution of majorly injured body parts showed statistical significance,with limbs/skin being the most affected followed by the head/neck,chest/abdomen,and back.CONCLUSION Medical institutions and government agencies can implement preventive measures and policies based on the characteristics of trauma determined in this study to enhance the quality and level of trauma care.展开更多
Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predi...Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.展开更多
BACKGROUND Pancreatic trauma(PT)is rare among traumatic injuries and has a low incidence,but it can still lead to severe infectious complications,resulting in a high mortality rate.Acute pancreatitis(AP)is a common co...BACKGROUND Pancreatic trauma(PT)is rare among traumatic injuries and has a low incidence,but it can still lead to severe infectious complications,resulting in a high mortality rate.Acute pancreatitis(AP)is a common complication after PT,and when combined with organ dysfunction and sepsis,it will result in a poorer prognosis.CASE SUMMARY We report a 25-year-old patient with multiple organ injuries,including the pancreas,due to abdominal trauma,who developed necrotising pancreatitis secondary to emergency caesarean section,combined with intra-abdominal infection(IAI).The patient underwent performed percutaneous drainage,pancreatic necrotic tissue debridement,and abdominal infection foci debridement on the patient.CONCLUSION We report a case of severe AP and IAI secondary to trauma.This patient was managed by a combination of conservative treatment such as antibiotic therapy and fluid support with surgery,and a better outcome was obtained.展开更多
It has long been asserted that failure to recover from central nervous system diseases is due to the system's intricate structure and the regenerative incapacity of adult neurons.Yet over recent decades,numerous s...It has long been asserted that failure to recover from central nervous system diseases is due to the system's intricate structure and the regenerative incapacity of adult neurons.Yet over recent decades,numerous studies have established that endogenous neurogenesis occurs in the adult central nervous system,including humans'.This has challenged the long-held scientific consensus that the number of adult neurons remains constant,and that new central nervous system neurons cannot be created or renewed.Herein,we present a comprehensive overview of the alterations and regulatory mechanisms of endogenous neurogenesis following central nervous system injury,and describe novel treatment strategies that to rget endogenous neurogenesis and newborn neurons in the treatment of central nervous system injury.Central nervous system injury frequently results in alterations of endogenous neurogenesis,encompassing the activation,proliferation,ectopic migration,diffe rentiation,and functional integration of endogenous neural stem cells.Because of the unfavorable local microenvironment,most activated neural stem cells diffe rentiate into glial cells rather than neurons.Consequently,the injury-induced endogenous neurogenesis response is inadequate for repairing impaired neural function.Scientists have attempted to enhance endogenous neurogenesis using various strategies,including using neurotrophic factors,bioactive materials,and cell reprogramming techniques.Used alone or in combination,these therapeutic strategies can promote targeted migration of neural stem cells to an injured area,ensure their survival and diffe rentiation into mature functional neurons,and facilitate their integration into the neural circuit.Thus can integration re plenish lost neurons after central nervous system injury,by improving the local microenvironment.By regulating each phase of endogenous neurogenesis,endogenous neural stem cells can be harnessed to promote effective regeneration of newborn neurons.This offers a novel approach for treating central nervous system injury.展开更多
AIM:To assess the utility and efficiency of endoscopyassisted vitrectomy(EAV)for the treatment of corneal opacity in severe ocular trauma.METHODS:Patients who underwent fundus examination using a preoperative slit lam...AIM:To assess the utility and efficiency of endoscopyassisted vitrectomy(EAV)for the treatment of corneal opacity in severe ocular trauma.METHODS:Patients who underwent fundus examination using a preoperative slit lamp and intraoperative endoscopy,followed by EAV and additional surgery were retrospectively recruited.Silicone oil removal and penetrating keratoplasty were used in selected eyes at postoperative follow-ups.Outcome measurements included the best corrected visual acuity(BCVA),intraocular pressure(IOP),findings of endoscopic fundus examination,and postoperative complications.RESULTS:Twenty-one eyes with severe ocular trauma and corneal opacity were followed up for 24-36mo.Retinal detachment(RD)and vitreous haemorrhage(VH)were identified in 16 eyes(76.2%),RD only in four eyes(19.0%),and VH combined with intraocular foreign body in one eye(4.8%).All