Injuries In China Research Articles

Epidemiological investigation of traumatic spinal cord injury caused by object strike in China: strategies for workplace safety improvement.

Being struck by an object is a major cause of traumatic spinal cord injury in China. This study aims to investigate epidemiological characteristics of spinal cord injury caused by object strike. This research analysed data from 435 cases of strike-induced spinal cord injury from 2013 to 2022. The collected information encompassed gender, age, level of neurological injury, surgical interventions, expense, occupation, and other relevant factors. χ2tests and Mann-Whitney U test were used with a statistical significance level of 0.05. The male-to-female ratio was 11.8:1. The 30-44 age group was more likely to suffer from complete spinal cord injuries (70.5%). The predominant occupations were workers (58.9%) and farmers (15.2%). Manual labourers are usually injured in the workplace (89.4%) with a high surgical rate (95.3%). Young and middle-aged males engaged in manual work constitute the primary demographic for strike-induced spinal cord injury. Safety education in workplaces such as construction sites and mines should be emphasized to reduce the occurrence of spinal cord injuries caused by object strikes.

Roles of NR1I3 and NR1H4 polymorphisms in the susceptibility to antituberculosis drug-induced liver injury in China: a case‒control study.

The pathogenesis of antituberculosis drug-induced liver injury (AT-DILI) remains largely unknown. The current investigation aimed to determine the genetic contribution of the nuclear receptor subfamily 1 Group I member 3 (NR1I3) and nuclear receptor subfamily 1 Group H member 4 (NR1H4) genes to the risk of AT-DILI in the Chinese population. A 1:4 matched case‒control study was conducted, and five single nucleotide polymorphisms (SNPs) in the NR1I3 and NR1H4 genes were detected and assessed. Utilizing a multivariate conditional logistic regression model, the effects of haplotype and genotype on the risk of AT-DILI were examined. Extended subgroup analysis was carried out based on sex. The distribution of the peak value of serum liver enzymes also compared among different genotypes. 224 AT-DILI cases and 896 controls were included in this study. No significant difference was observed in genotypes or haplotypes frequencies between AT-DILI cases and controls. However, comparisons of liver function indicators revealed significant differences in the peak values of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) among patients with different genotypes of NR1H4 rs56163822 (GG vs. GT vs. TT, 27.1 U/L vs. 26.0 U/L vs. 23.0 U/L, p = 0.020; 34.0 U/L vs. 31.0 U/L vs. 30.6 U/L, p = 0.008; 15.5μmol/L vs. 15.0μmol/L vs. 13.7μmol/L, p = 0.029, respectively), as well as in the peak values of ALT and AST among male patients with different genotypes of NR1H4 rs56163822 (29.0 U/L vs. 26.9 U/L vs. 22.6 U/L, p = 0.002; 34.0 U/L vs. 32.0 U/L vs. 30.5 U/L, p = 0.019, respectively). Based on this 1:4 individual-matched case‒control study, the SNP rs56163822 in the NR1H4 gene may be linked to the susceptibility to AT-DILI in Chinese patients receiving anti-TB treatment. Further studies in larger varied populations are needed to validate our findings.

Diagnosis and treatment of anterior cruciate ligament injuries: Consensus of Chinese experts part II: Graft selection and clinical outcome evaluation

