Objective To find the optimal perfusion temperature of focal hypothermia in rats with traumatic brain injury(TBI).Methods Modified Feeney's free-falling model was used in the study.Forty-nine male Sprague-Dawley(SD)rats were randomly divided into seven groups:TBI group,systemic hypothermia group,focal hypothermia groups(including 0℃,10℃,20℃ or 25℃ subgroups,respectively)and control group.The contents of total sodium,potassium and water of traumatic brain were measured,and pathological changes were examined in the seven groups.Results The damaged neurons were significantly fewer in focal hypothermia groups(including 10℃,20℃ or 25 ℃ subgroups,respectively)than those in systemic hypothermia group at 72 hours after TBI(P

Objective To investigate the features and neural mechanisms of sustained attention and executive function in patients with acute mild traumatic brain injury (mTBI) by comparing and analyzing behavioral and event-related potentials of patients and healthy controls.Methods Seventeen patients with acute mTBI and seventeen healthy controls participated in a cued continuous performance test.Behavioral data and event-related potentials were collected and analyzed.Results 1.There were significant differences between the mTBI group and the control group in hitting number ((66.76±3.27), (69.12± 1.41)) ,reaction time((533.66±144.20) ms, (413.03±94.57) ms) and the number of errors of omission ((3.24±3.27), (0.88± 1.41)) (P＜0.05), but no significant differences in the number of false errors ((0.35±1.00), (0.53±0.87)) (P＞0.05).2.The amplitude of Go-N2 and Nogo-N2 were significantly smaller in mTBI group than that in control group (P＜0.05).The main effect of group was significant of N2 amplitude (P＜0.05), but main effect of condition and the interaction effect were not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the latency of N2 (P＞0.05).The amplitude of Go-P3 was significantly smaller in mTBI group than that in control group (P＜0.05),while not on the amplitude of Nogo-P3(P＞0.05).The main effect of group and condition were significant on P3 amplitude (P＜0.05),but the interaction effect was not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the amplitude of P3 (P＞0.05).Conclusion Patients with mTBI show impairments in sustained attention and conflict monitoring, but not in response inhibition.

Objective To explore the influential factors of treatment of the intra-articular calcaneal fractures treated with calcaneal titanic alloy plate.Methods The treatment of intra-articularcalcaneal fractures with calcaneal titanic alloy plate was reviewed.Thefalling height, weight, complication, Sanders evaluation method,mechanism of injured, the change degree of B(o)hler and Gissane angle were recorded and compared.One-way ANOVA, Chi-Square Tests and logistic test were applied to evaluate the relationship of these factors.Results According to AOFAS scale system, the average recovery score was 86.35, excellent rate was 91.6%.Binary logistic stepwise regression showed that the correlation between weight and resu1ts of treatment was statistically significant( P ＜0.01 ).The correlation between the period before operation and the recovery score was statistically significant( P ＜0.01).Sanders evaluation method was statistically significant ( P ＜0.05).The correlation between preoperative B(o)hler'sngle and Gissane's angle and the postoperative functional recovery score was statistically significant ( P ＜ 0.05) .Conclusions Calcaneal titanic alloy plate used in treatment of intra-articular calcaneal fracturcs was a good method.The weight, the period before operation, level of trauma and the B(o)hler's angle and Gissane's angle influenced the treatment effect.

Objective To study the differences between preschool hearing-impaired children and normal-hearing children in the developmentof logic analogy ability. Methods 90 hearing-impaired and 90 normal-hearing preschool children underwent the Logic Analogy forChildren test. Results There was no significant difference in the scores of Logic Analogy between the genders (P>0.05). The ability of logicanalogy improved with age. The scores of Logic Analogy were significantly higher in normal-hearing children than in hearing-impaired children(P>0.05). Conclusion It is learned that the basic law and main characteristic of the logic analogy ability development in preschool hearing-impaired children.