eyes underwent at least three surgeries.Stage-Ⅰ surgeries involved wound closure(100%),lens extraction(76.2%),and anterior vitrectomy(14.3%).Stage-Ⅱ surgeries involved scleral buckling(28.6%),membrane peeling(47.6%),retinal laser photocoagulation(100%)and silicone oil tamponade(100%)using EAV.Stage-Ⅲ surgeries were conducted using endoscopy including silicone oil removal(52.4%),retinal laser photocoagulation(52.4%)and penetrating keratoplasty(28.6%).Nearly all eyes showed improvements in BCVA and IOP.Although there were no severe complications,glaucoma was noted in one eye,chronic hypotony in another eye,and band keratopathy in three eyes.CONCLUSION:EAV is an effective adjunct for restoring ocular anatomical structures and visual function in the case of corneal opacity after severe ocular trauma.展开更多
Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.Th...Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.展开更多
AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gende...AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the functional connectivity(FC)method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Pearson’s correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.RESULTS:Significantly increased FC between several regions was identified including the medial prefrontal cortex(MPFC)and left hippocampus formations(HF),the MPFC and left inferior parietal lobule(IPL),the left IPL and left medial temporal lobe(MTL),the left IPL and right MTL,and the right IPL and left MTL.No decreased region-to-region connectivity was detected in default mode network(DMN)sub-regions in patients with ET.Compared with HCs,ET patients exhibited significantly increased FC between several paired DMN regions,as follows:posterior cingulate cortex(PCC)and right HF(HF.R,t=2.196,P=0.032),right inferior parietal cortices(IPC.R)and left MTL(MTL.L,t=2.243,P=0.029),and right MTL(MTL.R)and HF.R(t=2.236,P=0.029).CONCLUSION:FC values in multiple brain regions of ET patients are abnormal,suggesting that these brain regions in ET patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of ET.展开更多
BACKGROUND Hypocalcemia is highly common in hospitalized patients,especially in those with trauma,On the other hand,abnormal calcium metabolism is an important metabolic challenge;however,it is often neglected and unt...BACKGROUND Hypocalcemia is highly common in hospitalized patients,especially in those with trauma,On the other hand,abnormal calcium metabolism is an important metabolic challenge;however,it is often neglected and untreated,and certain factors may induce serious neurological and cardiovascular complications.AIM To retrospectively analyze the impact of hypocalcemia on the prognosis of patients with multiple traumas.METHODS The study was conducted from January 2020 to December 2021.Ninety-nine patients with multiple injuries were treated at the critical care medicine department of Fuyang People’s Hospital.The selected indicators included sex,age,and blood calcium and hematocrit levels.Many indicators were observed,including within 24 h of hospitalization,and the prognosis was collected after 28 d.Based on the blood calcium levels,the patients were divided into the following two groups:Normocalcemia and hypocalcemia.Of the 99 patients included,81 had normocalcemia,and 18 had hypocalcemia.Separate experiments were conducted for these two groups.RESULTS There was an association between serum calcium levels and the prognosis of patients with polytrauma.CONCLUSION Clinically,the prognosis of patients with multiple traumas can be preliminarily evaluated based on serum calcium levels.展开更多
文摘Objective: To identify how hospital discharge data could discriminate the distribution patterns of high-risk trauma children in mandated and non-mandated trauma systems. Methods: Hospital discharge data of pediatric trauma patients 1 - 15 years of age in Florida (FL), USA—[a mature mandated trauma system with certified trauma centers (TCs)] and in Indiana (IN), USA—(an immature non-mandated trauma system) admitted both to trauma center (TC) and non-TC healthcare facilities were analyzed. The injury severity score (ISS) measurement was used to verify injury severities. Results: Analysis showed that the majority of admissions were mild injuries (ISS = 1 - 8), [FL 70%, IN 66%, odds ratio (OR) 1.2, 95% confidence interval (CI) 1.1, 1.3]. Florida trauma children (all severities) generally receive TC care more frequently than Indiana’s (OR = 1.8, CI 1.6 - 1.9). Particularly admission to TCs with severe (ISS ≥ 25) pelvic injury was greater in Florida (OR 3.5, CI 1.6 - 7.4). Florida, encountered some other severe injury mechanisms (motor vehicle accidents, falls) more frequently than Indiana (ORs and CI: 2.2, 1.5 - 3.3 and 3.1, 1.1 - 8.7, respectively). Conclusions: Hospital discharge data can demonstrate the expected patient distribution difference when comparing a mature trauma system with a voluntary evolving system. The level of maturity of the adopted trauma system often influences such difference.
