Objective To collect the clinical data of victims with traumatic brain injury (TBI) admitted in the West China Hospital of Sichuan University within 2 weeks after 4.20 Lushan earthquake, and to analyze their clinical characteristics and effects of early rehabilitation, so as to provide baseline data for rescue TBI victims with the early rehabilitation treatment during emergency medical rescue. Methods A total of 392 victims admitted in the hospital from April 20th, 2013 to May 3rd, 2013 were screened, of which the TBI victims were clinically assessed and treated with early rehabilitation. Then both the activities of daily living (ADL) and the Rancho Los Amigos Cognitive Recovery Scale (RLA) before and after the treatment were analyzed. The data were input by Excel software, and the statistical analysis was performed by SPSS softwar. Results A total of 51 TBI victims at age from 3 to 84 years old were included finally. The categories of TBI included subarachnoid hemorrhage (41.2%), intracranial hematoma (33.3%) and mixed type (33.3%), and the severity were associated with the type of TBI. The GCS score of cerebral concussion was higher (13.25 ± 0.62) while that of the diffuse axonal injury was lower (4.50 ± 0.71). All victims (100%) had limited ADL, 74.51% had cognitive dysfunction, 9.80% had speech disorder, and 7.84% had dysphagia. After the early rehabilitation treatment, both ADL (before treatment: 34.82 ± 58.29, after treatment: 69.63 ± 22.29) and RLA (pre-treatment: 4.16 ± 1.24, treatment: 7.20 ± 1.69) were obviously higher than those before treatment, with statistical differences (both P lt;0.05). Conclusion The TBI categories of Lushan earthquake victims are various and mixed, and the severity associated with the type of TBI. All TBI victims are accompanied with more clinical problems and functional limitation. Early rehabilitation treatment is safe and effective to improve ADL and RLA as well.
Objective To investigate the injury characteristics of 33 children of Lushan earthquake victims no more than 14 years old treated in the West China Hospital of Sichuan University, and to put forward the early rehabilitation strategy. Methods A total of 33 earthquake children victims were investigated with the modified barthel index score (MBI) and analyzed in following aspects: age, causes, and injury. Results a) The 33 children victims accounted for 10.28% of the total earthquake victims treated in the hospital, they were all no more than 14 years old, and the average age was 7.24 years old. 17 cases were fractures of trunk and limbs, six were traumatic brain injury, and four were soft tissue injury. b) The main traumatic causes were crush by falling objects and heavy stuffs; and some children rarely suffered from hurt, burn and fall injury when running. c) Most children victims were simple open injuries and fractures, especially the limbs fractures accounted for 51.51% of the total cases, and there was only one case suffered from abdominal organ injuries. d) Among 33 children victims, 30 (90.9%) were from the towns and villages. They mainly got injured by the collapse of house or courtyard walls which were not as ber as the house in the cities, so the incidence of severe injury was lower, the degree of injury was milder, and the injury of major organ was rarer. Conclusion Early rehabilitation treatment is helpful to prevent the complications and early recover the functions. It suggests the early rehabilitation treatment should be carried out for the earthquake children victims in order to promote the fracture healing and functional recovery, as well as to prevent the complications. In addition, attention should also be paid to the psychological problems while concerning rehabilitation training.
Within 4 weeks after Lushan earthquake, 400 person-times were rescued in the West China Hospital of Sichuan University. There were 325 hospitalized victims, 238 surgeries including 202 orthopedic surgeries, 28 critical victims, and 1 severe victim. In order to avoid and reduce the complications, minimize disability, and recover in the early stage, a set of early rehabilitation nursing process was established by the department of rehabilitation of the West China Hospital since the 28th hour after the earthquake: set up the emergency teams for early rehabilitation nursing, and clarify the responsibilities of each team; select the technicians of early rehabilitation nursing, and perform scientific management; build the information platform for early rehabilitation nursing, and make information unobstructed; strengthen the cooperation with professional and social organizations. This nursing mode helps the victims get rehabilitation care and treatment timely and efficiently. Up to the 4 weeks after earthquake, 178 person-times recover, accounted for 44.5%; and the records of 69 victims in Wenjiang branch of the hospital show zero death after orthopedic surgery.
