简介：客观：调查创伤的有三个尖头的不足的外科的治疗的最佳的时间和过程。方法：从1984年5月到2004年9月，八个病人为创伤的有三个尖头的阀门不足经历了操作。所有病人，男性，从7～67年变老[中部：38年，意味着：（38。5±18。1)年]。在损伤和操作之间的间隔从1个月到20年[中部：19个月，意味着：(52.5±80.3)月)]。Inseven病人，有三个尖头的不足被归因在三个病人包括车辆事故弄钝胸损伤，另外的病人是一处stab创伤。诊断是证实的byechocardiography。在病人的外科手术前的心脏的功能作为纽约HeartAssociation(NYHA)班Ⅱ-Ⅳ被分类。在手术期间，有三个尖头的阀门的前面的传单完全或部分在所有病人由于索的破裂被乱摆。氏族的传单的索的破裂在一个病人被发现。前面的传单在二个病人被穿孔。Septalleaflet被缩回并且支持者到在二个病人的室的中隔。阀门修理为所有病人被打算。最后，阀门修理在3个病人成功地被执行，有三个尖头的代替在5个病人被执行。结果：没有早或迟了的死亡发生了。与follow-upthrough为7-129月的临床的表明和回响心动描记法[中部：39个月，平均数:(53.4±42.8)月]，所有病人作为NYHA班Ⅰ被分类，没有任何changes.Conclusions：创伤的有三个尖头的不足的令人满意的治疗能被外科的治疗获得。更早的外科可以增加有三个尖头的阀门修理的可行性并且阻止恰好室的功能的恶化。

简介：AbstractThrombotic microangiopathy (TMA) is characterized by systemic microvascular thrombosis, target organ injury, anemia and thrombocytopenia. Thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome and Shiga toxin E-coli-related hemolytic uremic syndrome are the three common forms of TMAs. Traditionally, TMA is encountered during pregnancy/postpartum period, malignant hypertension, systemic infections, malignancies, autoimmune disorders, etc. Recently, the patients presenting with trauma have been reported to suffer from TMA. TMA carries a high morbidity and mortality, and demands a prompt recognition and early intervention to limit the target organ injury. Because trauma surgeons are the first line of defense for patients presenting with trauma, the prompt recognition of TMA for these experts is critically important. Early treatment of post-traumatic TMA can help improve the patient outcomes, if the diagnosis is made early. The treatment of TMA is also different from acute blood loss anemia namely in that plasmapheresis is recommended rather than platelet transfusion. This article familiarizes trauma surgeons with TMA encountered in the context of trauma. Besides, it provides a simplified approach to establishing the diagnosis of TMA. Because trauma patients can require multiple transfusions, the development of disseminated intravascular coagulation must be considered. Therefore, the article also provides different features of disseminated intravascular coagulation and TMA. Finally, the article suggests practical points that can be readily applied to the management of these patients.

简介：目的将与traumatic以后癫痫观察在病人的生活的质量并且讨论影响因素。我们用生活Scale-31(QOL-31)的质量作为控制与traumatic以后癫痫和100个健康的人估计了105个病人，并且在消沉上进行了回顾的分析的方法，自我等级压抑规模(SDS)和自我等级焦虑规模(SAS)，焦虑，损伤的地点，抓住的控制，EEG和治疗学的依从。有癫痫获得了的traumatic以后的结果病人很在QOL-31上比控制组降低(P<0.01)，但是比SDS和SAS上的控制组高(P<0.01)。多重回归分析显示生活的质量上的主要影响因素是焦虑，治疗学的依从，消沉，损伤的癫痫的抓住和地点的差的控制。在有posttraumatic癫痫的病人的生活的质量显著地衰退了的结论。医生们应该与癫痫注意病人的心理、心理的问题，例如消沉和焦虑，提高治疗学的依从并且控制癫痫的抓住，它是改进预后的关键。