文摘Background: There is growing evidence suggesting that those who suffer traumatic injury display high levels of perceived injustice which impedes their recovery, both physically and mentally. Aim: The aim of this systematic review was to examine the association between perceived injustice and pain-related, mental health and functional outcomes in patients who have suffered a traumatic injury. Methods: In May 2023, a systematic review of the literature was performed on the electronic databases of PubMed, Google Scholar, Embase, and the Cochrane Database of Systemic Reviews. Papers were collected and analysed as per PRISMA guidelines for systematic reviews. The outcomes of interest were pain intensity, pain interference, disability, depression, anxiety, and quality of life. The initial search identified 59 papers. Of these papers, five studies met the inclusion criteria and were subsequently analysed (N = 1172). Each of the papers was published in peer-reviewed journals in the English language. Individuals with pain or pathology prior to the trauma and those who were not hospitalised following the trauma were excluded from the study. Results: Of the papers reviewed, each study indicated significant associations between perceived injustice and pain, disability, depression, anxiety, post-traumatic stress disorder, as well as reduced return to work status. Conclusion: This systematic review investigated the relationship between perceived injustice and pain-related, mental health, and functional outcomes in trauma patients. The results highlight the negative role that perceived injustice has on recovery following traumatic injury. Further, it provokes the need for future research regarding the implementation of therapeutic interventions and the development of predictive models of injustice.
文摘Although Canada has a universal health care program that provides free in-hospital services to all citizens,its vast landmass and nonstandardized prehospital and posthospital systems make delivering quality trauma care challenging,particularly to resource-limited rural regions.This article summarizes the strengths of the prehospital system,facility-based care,trauma network,trauma registry,rehabilitation,and governance/financing/quality assurance components of Canada’s trauma system.Future directions,including the use of telemedicine,standardization of practices,and resource optimization,are also explored.Canada’s trauma system is well developed,yet geography impedes equitable access.More standardization and resource optimization are needed.
基金supported by Key Project of China Rehabilitation Research Center,Nos.2022ZX-05,2018ZX-08(both to JB)。
文摘Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.
文摘BACKGROUND The increase in severe traumatic brain injury(sTBI)incidence is a worldwide phenomenon,resulting in a heavy disease burden in the public health systems,specifically in emerging countries.The shock index(SI)is a physiological parameter that indicates cardiovascular status and has been used as a tool to assess the presence and severity of shock,which is increased in sTBI.Considering the high mortality of sTBI,scrutinizing the predictive potential of SI and its variants is vital.AIM To describe the predictive potential of SI and its variants in sTBI.METHODS This study included 71 patients(61 men and 10 women)divided into two groups:Survival(S;n=49)and Non-survival(NS;n=22).The responses of blood pressure and heart rate(HR)were collected at admission and 48 h after admission.The SI,reverse SI(rSI),rSI multiplied by the Glasgow Coma Score(rSIG),and Age multiplied SI(AgeSI)were calculated.Group comparisons included Shapiro-Wilk tests,and independent samples t-tests.For predictive analysis,logistic regression,receiver operator curves(ROC)curves,and area under the curve(AUC)measurements were performed.RESULTS No significant differences between groups were identified for SI,rSI,or rSIG.The AgeSI was significantly higher in NS patients at 48 h following admission(S:26.32±14.2,and NS:37.27±17.8;P=0.016).Both the logistic regression and the AUC following ROC curve analysis showed that only AgeSI at 48 h was capable of predicting sTBI outcomes.CONCLUSION Although an altered balance between HR and blood pressure can provide insights into the adequacy of oxygen delivery to tissues and the overall cardiac function,only the AgeSI was a viable outcome-predictive tool in sTBI,warranting future research in different cohorts.
文摘BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.METHODS Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of procedures.Review of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected.Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay.Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.CONCLUSION Dental complications occur in approximately 1 in 300 of upper endoscopy cases.These are easily preventable by pre-endoscopy screening.Protocols to mitigate dental injury are also suggested.
基金JMW,RSS,EP,EK,WM,ZBP,and NRMT have received research funding from a precision trauma care research award from the Combat Casualty Care Research Program of the US Army Medical Research and Materiel Command(DM180044).
文摘We read with interest the recent systematic reviewaArtificial intelligence and machine learning for hemorrhagic trauma careoby Peng et al.[1],which evaluated literature on machine learning(ML)in the management of traumatic haemorrhage.We thank the authors for their contribution to the role of ML in trauma.
