PURPOSE: Although there are significant differences between China and the United States (US) in trauma medical services, there has been no direct comparative research on the epidemiological data of trauma centers between the 2 countries. This study aims to fill this research gap by directly comparing trauma centers in China and the US, providing valuable data and insights for the development of trauma centers in both countries, promoting academic exchange and cooperation internationally, and enhancing the level of global trauma medical care. METHODS: This is a multicenter retrospective descriptive study. Data were collected for trauma patients with an injury severity score ≥16 treated from September 2013 to September 2019 at 2 hospital trauma centers in these 2 countries. Detailed clinical data (including injury mechanism, age, injury site, injury severity score, pre-hospital transport time, whether blood transfusion was performed, whether resuscitative thoracotomy was conducted, hospital and intensive care unit stay duration, the number of organ donor patients, mortality rates, and costs) were meticulously compiled and retrospectively analyzed to identify differences between the 2 trauma centers. The comparison was conducted using SPSS 23 software. Continuous variables are reported as median (Q₁, Q₃), and Mann Whitney U test is used to compare the median of continuous variables. Use clinically relevant critical points to classify continuous variables, with categorical variables represented as n (%), and comparisons were made between the 2 groups using the χ² test or Fisher's exact test. Statistical significance was defined as a 2-sided p < 0.05. RESULTS: These results point to significant differences in trauma center capacity, pre-hospital transport times, treatment procedures, hospital stay duration, mortality rates, and costs between the 2 centers. The volume of patients in trauma centers is less in China (2465 vs. 5288). Pre-hospital transport time was notably longer in China (180 min vs. 14 min), and the rate of emergency blood transfusions was lower in China (18.4% vs. 50.6%), Emergency thoracotomy was not performed in China but was conducted in 9.8% of cases in the US. Hospitalization costs were significantly lower in China than in the US ($5847 vs. $75,671). CONCLUSION There are clear differences in trauma center capacity (number of patients treated), pre-hospital transport time, age distribution of injured patients, injury mechanisms, injury sites, whether emergency thoracotomy is performed, hospital costs, and length of stay between the 2 trauma centers in China and America. Understanding these differences can help us further recognize the characteristics of Eastern and Western trauma patients.
Humans ; China/epidemiology* ; Trauma Centers/statistics & numerical data* ; Retrospective Studies ; United States/epidemiology* ; Male ; Female ; Wounds and Injuries/therapy* ; Middle Aged ; Adult ; Injury Severity Score ; Length of Stay/statistics & numerical data* ; Treatment Outcome

Primary cardiac tumors are extremely rare, occurring in 0.001% to 0.3% of autopsies.1 Most cardiac tumors are metastatic, and they are usually diagnosed in approximately 10% of patients with non-cardiac primary tumors at autopsy.2 3 4 About 75% of primary cardiac tumors are benign and are predominantly myxomas.5 Only 25% of these tumors are malignant, and the most common types in both children and adults, are sarcomas (75%).1 6 7 In a retrospective study done among 255 patients with cardiac tumors in the Philippine Heart Center from 1976 to 2006, the incidence of benign tumors was 91.8% while malignant tumors were reported in 8.2% of cases. Eighty-nine percent of the patients were adults, and 11% were from the pediatric age group.8 As in other similar studies,5 9 the most common cardiac tumors in the Philippine study were myxoma among the adult participants and rhabdomyoma among the pediatric participants.
Heart Neoplasms ; Cardiac Surgical Procedures

Ectopia cordis (EC) is a rare congenital malformation characterized by a complete or partial extrathoracic presentation of the heart,1 2 with an incidence of only 6 to 8 in a million live births globally.3 4 It occurs due to failure of maturation of the midline mesoderm and improper formation of the chest and abdomen during embryonic development.5 6 Depending on the heart’s ectopic location, EC is classified into four types—i.e., thoracic (65% of cases), thoracoabdominal (20%), abdominal (10%), and cervical (5%).1 2 4 7 Only two cases of EC, one thoracic and one thoracoabdominal, from the Philippines had been reported in literature.8 Cantrell’s pentalogy—findings of bifid sternum, absence of the diaphragm, defect of anterior diaphragmatic pericardium, defect of the anterior abdominal wall, and intracardiac defects—usually accompanies the thoracoabdominal type of EC.
Ectopia Cordis

The clinical presentation of Boerhaave’s syndrome (BS), a rare condition of the gastrointestinal tract characterized by a spontaneous rupture of the esophagus most often caused by vomiting after excessive alcohol drinking or after consuming a large meal, mimics other less serious illnesses, often leading to a missed or delayed diagnosis. The Mackler triad, which is rare and pathognomonic of BS, includes lower thoracic or chest pain, subcutaneous emphysema, and vomiting. Diagnosis is made through computed tomography scan and esophageal contrast studies. Treatment of BS is geared towards control of mediastinitis and sepsis, and repair of the perforation or reestablishment of the continuity of the gastrointestinal tract. We report the case of a 46-year-old male with BS, who was initially managed with a conservative resection of the perforated esophagus 48 hours after the onset of symptoms. When the mediastinitis persisted we decided to do a subtotal esophagectomy and subsequent esophageal reconstruction.
Esophagectomy