BackgroundIn the recent decade, there has been substantial progress in the technologies and philosophies associated with diagnosing and treating anterior cruciate ligament (ACL) injuries in China. The therapeutic efficacy of ACL reconstruction in re-establishing the stability of the knee joint has garnered widespread acknowledgment. However, the path toward standardizing diagnostic and treatment protocols remains to be further developed and refined. ObjectiveIn this context, the Chinese Association of Orthopaedic Surgeons (CAOS) and the Chinese Society of Sports Medicine (CSSM) collaboratively developed an expert consensus on diagnosing and treating ACL injury, aiming to enhance medical quality through refining professional standards. MethodsThe consensus drafting team invited experts across the Greater China region, including the mainland, Hong Kong, Macau, and Taiwan, to formulate and review the consensus using a modified Delphi method as a standardization approach. As members of the CSSM Lower Limb Study Group and the CAOS Arthroscopy and Sports Medicine Study Group, invited experts concentrated on two pivotal issues: “Graft Selection” and “Clinical Outcome Evaluation” during the second part of the consensus development. ResultsThis focused discussion ultimately led to a strong consensus on nine specific consensus terms. ConclusionThe consensus clearly states that ACL reconstruction has no definitive “gold standard” graft choice. Autografts have advantages in healing capability but are limited in availability and have potential donor site morbidities; allografts reduce surgical trauma but incur additional costs, and there are concerns about slow healing, quality control issues, and a higher failure rate in young athletes; synthetic ligaments allow for early rehabilitation and fast return to sport, but the surgery is technically demanding and incurs additional costs. When choosing a graft, one should comprehensively consider the graft's characteristics, the doctor's technical ability, and the patient's needs. When evaluating clinical outcomes, it is essential to ensure an adequate sample size and follow-up rate, and the research should include patient subjective scoring, joint function and stability, complications, surgical failure, and the return to sport results. Medium and long-term follow-ups should not overlook the assessment of knee osteoarthritis.

Trend analysis and prediction of injury incidence in China from 1990 to 2019 based on Bayesian age–period–cohort model

BackgroundInjury is a major challenge to global public health. Analysing the trend of injury incidence in China from 1990 to 2019 and predicting future trends in incidence can provide a...

The burden of injury among elderly individuals in China from 1990 to 2019: An analysis of data from the global burden of disease study 2019

BackgroundWith the rapid ageing of the population, injuries are increasingly threatening the health of elderly individuals. A comprehensive evaluation of the injury burden is important for selecting and formulating strategies for injury prevention. ObjectiveTo evaluate the temporal trends of injury burden among elderly Chinese individuals aged 60 years and older. MethodsBased on the results of the Global Burden of Disease Study 2019, the injury mortality, morbidity, and disability-adjusted life years (DALYs) of elderly individuals from 1990 to 2019 were estimated by age and sex. The autoregressive integrated moving average model was used to predict the injury burden in the next decade. ResultsIn 2019, there were an estimated 304 373 deaths due to injuries in China, accounting for 3.55 % of all deaths. The main cause of injury-related death was unintentional injuries (67.28 deaths per 100 000), followed by transport injuries (30.44 deaths per 100 000). The standardized DALYs rate due to injuries among elderly individuals was 3488.54 DALYs per 100 000. In the past 30 years, the morbidity of injuries among elderly individuals in China has increased by 52.18 %. In 2030, we estimated that there will be 398 200 deaths of elderly individuals due to injury. ConclusionsOver 21% of injury-related deaths among elderly individuals occurred in China. The injury burden among elderly individuals is high, and efforts are needed to inform injury prevention policies and adopt injury prevention strategies to reduce the injury burden and promote the health and well-being of elderly individuals.

Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis.

Over the past decade, numerous studies have described the types of pathogens and their antibiotic resistance patterns in patients with burn injuries in China; however, the findings have generally been inconsistent. We conducted a literature search and meta-analysis to summarize the infection spectra and antimicrobial resistance patterns in patients with burn injuries. We searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature, Wanfang, and Weipu databases for relevant articles published between January 2010 and December 2023. The DerSimonian-Laird random-effects model was used to estimate the proportions and 95% confidence intervals (CIs) of pathogens among Chinese patients with burn injuries. Meta-regression analyses were performed to explore differences in the proportions of pathogens among different subgroups and their resistance patterns. This study was registered with PROSPERO (CRD42024514386). The database searches yielded 2017 records; after removing duplicates and conducting initial screening, 219 articles underwent full-text screening. Ultimately, 60 studies comprising a total of 62,819 isolated strains reported the proportions of pathogens in patients with burn injuries and were included in this meta-analysis. Meta-analyses were conducted on 18 types of pathogens. The most common pathogens causing infections in Chinese patients with burn injuries were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis. Similar results were observed in the subgroup analysis focusing on wound infections. Since 2015, there has been a significant decrease in the proportion of Pseudomonas aeruginosa (R2 = 4.89%) and a significant increase in the proportion of Klebsiella pneumoniae (R2 = 9.60%). In terms of antibiotic resistance, there has been a significant decrease in the resistance of Staphylococcus aureus to multiple antibiotics and an increasing trend in the resistance of Klebsiella pneumoniae. We systematically summarized the epidemiological characteristics and antibiotic resistance patterns of pathogens among individuals suffering from burns in China, thus providing guidance for controlling wound infections and promoting optimal empirical antimicrobial therapy. The observed high levels of antibiotic resistance underscore the need for ongoing monitoring of antibiotic usage trends.