基金supported by the National Natural Science Foundation of China(Grant No.12372356)Postgraduate Scientific Research In-novation Project of Hunan Province(Grant No.CX20221044).
文摘Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.
文摘Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient procedure.Colonoscopy is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used,the sedatives used,but to the procedure related as well including bleeding and perforation.Injuries to the extra-luminal abdominal organs during colonoscopy are uncommon,however,serious complications related to the procedure have been reported infrequently in the literature.Life threatening injuries to the spleen,liver,pancreas,mesentery,and urinary bladder have been reported as early as in mid-1970s.These injuries should not be overlooked by clinicians and endoscopists.Steadily increasing abdominal pain,abdominal distension,and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ injury.Splenic and hepatic injury following colonoscopy are usually serious and may be life threatening.Although conservative management may help,yet they usually need interventional radiology or surgical intervention.Acute pancreatitis following colonoscopy is usually mild and is mostly managed conservatively.The mechanism of abdominal organ injuries during colonoscopy is not fully understood,however many risk factors have been identified,which can be classified as-organ related,procedure related,and local abdominal factors.Difficult colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these injuries.Left lateral position,avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.
基金supported by National High Level Hospital Clinical Research Funding(2022-PUMCH-B-110).
文摘Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by a manually operated force pump was reported in 1904.[1]Colorectal injuries have the potential to progress to high-mortality complications,such as abdominal infection,peritonitis,and septic shock.[2,3]Herein,we report a case of trans-anal barotrauma in a man who presented with pneumoperitoneum,pneumomediastinum,and pneumoscrotum.We performed laparoscopic exploration and loop ileostomy on this patient.
基金supported by Suzhou Gusu Health Talents Scientifi c Research Project(GSWS2021017)Scientific Pre-research Fund of the Second Affiliated Hospital of Soochow University(SDFEYQN2007).
文摘Severe trauma is one of the main causes of premature death,posing a significant challenge to public health systems.[1]At present,there is a lack of universally accepted guidelines for rapid detection of life-threatening severe trauma,[2]and the accuracy of existing prognostic models in predicting early death is limited.[3,4]Severe non-brain-injured trauma(SNT)patients account for approximately 70%of all trauma-related deaths.Moreover,there is a lack of studies on early death in SNT patients.[5]This study aims to identify risk factors associated with early death(≤72 h post-admission)in SNT patients.
文摘BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference in optic nerve sheath diameter(ONSD)between patients with and without a cervical collar using computed tomography(CT).METHODS:This was a single-center,retrospective study examining trauma patients who presented to the emergency department between January 1,2021,and December 31,2021.The ONSD on brain CT of the trauma patients was measured and analyzed to determine whether there was a difference between the ONSD with and without the cervical collar.RESULTS:The study population consisted of 169 patients.On CT imaging of patients with(n=66)and without(n=103)cervical collars,the mean ONSD in the axial plane were 5.43±0.50 mm and 5.04±0.46 mm respectively for the right eye and 5.50±0.52 mm and 5.11±0.46 mm respectively for the left eye.The results revealed an association between the presence of a cervical collar and the mean ONSD,which was statistically significant(P<0.001)for both the right and left eyes.CONCLUSION:A cervical collar may be associated with increased ONSD.The effect of this increase in the ONSD on clinical outcomes needs to be investigated,and the actual need for cervical collar in the emergency department should be evaluated on a case-by-case basis.
基金Supported by Ministry of Science and Technology Senior Foreign Expert Program,No.G2019028023 and No.G2020028007National College Student Innovation and Entrepreneurship Program,No.202210730172+1 种基金Medical Innovation and Development Project of Lanzhou University,No.lzuyxcx-2022-99Joint Research Fund Project of Gansu Province,No.23JRRA1496.
