简介：Theincreaseinneurotrophicfactorsaftercraniocerebralinjuryhasbeenshowntopromotefracturehealing.Moreover,neurotrophicfactorsplayakeyroleintheregenerationandrepairofperipheralnerve.However,whethercraniocerebralinjuryalterstherepairofperipheralnerveinjuriesremainspoorlyunderstood.Ratinjurymodelswereestablishedbytransectingtheleftsciaticnerveandusingafree-falldevicetoinducecraniocerebralinjury.Comparedwithsciaticnerveinjuryaloneafter6–12weeks,ratswithcombinedsciaticandcraniocerebralinjuriesshoweddecreasedsciaticfunctionalindex,increasedrecoveryofgastrocnemiusmusclewetweight,recoveryofsciaticnervegangliaandcorrespondingspinalcordsegmentneuronmorphologies,andincreasednumbersofhorseradishperoxidase-labeledcells.Theseresultsindicatethatcraniocerebralinjurypromotestherepairofperipheralnerveinjury.

简介：客观：为了改进痊愈，与由craniocerebral损害复杂的腹的内脏的损害病人评价。方法：由craniocerebral损害复杂的腹的内脏的损害的176个盒子的临床的数据回顾地被分析。结果：在这个系列，44个盒子死了，死亡是25.0%。死亡的主要原因是与吃惊相结合的腹的内脏的损害和严重craniocerebral损害。结论：在早舞台由精确诊断改进痊愈率是必要的。腹的帕拉穿刺术和CT应该即时并且动态地被执行。优先级应该被给life-threateninginjuries的治疗。

简介：Thephenomenonofischemia/reperfusioninjuryisdescribedintheexperimentalmodelsofacutemyocardialinfarction(AMI),causingadditionalfunctionalandstructuraldamagetotheacutereperfusedmyocardium,andischemicpreconditioningreferstothemyocardialischemiaafteralongperiodofreperfusionbeforeoneorseveralshortoccasionalduplicationofmyocardialischemia/reperfusion1,whichcanincreasemyocardialischemictolerance.ThetherapeuticstrategiesforAMIhavefocusedonmyocardialischemia/reperfusioninjury,whichaccountsforasignificantpartofthefinalinfarctsize.Althoughexperimentsinthelast20yearshavereportedthatpharmacologicalinterventionsatreperfusionmightreducemyocardialreperfusioninjury,thiscouldnotbeconfirmedinhumanstudies.Analternativetochemicalmodifiers,postconditioning(briefrepeatedperiodsofischemiaappliedattheonsetofreperfusion)isanothermethodproventobeefficientinanimalmodelsandtobeconfirmedinrecenthumanstudies.Thissimplemethod,appliedinthefirstminuteofreperfusion,reducesthefinalinfarctsizeby30%-50%.Thisreviewwillfocusonthemechanisms,pharmacologicalpreconditioning,postconditioningtechnique,whichiseasilyapplicableinhumanpatientsinthesettingofAMI.

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简介：Thecingulum,theneuraltractconnectingtheorbitofrontalcortexwiththemedialtemporallobe,playsanimportantroleincognition(Bushetal.,2000).Itisalsoimportantinmemorybecauseitprovidescholinergicinnervationstothecerebralcortexafterobtaininginnervationfromthemedialseptalnucleus,the

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简介：Theadipocytokine,apelin-13,isanabundantlyexpressedpeptideinthenervoussystem.Apelin-13protectsthebrainagainstischemia/reperfusioninjuryandattenuatestraumaticbraininjurybysuppressingautophagy.However,secondaryapelin-13effectsontraumaticbraininjury-inducedneuralcelldeathandblood-brainbarrierintegrityarestillnotclear.Here,wefoundthatapelin-13significantlydecreasescerebralwatercontent,mitigatesblood-brainbarrierdestruction,reducesaquaporin-4expression,diminishescaspase-3andBaxexpressioninthecerebralcortexandhippocampus,andreducesapoptosis.Theseresultsshowthatapelin-13attenuatessecondaryinjuryaftertraumaticbraininjuryandexertsaneuroprotectiveeffect.

