Chinese Med J Peking
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Chinese Med J Peking · Feb 1998
ReviewEmployment of trauma and injury severity score and a severity characterization of trauma in the outcome evaluation of trauma care and their research advances.
To review the application of trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) in the outcome evaluation of trauma care and their research advances. ⋯ TRISS can be employed for different purposes, that is, preliminary outcome-based evaluation (PRE) and definitive outcome-based evaluation (DEF). TRISS is a method which is now the most extensively used for the outcome evaluation of trauma. Even so, it still has some shortcomings, e.g., trauma can not be given the weights that should be given, and the section of age is too simple. ASCOT is also a physiologic and anatomic combined method for the evaluation of injury severity and outcome. To some extent, this method obviates the shortcomings of TRISS in the calculation of probability of survival (Ps) with injury severity score (ISS). Therefore, ASCOT is considered to be superior to TRISS in the evaluation of Ps. However, TRISS is still now more extensively used than ASCOT just because ASCOT was recently developed.
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To present some new concepts in the treatment of fractures and bone defects of long bones with internal fixation. ⋯ Reduction of fracture should be perfect, bone defect can be reconstructed by intramedullary and extramedullary bone graft. Relatively rigid fixation at the early stage and elastic fixation at the later stage are beneficial not only for fracture healing, but also for bone remodeling. In order to avoid complications including non-union, immobilization syndrome of the bone and joint, and implant failure, radiographs should be taken periodically; if there is any bone resorption, weight-bearing should be restricted.
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Chinese Med J Peking · Feb 1998
Trinucleotide repeat expansion of spinocerebellar ataxia (SCA1) found in a Chinese family.
To investigate the gene mutation and the ratio of the spinocerebellar ataxia type 1 (SCA1) in Chinese patients with autosomal dominant spinocerebellar ataxia (ADSCA). ⋯ The frequency of the SCA1 mutation is about 7% in the 13 Chinese families with ADSCA, suggesting that this type of genetic defect is not the main cause involved in the pathogenesis of ADSCA in China. Since the mutation has also been found in Caucasian, Japanese, Malaysian, and Bangladeshi kindreds, it is suggested that this genetic defect may well have multiple origins in different ethnic groups.
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To study the injury factors, pathogenic process and clinical features of delay two-phase multiple organ dysfunction syndrome (MODS) in severe burned patients and to replicate a standardized animal model that would accurately imitate the clinical features of MODS. ⋯ Both in human patients or animal experimentation, the typical delay two-phase MODS is shown to be produced by two successive insults in the forms of hypovolemic shock and sepsis. This postulation is helpful in formulating the prevention and treatment modality of MODS.