Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association
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Chin. J. Traumatol. · Dec 2018
ReviewThe roles of activated protein C in experimental trauma models.
Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermia, acidosis, and dilution. Primary coagulopathy consists of disseminated intravascular coagulation and acute coagulopathy of trauma shock (ACOTS). The pathophysiology of ACOTS is the suppression of thrombin generation and neutralization of plasminogen activator inhibitor-1 mediated by activated protein C that leads to hypocoagulation and hyperfibrinolysis in the circulation. This review tried to clarify the validity of activated protein C hypothesis that constitutes the main pathophysiology of the ACOTS in experimental trauma models.
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Chin. J. Traumatol. · Dec 2018
Reconstruction of post-traumatic upper extremity soft tissue defects with pedicled flaps: An algorithmic approach to clinical decision making.
Pedicled flaps are still the workhorse flaps for reconstruction of upper limb soft tissue defects in many centers across the world. They are lifeboat options for coverage in vessel deplete wounds. In spite of their popularity existing algorithms are limited to a particular region of upper limb; a general algorithm involving entire upper limb which helps in clinical decision making is lacking. We attempt to propose one for the day to day clinical practice. ⋯ The proposed algorithm allows a reliable and consistent method for addressing diverse soft tissue defects in the upper limb with high success rate.
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Chin. J. Traumatol. · Oct 2018
Case ReportsAn attempt to treat Hoffa fractures under arthroscopy: A case report.
We treated a 15-year-old female patient with fracture of the post-lateral femoral condyle and the bone shifted in front of the knee. Considering that the traditional surgical approach has the shortcomings of significant trauma and poor prognosis, we designed an arthroscopic procedure, which achieved satisfactory short-term efficacy, effectively reduced and fixed the fractures, avoided damage to vascular nerves, and maximally reduced the trauma caused by surgery itself.
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Chin. J. Traumatol. · Oct 2018
Multicenter Study Comparative StudyEvaluation of differences in injury patterns according to seat position in trauma victims survived traffic accidents.
Investigation of injury patterns epidemiology among car occupants may help to develop different therapeutic approach according to the seat position. The aim of the study was to evaluate and compare differences in the incidence of serious injuries, between occupants in different locations in private cars. ⋯ Out of victims who arrived alive to the hospital, highest mortality was found in front seat passengers. The rate of serious chest injuries was higher as well. Rear seat passengers are at greater risk for serious traumatic brain injuries. All passengers have a greater incidence of abdominal injuries. These findings need to be addressed in order to develop "customized" therapeutic policy in trauma victims.
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Chin. J. Traumatol. · Oct 2018
Comparative StudyEvaluation of massive transfusion protocol practices by type of trauma at a level I trauma center.
To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. ⋯ Despite the use of the same MTP for all injured patients requiring massive transfusion, significant differences existed between blunt trauma patients and penetrating trauma patients. These differences in transfusion characteristics and outcomes following MTP activation underscore the complexity of implementing MTPs and warrant vigilant transfusion practices to improve outcomes in trauma patients.