Examining speech-language pathology research relating to people with traumatic brain injury in China: a scoping review

Background/Aims Although there are many researchers reviewing the existing evidence related to traumatic brain injury from speech-language pathologists' perspectives, there have been no attempts to review the existing research evidence in Standard Chinese to the best of the authors' knowledge. The purpose of this scoping review was to identify and synthesise the existing research evidence available in China for therapy related to individuals with traumatic brain injury within the speech-language pathologists' scope of practice. Methods This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The literature search was conducted using databases that included articles in the Standard Chinese language. In collaboration with three therapists working in China, the data was extracted and translated into English. Results Eight research articles met the inclusion and exclusion criteria of this review. Six studies were randomised control trials, and two studies were cohort studies. These eight studies focused on collaboration, counselling and treatment. All studies addressed cognition and two also addressed language. Conclusions Evidence showed that treatment focusing on cognitive and language skills provided by speech-language pathologists can improve the lives of people with a traumatic brain injury living in China. More research is warranted to better understand traumatic brain injury and treatment efficacy in China. Implications for practice Clinicians, especially those who work with individuals who affiliate themselves with the Chinese culture, can consider the current research evidence discussed in this article when working with clients with traumatic brain injury. Additionally, for researchers, future research efforts can prioritise addressing the identified gaps outlined in this study.

Incidence, prevalence, and causes of spinal injuries in China, 1990-2019: Findings from the Global Burden of Disease Study 2019.

Spinal injuries are an urgent public health priority; nevertheless, no China-wide studies of these injuries exist. This study measured the incidence, prevalence, causes, regional distribution, and annual trends of spinal injuries in China from 1990 to 2019. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the incidence and prevalence of spinal injuries in China. The data of 33 provincial-level administrative regions (excluding Taiwan, China) provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (CDC) were use to systematically analyze the provincial etiology, geographical distribution, and annual trends of spinal injuries. The Bayesian meta-regression tool DisMod-MR 2.1 was used to ensure the consistency among incidence, prevalence, and mortality rates in each case. From 1990 to 2019, the number of living patients with spinal injuries in China increased by 138.32%, from 2.14 million to 5.10 million, while the corresponding age-standardized prevalence increased from 0.20% (95% uncertainty interval [UI]: 0.18-0.21%) to 0.27% (95% UI: 0.26-0.29%). The incidence of spinal injuries in China increased by 89.91% (95% UI: 72.39-107.66%), and the prevalence increased by 98.20% (95% UI: 89.56-106.82%), both the most significant increases among the G20 countries; 71.00% of the increase could be explained by age-specific prevalence. In 2019, the incidence was 16.47 (95% UI: 12.08-22.00, per 100,000 population), and the prevalence was 358.30 (95% UI: 333.96-386.62, per 100,000 population). Based on the data of 33 provincial-level administrative regions provided by CDC, age-standardized incidence and prevalence were both highest in developed provinces in Eastern China. The primary causes were falls and road injuries; however, the prevalence and specific causes differed across provinces. In China, the overall disease burden of spinal injuries increased significantly during the past three decades but varied considerably according to geographical location. The primary causes were falls and road injuries; however, the prevalence and specific causes differed across provinces.

Incidence, risk factors and outcome of postoperative acute kidney injury in China.