文摘BACKGROUND The continuous development of social and economic progress and ongoing enhancement of infrastructure construction has led to drastic changes in the occurrence of trauma.AIM To analyze the epidemiological characteristics of trauma in Lanzhou City to provide theoretical references for improving quality of trauma care.METHODS A retrospective analysis of clinical data from 16585 trauma patients treated at the First Hospital of Lanzhou University Trauma Center from November 1,2021 to October 31,2023 was conducted.Data including age,sex,time of trauma,cause of trauma,and major injured body parts were statistically analyzed.RESULTS A total of 18235 patients were admitted,with complete data for 16585 cases.Of these,9793 were male and 6792 were female(male-to-female ratio of 1.44:1).The peak times for trauma occurrence were 10 AM-12 PM and 6-10 PM,and the peak months were from May to October.The leading causes of trauma were falls(45.32%),other trauma(15.88%),road traffic accidents(15.15%),violence(10.82%),cutting/stabbing(9.41%),mechanical injuries(2.65%),winter sports injuries(0.36%),animal bites(0.22%),burns(0.09%),and electrical injuries(0.02%).The distribution of majorly injured body parts showed statistical significance,with limbs/skin being the most affected followed by the head/neck,chest/abdomen,and back.CONCLUSION Medical institutions and government agencies can implement preventive measures and policies based on the characteristics of trauma determined in this study to enhance the quality and level of trauma care.
文摘Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.
基金Supported by China Medical and Health Development Foundation,Young and Middle-aged Doctors Excellent Talent,Pei Ying Program,No.BJ2023YCPYJH003Tianjin Nankai Hospital integrated Traditional Chinese and Western Medicine Prevention and Treatment Key Technology and Program Optimization 2022 Key Project,No.NKYY-IIT-2022-009-2+3 种基金Tianjin Key Areas of Traditional Chinese Medicine Science and Technology Project,No.2022005Tianjin Natural Science Foundation Key ProjectTianjin Administration of Traditional Chinese Medicine Fund of Traditional Chinese and Western Medicine Integrated Research Project,No.2021006Tianjin 131 Innovative Talent Team,Innovation Team for Diagnosis and Treatment of Acute Abdomen Related to Biliary and Pancreatic Diseases,No.201938.
文摘BACKGROUND Pancreatic trauma(PT)is rare among traumatic injuries and has a low incidence,but it can still lead to severe infectious complications,resulting in a high mortality rate.Acute pancreatitis(AP)is a common complication after PT,and when combined with organ dysfunction and sepsis,it will result in a poorer prognosis.CASE SUMMARY We report a 25-year-old patient with multiple organ injuries,including the pancreas,due to abdominal trauma,who developed necrotising pancreatitis secondary to emergency caesarean section,combined with intra-abdominal infection(IAI).The patient underwent performed percutaneous drainage,pancreatic necrotic tissue debridement,and abdominal infection foci debridement on the patient.CONCLUSION We report a case of severe AP and IAI secondary to trauma.This patient was managed by a combination of conservative treatment such as antibiotic therapy and fluid support with surgery,and a better outcome was obtained.
基金supported by the National Natural Science Foundation of ChinaNos.82272171 (to ZY),82271403 (to XL),31971279 (to ZY),81941011 (to XL),31730030 (to XL)。
文摘It has long been asserted that failure to recover from central nervous system diseases is due to the system's intricate structure and the regenerative incapacity of adult neurons.Yet over recent decades,numerous studies have established that endogenous neurogenesis occurs in the adult central nervous system,including humans'.This has challenged the long-held scientific consensus that the number of adult neurons remains constant,and that new central nervous system neurons cannot be created or renewed.Herein,we present a comprehensive overview of the alterations and regulatory mechanisms of endogenous neurogenesis following central nervous system injury,and describe novel treatment strategies that to rget endogenous neurogenesis and newborn neurons in the treatment of central nervous system injury.Central nervous system injury frequently results in alterations of endogenous neurogenesis,encompassing the activation,proliferation,ectopic migration,diffe rentiation,and functional integration of endogenous neural stem cells.Because of the unfavorable local microenvironment,most activated neural stem cells diffe rentiate into glial cells rather than neurons.Consequently,the injury-induced endogenous neurogenesis response is inadequate for repairing impaired neural function.Scientists have attempted to enhance endogenous neurogenesis using various strategies,including using neurotrophic factors,bioactive materials,and cell reprogramming techniques.Used alone or in combination,these therapeutic strategies can promote targeted migration of neural stem cells to an injured area,ensure their survival and diffe rentiation into mature functional neurons,and facilitate their integration into the neural circuit.Thus can integration re plenish lost neurons after central nervous system injury,by improving the local microenvironment.By regulating each phase of endogenous neurogenesis,endogenous neural stem cells can be harnessed to promote effective regeneration of newborn neurons.This offers a novel approach for treating central nervous system injury.
基金Supported by the Guangdong Province Natural Science Foundation(No.2019A1515011732)Guangzhou Science and Technology Foundation of Guangdong Province(No.202002030413)Science and Technology Project of General Hospital of Southern Theater Command of PLA(No.2023NZB010).
