Suchergebnisse

In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c=0.034). However, there was a significant difference in the gender distribution of splenic injury patients in different months (P<0.05, c=0.063). In addition, admission numbers for splenic injury were highest in September, October and November. It was also found that splenic injury may occur at all ages, though patients of working age (20–50 years), which comprises 85.59% of patients, the highest proportion of all recorded cases. Associations between mortality rate and each management strategy were as follows: Operative management, 0.11% and non-operative management, 0.15%. Furthermore, multivariate analysis demonstrated that transfusion, New Injury Severity Score and management strategies were all correlated with mortality rate. Thus, despite a lack of data for inpatients from civilian hospitals, the present study has, in part, identified the epidemiology and management strategies of splenic injury in China. These findings may supplement those from previous analyses of splenic injury in other countries and regions.

Acute lung injury (ALI) is a common and severe disease that has been associated with significant morbidity and mortality. Understanding the epidemiology of ALI is vital for its prevention and treatment. The present study aimed to analyze the epidemiology of ALI by collecting data from patients that were submitted between 2000 and 2008 into the 'No. 1 Military Medical Project' information system. A total of 9,596 ALI patients were analyzed retrospectively, including 7,284 males (75.91%) and 2,312 females (24.09%). The median age of the patients was 44 years (interquartile range, 31–63 years), and there was a significant difference between the median ages of male and female patients (P0.05). In addition, ALI was more prevalent in May, July, August, October, November and December, as compared with the other months. ALI occurred at any age, although 40-years-old was the peak age. There was a significant difference in the age group distributions of male and female ALI patients (P<0.01). Among the predisposing conditions, pulmonary contusion represented the highest proportion (45.71%), followed by pneumonia or respiratory tract infection (23.68%) and pulmonary malignant tumor (6.30%). Of the 581 (6.05%) mortalities, pneumonia was the most common cause (37.87%), followed by malignancies (16.87%) and pulmonary embolism (11.02%). However, the highest mortality rate was associated with cardiopulmonary resuscitation (48.28%). In conclusion, the results of the present study suggested that ALI should be increasingly monitored in the future, and predisposing conditions should be regarded as one of the most important features determining the management of ALI.

AbstractThe construction and operation of large‐scale reservoirs alter the natural river flow regimes and destroy the original suitable reproduction and living conditions of aquatic organisms. Especially during the spawning season, the fluctuating water flow process is particularly important for fish reproduction. A bi‐objective optimization model considering both the environmental flow demand for fish spawning and the stability of hydropower output is established in this study and solved by one of the most widely used algorithms for multi‐objective problems, the Non‐Dominated Sorted Genetic Algorithm‐II. The derived Pareto Front can be used to guide reservoir operation during fish spawning seasons. The model proposed in this paper is applied to the Yangqu Reservoir, currently under construction on the upper Yellow River in China. The results show that the stability of hydropower output can still be improved by 4.80% to 10.56%, even if the environmental flow demand is taken into account. Even for the scheme preferring ecological recovery, the stability of hydropower output can be increased by more than 0.85%.