Postoperative acute kidney injury (AKI) is a common condition after surgery, however, the available data about nationwide epidemiology of postoperative AKI in China from large and high-quality studies are limited. This study aimed to determine the incidence, risk factors and outcomes of postoperative AKI among patients undergoing surgery in China. This was a large, multicentre, retrospective study performed in 16 tertiary medical centres in China. Adult patients (≥18years of age) who underwent surgical procedures from 1 January 2013 to 31 December 2019 were included. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes creatinine criteria. The associations of AKI and in-hospital outcomes were investigated using logistic regression models adjusted for potential confounders. Among 520707 patients included in our study, 25830 (5.0%) patients developed postoperative AKI. The incidence of postoperative AKI varied by surgery type, which was highest in cardiac (34.6%), urologic (8.7%) and general (4.2%) surgeries. A total of 89.2% of postoperative AKI cases were detected in the first 2 postoperative days. However, only 584 (2.3%) patients with postoperative AKI were diagnosed with AKI on discharge. Risk factors for postoperative AKI included older age, male sex, lower baseline kidney function, pre-surgery hospital stay ≤3days or >7days, hypertension, diabetes mellitus and use of proton pump inhibitors or diuretics. The risk of in-hospital death increased with the stage of AKI. In addition, patients with postoperative AKI had longer lengths of hospital stay (12 versus 19days) and were more likely to require intensive care unit care (13.1% versus 45.0%) and renal replacement therapy (0.4% versus 7.7%). Postoperative AKI was common across surgery type in China, particularly for patients undergoing cardiac surgery. Implementation and evaluation of an alarm system is important for the battle against postoperative AKI.

Epidemiology features of traumatic and non-traumatic spinal cord injury in China, Wuhan

Spinal cord injuries are incredibly disabling and can have fatal consequences. At present, there is a lack of available information regarding the epidemiological characteristics of patients who have experienced spinal cord injury (SCI) in China. This retrospective hospital-based study was conducted in the Rehabilitation department of Wuhan’s Tongji Hospital between 2016 and 2022. A total of 649 individuals diagnosed with SCI (both traumatic and non-traumatic) were admitted during this period. Data regarding various epidemiological features were gathered, including sex, age, etiology, occupation, neurological level of injury, the American Spinal Injury Association Impairment Scale at the time of admission, and information on any accompanying injuries. Out of the 649 cases of SCI, there were 539 cases of traumatic SCI and 110 cases of non-traumatic SCI. The mean age at the time of injury was 45.6 ± 14.8 years. The ratio of male to female patients was higher in traumatic SCI at 2.82:1compared to non-traumatic SCI at 1.68:1. Traffic accidents were the most common cause of TSCI, accounting for (n = 207/539; 38.40%) of cases. On the other hand, neoplasm was the most common cause of NTSCI, accounting for (n = 38/110; 34.54%) of cases. The findings indicated a higher proportion of males, with traffic accidents being the main cause of injury among TSCI patients. It is crucial to prioritize the risk of falling among older adults and allocate more attention to this issue. These results emphasize the need for tailored preventive strategies that consider the unique characteristics of different types of SCI patients.

Mood assessments of family caregivers of patients with severe brain injury in China.

Long-term care of severe brain injury patients places a significant mental burden on family caregivers, yet few studies have reported the situation in China. We aimed to describe the mood states of family caregivers of patients with severe brain injury and examine the influencing factors that affect caregivers' moods. Cross-sectional survey was used to assess the mood profiles of Chinese family caregivers between February 2019 and February 2020. Demographic data of caregivers and patients, the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were used to assess the level of depressive and anxiety symptoms. The quality of life score was also assessed by a visual analog scale, and the Coma Recovery Scale-Revised was used to assess the patient's consciousness. One hundred and one patients with severe brain injury (57 unresponsive wakefulness syndrome, UWS) between the age of 14 and 70 and their main family caregivers were enrolled in the study. Most caregivers displayed depressive (n = 62) and anxiety symptoms (n = 65), with 17 and 20 of these family caregivers reporting (moderately) severe depressive symptom and severe anxiety symptom, respectively. The caregiver's depressive symptom level significantly decreased as the patient's injury lasted longer (r = - 0.208, P = 0.037). Moreover, the age of the patient negatively related to the levels of depressive (r = - 0.310, P = 0.002) and anxiety symptoms (r = - 0.289, P = 0.003) in caregivers. There was a significant positive correlation between anxiety and depressive symptoms scores in family caregivers (r = 0.838, P < 0.001). The higher the level of anxiety (r = - 0.273, P = 0.006) and depressive symptoms (r = - 0.265, P = 0.007), the worse the quality of life. Many family caregivers of patients with severe brain injury experience various levels of anxiety and depressive symptoms in China. Tailor-made psychological help seems imperative. Researchers and doctors can provide information about patient's conditions to assist family members in discussing rehabilitation options for patients in different states of consciousness will help to ease anxiety of family caregivers.