Objective To investigate the clinical effect of distal clavicle anatomical locking plate internal fixation com-bined with coracoclavicular ligament reconstruction in the treatment of old Neer type Ⅱb distal clavicle fractures.Methods Ninety-five patients with old Neer type Ⅱb distal clavicle fractures admitted to the Department of Emergency Trauma Surgery,Nanyang First People's Hospital from February 2019 to January 2022 were selected as the research subjects,and the patients were divided into a control group(n=50)and an observation group(n=45)according to the surgical protocols.The patients in the control group received distal clavicle anatomical locking plate internal fixation,while the patients in the observation group received distal clavicle anatomical locking plate internal fixation combined with coracoclavicular ligament reconstruction.The fracture healing time of patients in the two groups was calculated based on the criteria of blurred fracture line under X-ray,continuity of bone scab passing through the fracture line,and the absence of pain on percussion and pressure;at the final follow-up,the functional recovery of the shoulder joint was evaluated according to Herscovici efficacy criteria to calculate the overall excellent rate;before operation,at 6 months after operation,and at 12 months after operation,the subjective pain of patients in the resting state was evaluated by using the visual analogue scale(VAS),the shoulder joint function of patients in the resting state was evaluated by using the Constant-Murley scale,and the coracoclavicular distance,acromioclavicular distance,forward flexion mobility,and external rotation mobility of patients were determined by using the spiral CT.The perioperative complications such as superficial incision infection,distal fracture displacement,shoulder joint pain,vascular nerve injury,re-fracture,and bone infection were compared between the two groups.Results The absorption time of absorbable sutures of patients in the observation group was(4.12±1.28)weeks.The fracture healing time of patients in the observation group was significantly shorter than that in the control group(t=5.558,P＜0.05).The overall excellent rate of shoulder joint function recovery of patients in the observation group was significantly higher than that in the control group(x2=4.222,P＜0.05).Before operation,there was no statistically significant difference in the VAS score and Constant-Murley score of patients between the control group and the observation group(P＞0.05);at 6 and 12 months after operation,the VAS scores of the patients in the two groups were significantly lower than those before operation,while the Constant-Murley scores were signifi-cantly higher than those before operation(P＜0.05);the VAS scores of patients in the two groups at 12 months after operation were significantly lower than those at 6 months after operation,while the Constant-Murley scores were significantly higher than those at 6 months after operation(P＜0.05);at 6 and 12 months after operation,the VAS scores of patients in the observation group were significantly lower than those in the control group,while the Constant-Murley scores were significantly higher than those in the control group(P＜0.05).Before operation,there was no statistically significant difference in coracoclavicular distance,acromioclavicular distance,forward flexion mobility,and external rotation mobility between the control group and the observation group(P＞0.05);at 6 and 12 months after operation,the coracoclavicular distance and acromioclavicular distance of patients in the two groups were significantly smaller than those before operation,while the forward flexion mobility and external rotation mobility were significantly greater than those before operation(P＜0.05);the coracoclavicular distance and acromio-clavicular distance of patients in the two groups at 12 months after operation were significantly smaller than those at 6 months after operation,while the forward flexion mobility and external rotation mobility were significantly greater than those at 6 months after operation(P＜0.05);at 6 and 12 months after operation,the coracoclavicular distance and acromioclavicular distance of patients in the observation group were significantly smaller than those in the control group,while the forward flexion mobility and external rotation mobility were significantly greater than those in the control group(P＜0.05).There were no perioperative complications in patients in the two groups,such as vascular nerve injury,re-fracture,and bone infection.The total complication rates of patients in the control group and the observation group were 6.00％(3/50)and 6.67％(3/45),respectively;there was no statistically significant difference in total complication rates of patients between the control group and the observation group(x2=0.084,P＞0.05).Conclusion Distal clavicle anatomical locking plate internal fixation combined with coracocla-vicular ligament reconstruction has a significant effect in the treatment of old Neer type Ⅱb distal clavicle fractures,which can quicken fracture healing,reduce pain,and improve shoulder joint function and the three-dimensional morphology of the acromiocla-vicular joint,with few complications.

Objective:To explore the effect of progressive case teaching based on Omaha system in standardized training for new nurses.Methods:Using convenience sampling method, 58 new nurses from Yantai Affiliated Hospital of Binzhou Medical University from January to December 2021 were selected as control group, and 58 new nurses from January to December 2022 were selected as experimental group. Experimental group received progressive case teaching based on Omaha system, while control group received routine standardized training. Both groups received training for six months. After six months of training, the academic performance, clinical thinking ability, and satisfaction of the two groups were compared.Results:After intervention, experimental group scored higher in various dimensions of academic performance and clinical thinking ability, as well as satisfaction scores with the teacher, teaching methods, and teaching effectiveness, compared to the control group, with statistical differences ( P<0.05) . Conclusions:The progressive case teaching based on Omaha system in standardized training for new nurses can improve academic performance, enhance clinical thinking abilities, and gain recognition from new nurses.

Uremic pruritus (UP) is a common complication in patients with end-stage renal disease, which seriously reduces the quality of life of patients. Compared with the internal treatment of TCM, the external treatment of TCM for UP is simpler and more effective, and can avoid the first pass effect caused by oral drugs and may cause liver and kidney damage. The treatment methods mainly include external washing of TCM, medicated bath, fumigation, wet compress, enema, scraping, acupuncture, auricular point sticking, acupoint application, acupoint iontophoresis, autologous blood acupoint injection and so on. At present, most studies are based on the conventional treatment of Western medicine, and the addition of external treatment of TCM can improve the efficacy, and has certain advantages in improving itching symptoms, inflammatory indicators, sleep quality, anxiety and depression. Some studies have selected parathyroid hormone, blood phosphorus, CRP, IL-6, histamine, SCr, BUN, β2-microglobulin and other indicators to evaluate the efficacy. The results suggest that external treatment of TCM can improve the micro-inflammatory state of patients and protect renal function, but further mechanism research is needed. The existing research has the following problems: the clinical efficacy evaluation scale is not uniform, and it is difficult to compare and summarize horizontally; the relief of pruritus symptoms is based on the scale evaluation, which is subjective; the course of treatment is short, and the long-term efficacy and safety can not be evaluated; some studies do not specify the patients' syndrome type, which is difficult to reflect the advantages of TCM syndrome differentiation and treatment, and needed to be improved in the future.