简介：AbstractPost-traumatic osteomyelitis (PTO) is a worldwide problem in the field of orthopaedic trauma. So far, there is no ideal treatment or consensus-based gold standard for its management. This paper reviews the representative literature focusing on PTO, mainly from the following four aspects: (1) the pathophysiological mechanism of PTO and the interaction mechanism between bacteria and the body, including fracture stress, different components of internal fixation devices, immune response, occurrence and development mechanisms of inflammation in PTO, as well as the occurrence and development mechanisms of PTO in skeletal system; (2) clinical classification, mainly the etiological classification, histological classification, anatomical classification and the newly proposed new classifications (a brief analysis of their scope and limitations); (3) imaging diagnosis, including non-invasive examination and invasive examination (this paper discusses their advantages and disadvantages respectively, and briefly compares the sensitivity and effectiveness of the current examinations); and (4) strategies, including antibiotic administration, surgical choices and other treatment programs. Based on the above-mentioned four aspects, we try to put forward some noteworthy sections, in order to make the existing opinions more specific.

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简介：Objective:Toreporttheexperienceinthediagnosisandtreatmentofpost-traumaticpseudoaneurysmsandarteriovenousfistulas.Methods:Aseriesof30patients(11womenand19men)withposttraumaticpseudoaneurysmswerereviewedretrospectively.Amongthem7patients(5womenand2men)wereassociatedwitharteriovenousfistula.Results:Thecausesincludedsharppenetrationtrauma(18cases),blunttrauma(6cases)andiatrogenicarterialinjury(6cases).Themainclinicalmanifestationsconsistedoflocalpulsatilemass(26cases),vascularbruits(19cases),thrill(13cases),ischemiaofdistallimb(9cases),neuropathy(5cases)andpseudoaneurysmrupture(2cases).Allpatientsunderwentsurgery.Theoperationsincluded:ligationofthevessels(12cases),surgicalresectionandprimarysuturerepainofthevasculardefectoranastomosis(11cases),vascularreconstructionwithautogenoussaphenousvein(3cases)andsyntheticvasculargraft(4cases).Conclusions:Becauseoftheimminentclinicalcourse,earlyoperationisusuallyindicated.Theoperativetreatmentiseffectiveandsafeformostofthepatientswithpost-traumaticpseudoaneurysmsandarteriovenousfistulas.

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简介：Thestrainmonitoringandstressanalysisofanewtypeofpost-prestressedtunnellinerwerecarriedout.Theinstrumentationblockofthetunnelliner,withthedimensionsof12.06minlength,6500mmindiameter,and650mminthickness,waspost-prestressedwiththeunbondedtendons,eachofwhichconsistsof8piecesofdouble-loopedstrandsandtheaxialspacingofthetendonsis500mm.Concretestrainmeters,rebarmeters,loadcellandzero-stressmeterswereinstalledforthestrainmonitoring.Thetensioningloadswereappliedincrementallyinthreecycles(50%,77%and100%)attheconcreteageof28dandthetensioningworklastedfor187.1h.Strainreadingsweretakenbeforeandaftereachcycleduringtensioningperiodandatthespecifiedtimeintervalaftertensioningperiod.Itisfoundthatconcretecreepdevelopedovertensioningperiodis30%oftotalstrainand41.5%ofelasticstrainrespectively.Prestressforceintheunbondedtendonandconcretestressinthelinerwereevaluatedaccordingtotheobservedstrainvariations.Bothofthemaretime-dependent,andabout5.3%,8.3%and9.0%oftheprestresslossesareobservedattheageof1d,30dand60drespectivelyafterstressing.Thedistributionofprestressinthelinerisrelativelyuniformandmeetsthedesignrequirement.

