Objective To study the relations between the site of head injury and the position of brain edema induced tentorial notch herniation (TNH). Method The formalin fixed brain specimens of 91 cases were cut either coronally, or sagittally or horizontally, according to different requirement. Then, the characteristics of injury were observed. Results There were three types of brain edema induced TNH after cerebral injury: 65 cases with anterior herniation (71.4%), 5 cases with posterior herniation (5.5%), and 21 cases with unilateral or bilateral total herniation (23.1%). Anterior herniation was notable among 16 cases with total herniation. Conclusion Frontotemporal anterior herniation was the most common type of TNH after cerebral injury. The occurrence of TNH was related to the site and manner of injury, as well as the strength of force and survival interval after injury.

Abstract OBJECTIVE To carry out clinical comprehensive evaluation of prophylactic drugs for clean surgery(type I incision) in children, and to promote the rational use of antibiotics during perioperative period. METHODS According to the Guidelines for the Management of Comprehensive Clinical Evaluation of Drugs(trial edition of 2021), the clinical comprehensive evaluation system of prophylactic drugs for clean surgery(type I incision) was established by using the methods of literature research, brainstorming, expert interview and Delphi, and the evaluation evidence was collected to carry out the comprehensive evaluation of multi-dimensional and multi-level evidence. RESULTS The clinical comprehensive evaluation system was constructed, including 5 first-class indicators(safety, effectiveness, economy, suitability, and accessibility), 11 second-class indicators and 30 third-class indicators. The clinical comprehensive evaluation score of cefazolin was 86.09, and that of cefuroxime was 81.86. The former was better than the latter in safety, effectiveness, economy and suitability, while the latter was better than the former in accessibility. CONCLUSION The clinical comprehensive evaluation of prophylactic drugs for clean surgery(type I incision) in children constructed in this study is scientific, and the results provides a basis for the selection of antibiotics for clean surgery(type I incision) in hospital