Objective To assess the effectiveness of statins in treating early diabetic kidney disease (DKD). Methods We searched the Cochrane Central Register of Controlled Trials (Issue 2, 2009), MEDLINE (1991 to August 2009), EMbase (1991 to August 2009), CBMdisc (1991 to August 2009) and CNKI (1994 to August 2009). We also handsearched relevant journals and conference proceedings. Randomized controlled trials (RCTs) in which statins were used to treat patients with early DKD were collected. Then we screened the retrieved studies according to predefined inclusion and exclusion criteria, evaluated the quality of the included studies, and performed meta-analyses by RevMan 4.2 software. Results A total of 281 articles were found and 22 articles inolving 1838 patients were finally included. All these articles were regarded as low quality. We chose the random-effect model to conduct meta-analysis because significant heterogeneities were found among these articles. The results of meta-analysis showed that after treatment with statins, there were significant reductions in urinary albumin excretion rate (UAER) (WMD= –55.77, 95%CI –74.20 to –37.34, Plt;0.000 01), serum creatinine (Scr) (WMD= –4.34, 95%CI –6.74 to –1.94, P=0.000 4), C reactive protein (CRP) (WMD= –1.48, 95%CI – 2.32 to – 0.63, P=0.006), total cholesterol (TC) (WMD= –1.33, 95%CI –1.75 to –0.91, Plt;0.000 01), and triglyceride (TG) (WMD= –0.72, 95%CI-1.17 to -0.27, P=0.002) in group treatment compared with group control. Funnel-plot displayed a symmetrical figure, indicating there was no publication bias. No severe adverse effects were found in these articles except 12 patients with high level of transaminase which were cured after using hepatic protect therapy. Conclusion Currently available evidence shows that with the reduction of TC and TG, statins may decrease UAER and Scr in patients with early DKD and the reduction of CRP may be involved in the mechanism. Statins provide effective renal protection and no severe adverse effects in treating early DKD. However, due to lack of quality in the included studies, more studies of better quality should be conducted
目的:探讨早期乳腺癌高频钼靶X线的征象。方法:采用高频钼靶常规乳腺摄影,对经手术及病理证实的25例早期乳腺癌的X线表现资料进行回顾性分析。结果:其中导管原位癌及导管原位伴早浸14例,浸润性导管癌8例,小叶原位癌及小叶癌早浸3例。其X线影像表现为:单纯簇状钙化者8例占32% (8/25),单纯结节5例占20%(5/25),星芒征5例占20% (5/25),结节合并钙化4例占16% (4/25),团片状密度增高影3例12% (3/25)。结论:高频钼靶可以清晰地显示早期乳腺癌的病变结构,是诊断早期乳腺癌首选而有效的方法。
目的:探讨上颈椎损伤的早期诊断方法和治疗措施。方法：回顾分析2000年1月至2008年7月间收治住院的上颈椎损伤患者35例临床资料，其中寰椎骨折6例，枢椎骨折24例，无骨折的寰枢关节脱位5例。除3例陈旧性齿状突骨折和2例陈旧性寰枢关节脱位外，其余为新鲜损伤。评价其早期诊治方法及其预后。结果：早期漏诊6例，35例患者X线检查后均需结合CT或MRI检查完善诊断及分型。手术治疗18例，其中5例为齿状突骨折早期保守治疗后改手术治疗，2例为漏诊的陈旧性寰枢关节脱位。非手术治愈16例，其中3例齿状突骨折Ⅲ型畸形愈合。1例复合性损伤患者住院3月后诊断出寰枢关节脱位出院。33例得到4～38个月随访。随访的33例患者中，骨折患者均愈合，4例寰枢关节脱位患者脱位整复，上颈椎稳定性均维持良好，神经功能改善。结论：重视上颈椎损伤患者影像检查方法早期合理的分步选择与充分利用，避免漏诊。治疗上，积极地整复骨折与脱位，尽早恢复上颈椎的稳定性。
目的 对比分析腹腔镜与开腹结直肠癌切除术后早期炎症性肠梗阻（EPISBO）的发生率，总结EPISBO的诊治经验。方法 非随机同期对照分析同一组医师连续实施的812例腹腔镜结直肠癌切除术（LS组）与615例开腹结直肠癌切除术（OS组）患者的资料，比较2组EPISBO发生率的差异。结果 术后EPISBO总发生率为4.56%（65/1 427），均经保守治疗治愈，无死亡病例。 LS组患者术后EPISBO的发生率为3.20%（26/812），低于OS组的6.34%（39/615），P＜0.05。LS组患者术后EPISBO的治愈时间为（7.51±5.72) d，OS组为（8.12±5.74) d，2组差异无统计学意义（P＞0.05）。结论 腹腔镜手术可降低EPISBO的发生率，EPISBO应以保守治疗为主。
目的 探讨应用双吻合器低位直肠癌前切除术后吻合口漏的早期诊断和防治措施。方法 回顾性分析 2005～2011年期间笔者所在医院收治的160例应用双吻合器行低位直肠癌前切除患者的临床资料。结果 本组患者术后发生吻合口漏13例（8.1%），发生吻合口漏的时间为术后 3～12d，平均7d；8例经保守治疗后治愈，4 例经二次手术行结肠或回盲部造瘘后好转，1 例于术后12d死亡。结论 直肠癌前切除术后吻合口漏的早期正确诊断和合理治疗是降低患者死亡率的关键；早期的造瘘手术和通畅引流是治愈吻合口漏的必要措施。