Objective: To investigate the prophylactic effect of EEN on pulmonary infection in patients with severe traumatic brain injury.Methods: 60 cases of young adults with severe brain injury were randomized into the early enteral nutrition group(experimental group) or the control group.The experimental group was feeded 12～24 hours after injury or surgery and the control group was feeded 24 h～5 d after injury or surgery.The double-sugar test method was used for determination of intestinal barrier function,and the duration of pulmonary infection was recorded.Results: The lactulose/mannitol ratio in experimental group was significantly lower than in control group on the 7th postoperative day.The average body temperature and duration of pulmonary infection in experimental group were significantly lower than in control group.According to ADL scores,the daily capacity of convalescent patients in experimental group was significantly better than in control group.Conclusion: The early enteral nutrition can improve mucosal barrier function,reduce the incidence of pulmonary infection and improve overall prognosis in patients with severe traumatic brain injury.

Objective To investigate the key words related with the growth of psychological rehabilitation literature of psychological rehabilitation in China. Methods The journal articles associated with psychological rehabilitation in CNKI were analyzed with key word frequency.The relationship between the cumulative frequency of key words and the growth of literature were analyzed with Linear Regression Analysis. Result Based on the cumulative frequency of 340 key words frequencies more than 4 in each year, Linear Regression Analysis extracted 10 words that correlated with the literature growth, which were Psychological Nursing, Psychological Problem, Psychological Response,Psychotics, Emotional Disorder, Type A Behavior, Social Psychology, SCL-90, Prosthesis, and Psychiatry. Conclusion The major objects of the researches of psychological rehabilitation in China were psychological problem, psychological response, psychotics, emotional disorder, type A behavior; the major tools were social psychology, SCL-90; the researchers mainly come from the nurse, and the professionals of prosthesis and psychiatry.

Objective To investigate the strategies of reducing the incidence of missed diagnosis of severe traumatic brain injuries combined with multiple trauma. Methods Data of 432 patients with severe traumatic brain injuries and multiple trauma (ISS≥20) from January 2000 to August 2007 were analyzed retrospectively. All patients were divided into missed diagnosis group (MD group, n =54) and non-missed diagnosis group (NMD group, n =378) for correlation analysis on ISS, GCS, anatomical locations of the missed diagnosis, the time of delayed diagnosis and the prognosis. Results ISS was (42.97±10.94) points in MD group, with statistical difference compared with NMD group (P < 0.05). The patients with GCS≤8 in MD group was more than those in NMD group (P < 0.05). Conclusions It is effective to prevent missed diagnosis and improve the survival of patients with severe traumatic brain injuries combined with multiple trauma by judging injury severity quickly and precisely based on the principle of "life first" and repeated and systemic physical examination.

PURPOSETo investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling.

METHODSTwenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4-5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of-interest in two groups were analyzed and compared before and after treatment.

RESULTSCompared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly (p < 0.05) in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group.

CONCLUSIONExternal ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.

Adult ; Aged ; Brain ; physiopathology ; Brain Edema ; physiopathology ; therapy ; Brain Injuries ; complications ; Cerebrovascular Circulation ; Drainage ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Retrospective Studies

While the development of multi-campus hospitals is conducive to promoting the expansion and equal distribution of high-quality medical resources and improving the overall medical quality of municipalities, the model puts forward high requirements for the capabilities of integrated operation and management of public hospitals. As key part of health services and the higher medical education system, facing the multi-campus hospital reform, hospital affiliated to colleges and universities should carry out rearrangements in both medical and educational aspects at the same time. Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine has made substantial progress in integrated and homogenized management since the integration of the Lingang campus as a whole into the parent hospital in 2021. The department of undergraduate clinical medical education has analyzed the difficulties in teaching management and talent cultivation in the multi-campus system during the rearrangement process, forming a coordinated management mechanism for undergraduate clinical medical education within campuses under the concept of "homogeneity-difference-collaboration". This article may provide a reference for enriching multi-campus hospital management practice and improving the quality of undergraduate clinical medical education in hospitals affiliated to colleges and universities.