Hospitalization costs of road traffic injuries in Hunan, China: A quantile regression analysis

BackgroundHealthcare expenditure of road traffic injuries in China has not been adequately investigated so far. We aim to provide comprehensive information about the hospitalization costs of inpatients who suffered road traffic injuries, and explore the components and influencing factors of costs. MethodsWe extracted the data of all inpatients (n = 60535) with road traffic injuries during the year 2019 from Chinese National Health Statistics Network Reporting System database in Hunan, China. We calculated the components of hospitalization costs and analyzed the association between hospitalization costs and patient characteristics using quantile regression models. ResultsThe median hospitalization cost was $853.48, and the median length of hospital stay was 9 days. Vulnerable road users accounted for 84.9 % of all cases. Medicine cost is the first driver of hospitalization cost, accounting for 25.94 %. In the low- and medium-cost groups, hospitalization costs were highly concentrated on diagnosis, medicine, and medical services, while in the high-cost groups, consumable cost constituted the highest percentage. Male, a longer length of stay, more severe injuries, two or more comorbidities, surgical treatment, and admission to tertiary hospitals were significantly associated with higher hospitalization costs, and the regression coefficients increased with increasing of quartile points. Costs were lower in the 0–14 years group than in the other groups across all quartiles. At the median, occupants of heavy transport vehicle incurred the highest costs, $44.18 higher than pedestrians; injuries at lower extremities generated higher costs than those at any other site; and vascular injuries caused the greatest costs, $786.24 higher than superficial injuries. ConclusionsRoad traffic injuries cause huge healthcare costs for victims, most of whom are vulnerable road users. The total cost of hospitalization is incurred mainly for medicine, consumables, diagnosis, medical services, and treatment. Patients’ demographic factors (gender and age), clinical factors (injury severity, location, nature, and number of comorbidities), treatment factors (surgery, length of stay, and hospital level), and road user type are all significantly associated with hospitalization costs.

Discrepancy of eye injuries in mechanism, clinical features, and vision prognosis by different causative sports.

To investigate the epidemiological and clinical characteristics of sports-related eye injuries in China, as well as how they differ depending on the sport or other specific factor that caused them. Consecutive medical records from 2015 to 2019 of sports-related eye injuries from a standardized database in nine tertiary referral hospitals in China were retrospectively reviewed and analyzed. A total of 377 eyes in 376 inpatients (mean age, 22.5 ± 7.3 years; men:women 15.4:1) were included. Soccer (46.8%), basketball (27.1%), and badminton (16.8%) were the top three sports that caused injury. Ball strikes (74.7%), physical collision (13.8%), and racket/equipment beating (9.0%) were the common specific causes of injury. Blunt force injuries (95.8%) and close globe injuries (95.1%) accounted for the majority of injuries. Open globe injuries occurred more in basketball (8.3%) than in other sports, mainly due to physical collision (12.8%) and racket/equipment beating (11.8%). Basketball (13.4%) or physical collision (21.3%) caused Zone I injuries more frequently than other sports. Soccer (60.5%) and basketball (54.6%) caused more injuries to the posterior segment of the eyeball than other sports, mainly due to ball strikes (96.6%). Badminton (69.8%) and racket beating (61.8%) caused more Zone II globe injuries than other sports. In badminton, the percentage of hyphema (85.7%), the most typical symptom of eye damage, and ultimate visual acuity (VA) ≥20/40 (88.9%) was the greatest. A final low vision score of (≤4/200) was observed in 10.6% of all participants, including three participants who had an eye removed due to rupturing. The final VA was positively correlated with the presenting VA (r = 0.421). Sports can lead to high proportions of ocular contusion injury and low vision. VA prognosis is closely related to initial VA following ocular sports trauma, which is directly determined by the causative sports and/or the specific causes. Effective eye protection is imperative to avoid or reduce visual impairments of sports participants.