文摘AIM:To assess the utility and efficiency of endoscopyassisted vitrectomy(EAV)for the treatment of corneal opacity in severe ocular trauma.METHODS:Patients who underwent fundus examination using a preoperative slit lamp and intraoperative endoscopy,followed by EAV and additional surgery were retrospectively recruited.Silicone oil removal and penetrating keratoplasty were used in selected eyes at postoperative follow-ups.Outcome measurements included the best corrected visual acuity(BCVA),intraocular pressure(IOP),findings of endoscopic fundus examination,and postoperative complications.RESULTS:Twenty-one eyes with severe ocular trauma and corneal opacity were followed up for 24-36mo.Retinal detachment(RD)and vitreous haemorrhage(VH)were identified in 16 eyes(76.2%),RD only in four eyes(19.0%),and VH combined with intraocular foreign body in one eye(4.8%).All eyes underwent at least three surgeries.Stage-Ⅰ surgeries involved wound closure(100%),lens extraction(76.2%),and anterior vitrectomy(14.3%).Stage-Ⅱ surgeries involved scleral buckling(28.6%),membrane peeling(47.6%),retinal laser photocoagulation(100%)and silicone oil tamponade(100%)using EAV.Stage-Ⅲ surgeries were conducted using endoscopy including silicone oil removal(52.4%),retinal laser photocoagulation(52.4%)and penetrating keratoplasty(28.6%).Nearly all eyes showed improvements in BCVA and IOP.Although there were no severe complications,glaucoma was noted in one eye,chronic hypotony in another eye,and band keratopathy in three eyes.CONCLUSION:EAV is an effective adjunct for restoring ocular anatomical structures and visual function in the case of corneal opacity after severe ocular trauma.
文摘Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Key R&D Program of Jiangxi Province(No.20223BBH80014)+1 种基金Science and Technology Project of Jiangxi Province Health Commission of Traditional Chinese Medicine(No.2022B258)Science and Technology Project of Jiangxi Health Commission(No.202210017).
文摘AIM:To study functional brain abnormalities in patients with eye trauma(ET)and to discuss the pathophysiological mechanisms of ET.METHODS:Totally 31 ET patients and 31 healthy controls(HCs)were recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the functional connectivity(FC)method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Pearson’s correlation analysis was used to explore the relationship between FC values in specific brain regions and clinical behaviors in patients with ET.RESULTS:Significantly increased FC between several regions was identified including the medial prefrontal cortex(MPFC)and left hippocampus formations(HF),the MPFC and left inferior parietal lobule(IPL),the left IPL and left medial temporal lobe(MTL),the left IPL and right MTL,and the right IPL and left MTL.No decreased region-to-region connectivity was detected in default mode network(DMN)sub-regions in patients with ET.Compared with HCs,ET patients exhibited significantly increased FC between several paired DMN regions,as follows:posterior cingulate cortex(PCC)and right HF(HF.R,t=2.196,P=0.032),right inferior parietal cortices(IPC.R)and left MTL(MTL.L,t=2.243,P=0.029),and right MTL(MTL.R)and HF.R(t=2.236,P=0.029).CONCLUSION:FC values in multiple brain regions of ET patients are abnormal,suggesting that these brain regions in ET patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of ET.
文摘BACKGROUND Hypocalcemia is highly common in hospitalized patients,especially in those with trauma,On the other hand,abnormal calcium metabolism is an important metabolic challenge;however,it is often neglected and untreated,and certain factors may induce serious neurological and cardiovascular complications.AIM To retrospectively analyze the impact of hypocalcemia on the prognosis of patients with multiple traumas.METHODS The study was conducted from January 2020 to December 2021.Ninety-nine patients with multiple injuries were treated at the critical care medicine department of Fuyang People’s Hospital.The selected indicators included sex,age,and blood calcium and hematocrit levels.Many indicators were observed,including within 24 h of hospitalization,and the prognosis was collected after 28 d.Based on the blood calcium levels,the patients were divided into the following two groups:Normocalcemia and hypocalcemia.Of the 99 patients included,81 had normocalcemia,and 18 had hypocalcemia.Separate experiments were conducted for these two groups.RESULTS There was an association between serum calcium levels and the prognosis of patients with polytrauma.CONCLUSION Clinically,the prognosis of patients with multiple traumas can be preliminarily evaluated based on serum calcium levels.