简介：ToinvestigatethechangesofimmunefunctionsandtheeffectsofAstragaiuspolysaccharide(ASP)onthecell-mediatedimmunityofthetraumaticstressmodelofmousebyamputation,50micewererandomlydividedinto5groupsforstudy,inwhichthegroupAandBservedasthenormalcontrol(byinjectonof0.5mlofsalineintra-peritoneallydaily),andasthestresscontrol(byintra-peritonealinjectonof0.5mlofnormalsalineintomiceafteramputation)respectively,tothegroupC,DandEofmice,1000mg/kg(highdose),300mg/kg(mediandose)and250mg/kg(lowdose).TheCD4^+andCD8^+Tcellsaswellastheexpressionofthec-fosproteinweredeterminedbyimmunohistochemicaltechniques,andtheexpressionsofNF-κBmRNAandIL-10mRNAwereassayedbyhybridizationinsitu.Theexperimentalresultsshowedthatincomparisonwiththenormalcontrolgroupofmice(groupA),theexpressionlevelsofNF-κBmRNA,IL-10mRNAandthec-fosproteininthetissuesofthymusandspleeninthestresscontrolsweresignificantlyelevatedandtheCD4^+TcellsandCD4/CD8ratioweredecreased.However,incomparisonwiththestresscontrolofmice(groupB),theexpressionsofNF-κBmRNAandIL-10mRNAwereinhibitedbyASP,andtheCD4^+TcellsandCD4/CD8ratiowereincreasedingroupsC,DandE,butthelevelofc-fosproteinwasdecreased.TherewasnosignificantdifferenceintheseparametersamonggroupC,DandE.Itiscon-cludedthatthefunctionsofcell-mediatedimmunityofmiceweredisturbedunderthestressconditionofthetraumaticinjuriesafteramputation.AndtheimmunefunctionscanbeeffectivelyrestoredbytheuseofAstraga/uspolysaccharide.

简介：AbstractPurpose:Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.Methods:Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.Results:A total of 1902 records were initially identified and screened. After duplicates removal and title & abstract review, finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD)=-0.33; 95% CI [-0.45,-0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD=-0.33, 95% CI [-0.46,-0.19]; SMD=-0.49, 95% CI [-0.88,-0.10], respectively), formats of delivery (group-based or individual-based, SMD=-0.30, 95% CI [-0.42,-0.17], SMD=-0.49, 95% CI [-0.90,-0.08], respectively) and intervention durations (short-term or standard duration, SMD=-0.27, 95% CI [-0.46,-0.08], SMD=-0.40, 95% CI [-0.58,-0.21], respectively) were equally effective in improving military-related PTSD symptoms.Conclusion:Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidence with higher quality and more rigorous design is needed in the future.

简介：Freeradicalsinducedbytraumaticbraininjuryhavedeleteriouseffectsonthefunctionandantioxidantvitaminlevelsofseveralorgansystemsincludingthebrain.Melatoninpossessesantioxidanteffectonthebrainbymaintainingantioxidantenzymeandvitaminlevels.Weinvestigatedtheeffectsofmelatoninonantioxidantabilityinthecerebralcortexandbloodoftraumaticbraininjuryrats.Resultsshowedthatthecerebralcortexβ-carotene,vitaminC,vitaminE,reducedglutathione,anderythrocytereducedglutathionelevels,andplasmavitaminClevelweredecreasedbytraumaticbraininjurywhereastheywereincreasedfollowingmelatonintreatment.Inconclusion,melatoninseemstohaveprotectiveeffectsontraumaticbraininjury-inducedcerebralcortexandbloodtoxicitybyinhibitingfreeradicalformationandsupportingantioxidantvitaminredoxsystem.

简介：AbstractPurpose:One of the consequences of trauma-related injuries is disability. There are more than one billion people with disabilities worldwide. Disability in people reduces their quality of life. The goal of this study was to determine the rate of post-trauma stress and disability related to trauma in the population over 15 years old in Kashan during a solar year of 2018-2019.Methods:This is a cross-sectional population-based study. A cluster sampling method was used in the city of Kashan, and 3880 persons were interviewed with individuals randomly selected in each household. If a person had trauma during one year ago, the World Health Organization Disability Assessment Schedule 2.0 and Post Trauma Stress Disorder (PTSD) Checklist were applied for further interview. Data were analyzed using Chi-square test or t-test.Results:Among the 3880 participants residing in Kashan, 274 (7.1%) reported a history of traumatic injury during one year ago in 2018-2019. Incidence of all injuries was estimated to be 70.61 (62.60-78.70) per 1000 people. For the trauma population, 213 (77.7%) were male and 75.1% were married. About half of them (50.3%, 138/274) aged 21-39 years. The most common cause of injuries was related to traffic accidents: 140 (51.1%). Of the 274 trauma participants, 47 (17.2%) reported PTSD; 244 (89.1%) had a mild disability, and 30 (10.9%) reported moderate disability.Conclusion:One of the main causes of disability in the human community is the traumatic injuries. According to the results of this study, 89.1% of trauma participants have sustained at last mild disability following trauma. These people require follow-up and post-treatment support. It should be noted that psychological complications such as PTSD are as significant as physical symptoms.