简介：Inflammationafterstrokeisthemaincauseofcerebralischemia/reperfusioninjury.Cascadingeventsafterinjurycanleadtocelldeath.Heatshockprotein70andotherendogenousinjury-signalingmoleculesarereleasedbydamagedcells,whichcanleadtosystemicstressreactions.Protectingthebrainthroughrepairbeginswiththestress-injury-repairsignalingchain.Thisstudyaimedtoverifywhetheracupunctureactsthroughthischaintofacilitateeffectivetreatmentofischemicstroke.Ratmodelsofcerebralischemia/reperfusioninjurywereestablishedbyZeaLonga'smethod,andinjurysiteswereidentifiedbyassessingneurologicalfunction,2,3,5-triphenyltetrazoliumchloridestaining,andhematoxylin-eosinstaining.ElectroacupunctureatacupointsBaihui(DU20)andZusanli(ST36)wasperformedinthemodelratswithdilatationalwaves,deliveredfor20minutesadayat2–100Hzandanamplitudeof2mA.Weanalyzedthebloodserumfromtheratsandfoundthatinflammatorycytokinesaffectedthelevelsofadrenotrophinandheatshockprotein70,eachofwhichfollowedasimilarbimodalcurve.Specifically,electroacupunctureloweredthepeaklevelsofadrenocorticotrophichormoneandheatshockprotein70.Thus,electroacupuncturewasabletoinhibitexcessivestress,reduceinflammation,andpromotetherepairofneurons,whichfacilitatedhealingofischemicstroke.

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简介：Objective:Tosummarizesurgicaltreatmentsandtheircorrespondingcurativeeffectsonsciaticnerveinjuries.Methods:Surgicaltreatmentsonsciaticnerveinjurywereperformedin28patientsfromJanuary1990toJuly2000.Thetreatmentsincludedneurolysis,neurolysispluspartialnerveanastomosis,nerveanastomosisandnervetransplantation.ThecurativeeffectwasevaluatedaccordingtoSunderlandcriteria.Results:Of28cases,22patientswerefollowedupwithafollow-upperiodof13monthsto5years(average30months).Of22nerves,7wereexcellent,5good,7fairand3poor,withanexcellencerateof54.5%.

简介：Effortstopharmacologicallyrestorecentralnervoussystem(CNS)functionafterinjuryhashistoricallyfocusedonpromotingnervegrowthwithnervegrowthfactorssuchasnervegrowthfactor(NGF),neurotrophin3(NT3)andbrain-derivedneurotrophicfactor(BDNF).However,spinal

简介：客观：为了分析损伤的数据，有在欺骗的地震的胸的损害的病人为更好在主要地震理解胸的损害的类型和后果承认了到医药科学(弦音器)的德黑兰大学的医院。方法：登记6的AfterBam地震。5在Richter上可伸缩，526个损伤病人进入弦音器的医院。在之中“他们，53个病人支撑了胸的损害。结果：这个组由21females(39.6%)和32男性(60.4%)组成。十五个病人(28.3%)孤立胸损害。Ribfracture(36.4%)是在我们的病人的最普通的损害，haemo/pneumothorax(25.5%)列在后面。表面的损害是最普通的伴随损害。有胸损害的多重损伤的病人与孤立的胸损害(P=0.003)有更高的损害严厉分数(ISS)对病人。结论：胸墙损害和haemo/气胸在地震的幸存牺牲品包括损害的一个可观的数字。因而，这些病人的多数能与观察或试管thoracostomy被对待。我们应该训练并且装备健康工人和救援队的成员在这块地里对待并且设法这些病人。

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简介：AbstractAdrenal gland trauma is a rare phenomenon, due to the small size and retroperitoneal location of the organ. The majority of adrenal gland trauma is due to blunt force injury and is only rarely encountered due to the penetrating mechanisms. A 20-year-old male sustained a gunshot wound to the left abdomen. Upon exploration, he was found to have a through and through injury to the left adrenal gland, among other injuries. Injury to the adrenal gland due to penetrating trauma is exceptionally rare. The principles of management are to control bleeding from the gland with debridement and hemostasis rather than attempt to resect the entire organ. The management of a penetrating injury to the adrenal gland is straightforward and should not be a contributor to a patient's morbidity or mortality.

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简介：AbstractPurpose:The injury severity score (ISS) and new injury severity score (NISS) have been widely used in trauma evaluation. However, which scoring system is better in trauma outcome prediction is still disputed. The purpose of this study is to evaluate the value of the two scoring systems in predicting trauma outcomes, including mortality, intensive care unit (ICU) admission and ICU length of stay.Methods:The data were collected retrospectively from three hospitals in Zhejiang province, China. The comparisons of NISS and ISS in predicting outcomes were performed by using receiver operator characteristic (ROC) curves and Hosmer-Lemeshow statistics.Results:A total of 1825 blunt trauma patients were enrolled in our study. Finally, 1243 patients were admitted to ICU, and 215 patients died before discharge. The ISS and NISS were equivalent in predicting mortality (area under ORC curve [AUC]: 0.886 vs. 0.887, p = 0.9113). But for the patients with ISS ≥25, NISS showed better performance in predicting mortality. NISS was also significantly better than ISS in predicting ICU admission and prolonged ICU length of stay.Conclusion:NISS outperforms ISS in predicting the outcomes for severe blunt trauma and can be an essential supplement of ISS. Considering the convenience of NISS in calculation, it is advantageous to promote NISS in China’s primary hospitals.