Laser Doppler perfusion imaging (LDPI) works through the Doppler effect of light wave, and it could depict the blood flow value of the entire wound in two-dimensional image without contacting the detection site directly. In resent years, LDPI has been proved to be effective to evaluate healing potential of a wound, and to predict burn depth and scar formation. The accuracy of LDPI is higher than other traditional methods and technique. However, there are still many influencing factors for the clinical application of LDPI scanning. This paper presents a comprehensive overview of advances in the research of LDPI for clinical application in the care of burn wounds and influencing factors for accurate scanning.
Burns ; physiopathology ; therapy ; Cicatrix ; Humans ; Laser-Doppler Flowmetry ; methods ; Perfusion Imaging ; methods ; Wound Healing

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective: To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy. Methods: The prospective study was conducted. The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected, including 380 in the Zhongshan Hospital of Fudan University, 351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine, 130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 139 in the Peking University Cancer Hospital, 128 in the Fujian Provincial Cancer Hospital, 114 in the First Hospital Affiliated to Army Medical University, 104 in the First Affiliated Hospital of Nanchang University, 104 in the Affiliated Hospital of Qinghai University, 103 in the Weifang People′s Hospital, 102 in the Fujian Medical University Union Hospital, 99 in the First Affiliated Hospital of Air Force Medical University, 97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, 60 in the Hangzhou First People′s Hospital Affiliated to Zhejiang University School of Medicine, 48 in the Fudan University Shanghai Cancer Center, 29 in the First Affiliated Hospital of Xi′an Jiaotong University, 26 in the Lishui Municipal Central Hospital, 26 in the Guangdong Provincial People′s Hospital, 23 in the Jiangsu Province Hospital, 13 in the First Affiliated Hospital of Sun Yat-Sen University, 7 in the Second Hospital of Jilin University, 4 in the First Affiliated Hospital of Xinjiang Medical University, 2 in the Beijing Chao-Yang Hospital of Capital Medical University. Observation indicators: (1) the incidence of POPF after radical gastrectomy; (2) treatment of grade B POPF after radical gastrectomy; (3) analysis of clinicopathological data; (4) analysis of surgical data; (5) risk factors for grade B POPF after radical gastrectomy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinico-pathological and surgical data. Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis. Results: There were 2 089 patients screened for eligibility, including 1 512 males, 576 females and 1 without sex information, aged (62±11)years. The body mass index (BMI) was (23±3)kg/m². (1) The incidence of POPF after radical gastrectomy: the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089). The incidence rates of biochemical fistula, grade B pancreatic fistula, and grade C pancreatic fistula were 19.627%(410/2 089), 1.101%(23/2 089), 0, respectively. (2) Treatment of grade B POPF after radical gastrectomy: 2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy. Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination, of which 2 received peritoneal drainage guided by ultrasound, 1 received failed puncture drainage, 1 received no puncture drainage, and they were given anti-infective therapy. Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations, and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells. Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days). All the 23 patients recovered well after treatment, without reoperation. (3) Analysis of clinicopathological data: for the 2 089 patients, BMI, cases with or without neoadjuvant therapy were (23±3)kg/m^2, 1 487, 160 of patients without pancreatic fistula, (23±3)kg/m^2, 386, 22 of patients with biochemical fistula, and (24±3)kg/m^2, 22, 1 of patents with grade B pancreatic fistula, showing significant differences between the three groups (F=5.787, χ²=8.269, P<0.05). (4) Analysis of surgical data: for the 2 089 patients, cases with open surgery, laparoscopic assisted surgery, totally laparoscopic surgery (surgical method), cases with D₁ lymph lode dissection, D₂ lymph lode dissection, and other lymph lode dissection (range of lymph lode dissection), cases with no omentectomy, partial omentectomy, and total omentectomy (range of omentectomy), cases with no usage of energy facility, usage of CUSA, LigaSure, LigaSure+ CUSA as energy facility, cases with or without biological glue, the number of lymph node dissection were 737, 624, 292, 24, 1 580, 51, 418, 834, 381, 63, 1 530, 23, 16, 1 431, 201, 33±14 of patients without pancreatic fistula, 146, 189, 74, 11, 389, 9, 110, 171, 128, 35, 359, 6, 9, 378, 31, 31±14 of patients with biochemical fistula, and 14, 5, 4, 0, 20, 3, 6, 13, 4, 2, 18, 1, 2, 22, 1, 37±16 of patients with grade B pancreatic fistula, showing significant differences between the three groups (χ²=15.578, 9.397, 15.023, 28.245, 8.359, F=4.945, P<0.05). (5) Risk factors for grade B POPF after radical gastrectomy: results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (χ²=9.914, P<0.05). Results of multivariate analysis showed that laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168, 3.922, 9.250, 1.030, 95% confidence interval: 0.036-0.789, 1.031-14.919, 1.036-82.602, 1.001-1.059, P<0.05). Conclusions The incidence of grade B POPF after radical gastrectomy is relatively low. Laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, and the number of lymph lode dissection are independent risk factors for grade B POPF. Trial Registration: This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.