简介：AbstractPurpose:Evidence suggests that the oxytocin receptor (OXTR) gene may be involved in the psychopathology of posttraumatic stress disorder (PTSD). This study aimed to investigate the effects of OXTR rs53576 genotype on PTSD symptoms introduced in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5).Methods:This study was a cross-sectional study conducted among 1140 adults who had personally experienced the Wenchuan earthquake. PTSD symptoms were measured with the PTSD checklist for DSM-5. A custom-by-design 2 × 48-Plex SNPscanTM Kit were used to determine the OXTR rs53576. Multiple regression models were used to analyze the independent and interactive effects of OXTR rs53576 genotype and earthquake exposure on the severity of total PTSD symptoms and different dimensions of PTSD symptoms.Results:The results revealed that the rs53576 genotype could significantly predict PTSD symptoms (β = 0.055, p = 0.045). Further analysis showed that the rs53576 genotype was only significantly associated with dysphoric arousal symptoms of PTSD (β = 0.080, p = 0.005). The rs53576 genotype × earthquake exposure interaction had no significant effect on different symptom clusters (p > 0.05).Conclusion:This study showed that the rs53576 genotype was only associated with the dysphoric arousal symptoms but not with other symptom clusters of PTSD. These findings support the role of the OXTR on the psychopathology of PTSD and help us to understand the genetic basis of PTSD.

简介：Background:Depressiondisordercoexistsinchronicdiseaseswithsomaticdiseasesandhashighmorbidity,disabilityandmortality.Currentresearcheshaveconfirmedthatdepressionmaybecausedbycoronaryheartdisease,hypertensionandheartfailure.Meanwhile,cardiovasculardiseasesmaycauseorworsendepression,leadingtoprolongedhospitalizationandcomplications.

简介：你的睡眠质量如何？是否有夜黑被噩梦惊醒的时候？科学研究证发现，我们正睡眠时，眼球仍然在迅速移动，那么这就表明你正在做梦，REM睡眠到底是怎么一回事？它与我们的大脑神经有何联系？相信读完下面的短文后，你就会找到答案的。

简介：Today＇sMissionWhataretwothingsapostmancando？You＇vegotmail!TodayIamlearningtobeapostman.APostmanstartshisdayearlyatthepostoffice.Hereeverypostmanneedstoorganizethemailbyaddress,roadsandpostalcodes.

简介：小李：我要寄这个包。邮局职员：你要保价吗？小李：保一百元吧，我还要两张邮票。邮局职员：你要到邮票窗口买。

简介：Interhemisphericsubduralhaematoma(ISH)probablyrepresentsoneoftherarestformsofposttraumaticintracranialhaemorrhagesbecauseofthepeculiaranatomicallocation.ItwasfirstdescribedatautopaybyAirrngandEransin1940andfewcases(110)havebeenreportedsinceJobobefirstdescribedclinicalcasesin1955.1-7SincethereisnoinitialpathognomoniccharacteristicpresentingmodeofISH,ISHwouldresultinaserioussituationifnottreatedproperlyandpromptly.Recently,wetreatedtwopatientssufferingISHinourneurosurgeryunit.

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简介：Studiesonbrain-evokedpotentialandcontingentnegativevariation(CNV)inmooddisorderremaincontroversial.Todate,noCNVdifferencebetweenunipolarandbipolardepressionhasbeenreported.Brain-evokedpotentialsweremeasuredinthepresentstudytoanalyzeCNVinthreesubtypesofmooddisorder(mania,unipolardepression,andbipolardepression),andtheseresultswerecomparedwithnormalcontrols.Inthemaniagroup,CNVamplitudeBwasgreaterthanincontrols,andthedepressiongroupexhibitedlowerCNVamplitudeBandsmallerA-S'2area,andprolongedpost-imperativenegativevariationlatency.TheCNVcomparisonbetweenunipolarandbipolardepressionfoundthattheprolongedpost-imperativenegativevariationlatencywasonlyinunipolardepression.Theseresultssuggestthatprolongedpost-imperativenegativevariationlatencyisacharacteristicofunipolardepression,andCNVamplitudechangeisastatecharacteristicofmooddisorderpatients.