简介：AbstractPurpose:To discuss and share the experience of treatment of traumatic innominate arterial injury.Methods:A retrospective analysis was performed on patients with innominate arterial injuries admitted from January 2016 to July 2018 at the department of vascular surgery, Beijing Jishuitan Hospital, China. All the arterial injuries were confirmed by arteriography. Clinical data including mechanism of injury, type of injury, demographics, concomitant injuries, time interval from trauma to blood flow reconstruction, and operation methods were collected. Follow-up program included outpatient visit and duplex-ultrasonography. SPSS version 23.0 was adopted for data analysis. Categorical variables are presented as number and/or frequency and continuous variables as mean ± standard deviation.Result:Altogether 7 patients were included and 6 (85.7%) were male. The mean age of patients was (29.43 ± 7.98) years, range 19-43 years. Six patients had isolated innominate arterial injuries and the rest 1 combined innominate arterial and vein injuries. The injury causes were road accidents in 3 patients, stab wound in 2, gunshot wound in 1, and crush injury in 1. All the 7 patients presented hemorrhagic shock at admission, which was timely and effectively corrected. No perioperative death or technical complications occurred. Intimal injury (n = 2) and partial transaction (n = 2) of the innominate artery were treated with covered stents. Two patients with complete transection of artery received vascular reconstruction by artificial grafts. One patient with partial transaction received balloon dilation and open surgical repair (hybrid operation). The mean time interval from trauma to blood flow reconstruction was (4.27 ± 0.18) h, range 4.0-4.5 h; while the operation time was (48.57 ± 19.94) min, range 25-75 min. Cerebral infarction occurred in one patient with brain injury due to anticoagulation contraindication. The average follow-up was (13.29 ± 5.65) months, range 6-24 months. No severe stenosis, occlusion, and thrombosis of covered stents or artificial vessels were found by color Doppler ultrasound.Conclusion:Urgent control of hemorrhage and restoration of blood supply are critical for the treatment of traumatic innominate arterial injury. Endovascular therapy is a feasible and effective method with short operation time and less trauma.

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简介：Objective:Toexplorethecharacteristicsofclosedabdominalinjuryinpregnancywomenanditstreatment.Methods:Theclinicaldataof37pregnancypatientswithclosedabdominalinjurytreatedinourhospitalfromJune1993toJune2003werecollectedandanalyzed.Results:Allthe37patientsweretreatedwithoperation.Amongthem2earlypregnancypatientswithintestinalruptureand1patientwithretroperitonealhematomaweretreatedunderlaparoscope;inother34pregnancypatientslaparotomywasperformed.Ofthe34patients8usedcesareansectionbecauseprematureseparationofplacentaandenlargedwombinterruptedthemanagementofintra-abdominalorganinjury.Inthe37patients33(89.1%)werecured,4(10.8%)die,postoperativecomplicationratewas16.2%(6/37).Twopatients(5.4%)sufferedfromabdominalcavityinfection,3(8.1%)frompulmonaryinfection,and1(2.7%)hadmulti-organfailure.Conclusions:Forpregnancypatientswithclosedabdominalinjury,besidesobstericdiseasesintra-abdominalinjuryshouldbegivenmuchattention.Accuratediagnosisandtimelytreatmentcangainthetimetosavethelifeofbothmotherandfetus.

简介：Objective:Toinvestigatetheinfluenceofhipandpelvicfracture,especiallyacetabularfracturecomplicatedbysciaticnerveinjuryonclinicalfeaturesandprognosisofsciaticnerveinjury.Methods:FromJanuary1987toJanuary2000,17patients(14maleand3female)whohadhipandpelvicfracturescomplicatedbysciaticnerveinjuryweretreatedwithoperativereductionandinternalfixationandfollowedupfrom10monthsto5years.Theaverageagewas38years(ranging23-56years).Theleftextremitieswereinvolvedin11patientsandtherightin6.Twelvepatientsunderwentprimaryexplorationandneurolysisand5patientsunderwentsecondaryoperation.Results:Preoperatively,8patientsweretreatedwithlargedosesoforalnarcoticstocontroltheirseveresciaticpain.Threeofthe8patientsunderwentpatient-controlledanalgesiaandepiduralanalgesia.Afteroperation,excellentandgoodratesofreductionandfunctionalrecoveryofsciaticnervewere94.1%and88%respectively.Fourpatientsstillhadsciaticpainand2patientsfailedtorecover.Sciaticnervefunctionimprovedwithin3-6monthsaftersurgeryin11patients.Conclusions:Hipandpelvicfracturescanresultinsciaticnerveinjury,especiallycommonperonealnerveinjuryandprognosisispoor.Openreductionandinternalfixationcombinedwithnerveexplorationandneurolysisshouldbeusedasearlyaspossibleforseveresciaticpain.