Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association
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Chin. J. Traumatol. · Aug 2009
Randomized Controlled TrialRemifentanil combined with low-dose ketamine for postoperative analgesia of lower limb fracture: a double-blind, controlled study.
To investigate the adjuvant effect of intraoperative and postoperative low-dose ketamine administration to remifentanil consumption in patient-controlled analgesia (PCA) for lower limb fracture. ⋯ Low-dose ketamine can relieve postoperative pain and moderately decrease remifentanil consumption for PCA, with no obvious side effects of ketamine.
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Chin. J. Traumatol. · Aug 2009
ReviewProne positioning ventilation for treatment of acute lung injury and acute respiratory distress syndrome.
Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health care workers have implemented various strategies in an attempt to compensate for these pathological alterations. By rotating patients with ALI/ARDS between the supine and prone position, it is possible to achieve a significant improvement in PaO2/FiO2, decrease shunting and therefore improve oxygenation without use of expensive, invasive and experimental procedures. ⋯ Because a specific cure for ARDS is not available, the goal is to support the patients with therapies that cause the least amount of injury while the lungs have an opportunity to heal. Based on current data, a trial of prone positioning ventilation should be offered to the patients who have ALI/ARDS in the early course of the disease. Published studies exhibit substantial heterogeneity in clinical results, suggesting that an adequately sized study optimizing the duration of proning ventilation strategy is warranted to enable definitive conclusions to be drawn.
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Chin. J. Traumatol. · Aug 2009
ReviewPotential therapeutic application of adult stem cells in acute respiratory distress syndrome.
Acute respiratory distress syndrome (ARDS) remains a poor prognosis in spite of the recent development of new therapeutic strategies. Cell-based therapy with stem cells has been considered as a promising way for the treatment of vital organ damage. Putative endogenous stem cells have been shown to be located within the adult lung in the basal layer of the upper airways, within or near pulmonary neuroendocrine cell rests, at the bronchoalveolar junction, as well as within the alveolar epithelium. ⋯ Exogenous stem cells have the ability to differentiate and function as both airway and lung parenchymal epithelial cells in both in vitro and increasingly in vivo experiments. However, there is great controversy concerning the repair effect of adult stem cells in lung injury. This review evaluates the advances in endogenous respiratory stem cells, and assesses the evidence for the use of stem cells in the repair of lung injury.
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Chin. J. Traumatol. · Aug 2009
Relationship between disseminated intravascular coagulation and levels of plasma thrombinogen segment 1+2, D-dimer, and thrombomodulin in patients with multiple injuries.
To explore the relationship between disseminated intravascular coagulation (DIC) and levels of plasma thrombinogen segment 1+2 (F1+2), D-dimer (D-D), and thrombomodulin (TM) in patients with severe multiple injuries. ⋯ Besides being related to trauma severity, F1+2, D-D and TM levels correlate closely with the occurrence of posttraumatic DIC. Therefore, changes in plasma F1+2, D-D and TM levels may predict the occurrence of DIC.
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Chin. J. Traumatol. · Aug 2009
Road traffic fatalities among pedestrians, bicyclists and motor vehicle occupants in Sirjan, Kerman, Iran.
To analyze the crash and injury data in forensic medicine for years of 2004-2007. ⋯ In spite of reduction of road traffic fatalities in Sirjan in 2007, it is still one of the cities with high road traffic fatality in the world. These results underline the importance of preventive strategies in transportation, suggesting that different methods are necessary to reduce fatalities of various traffic participants.