Temporal trends in the incidence and mortality of road injuries in China: Current trends and future predictions

BackgroundChina has the highest number of road injury deaths in the world. The aim of this study was to determine the long-term incidence and mortality trends of road injuries in China between 1990 and 2019 and to make projections up to 2030. MethodsIncident and death data were extracted from the Global Burden of Disease (GBD) 2019 study and population data were extracted from the GBD 2019 and World Population Prospects 2019 studies. An age-period-cohort framework was used for the analysis. ResultsIn 2019, 16.1 million road injuries (age-standardized incidence rate [ASIR]: 991.3/100,000) occurred in China. Between 1990 and 2019, the ASIR of road injuries in China increased by 87.4 %. In 2019, there are 250.0 thousand road deaths (age-standardized mortality rate [ASMR]: 14.79/100,000), and the ASMR decreased by 27.0 % between 1990 and 2019. Period and cohort risks for the incidence of road injuries were increased for both sexes. Period and cohort risks for road injury mortality appeared to increase in recent period and birth cohorts. The ASIR of road injuries was projected to increase in the future, and the ASMR was projected to decrease; however, the ASIR of cyclist road injuries in females was projected to increase in the future. Among road injuries, elderly individuals were projected to have an increasing proportion of occurrence and death. Although the proportion is decreasing, pedestrian road injuries were projected to still account for more than half of road injury deaths in China up to 2030. ConclusionsThe incidence of road injuries in China has increased overall, while the overall mortality rate has decreased over the past 30 years, and this trend is expected to continue in the future. Effective effort is needed to improve road safety, especially for elderly individuals and female cyclists. In addition, pedestrian road safety also needs to be improved.

FAdV-4 Promotes Expression of Multiple Cytokines and Inhibits the Proliferation of aHEV in LMH Cells.

Single or mixed infections of multiple pathogens such as avian hepatitis E virus (aHEV) and avian leukosis virus subgroup J (ALV-J) have been detected in numerous laying hens with severe liver injury in China. Thus, aHEV and immunosuppressive viruses are speculated to cause co-infections. In this study, co-infection with aHEV and fowl adenovirus (FAdV) was confirmed by nested RT-PCR and recombinase-aided amplification combined with gene sequencing in two flocks with severe liver injury. Subsequently, the two reference strains, aHEV and FAdV-4, were inoculated into LMH cells to identify their co-infection potential. Confocal microscopy revealed aHEV and FAdV-4 co-infected LMH cells. In addition, the replication dynamics of aHEV and FAdV-4 along with the expression levels of immuno-cytokines were measured. The results indicated colocalization of aHEV and FAdV-4 and inhibition of viral replication in LMH cells. The transcription levels of MDA5, Mx, OASL, and IFN-α were significantly upregulated in LMH cells, whereas those of immune-related factors induced by FAdV-4 were downregulated upon FAdV-4 and aHEV co-infection. These results confirmed the co-infection of aHEV and FAdV-4 in vitro and prompted the antagonistic pathogenic effects of FAdV-4 and aHEV, thereby providing novel insights into the counterbalancing effects of these viruses.

Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study.

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, -0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (-4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals' ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Incidence of Neonatal Seizures in China Based on Electroencephalogram Monitoring in Neonatal Neurocritical Care Units

Neonatal seizures pose a significant challenge in critical care, and continuous video electroencephalography (cEEG) monitoring holds promise for early detection of seizures. However, large-scale data on the incidence of neonatal seizures and monitoring systems in China are lacking. To determine the incidence of neonatal seizures in infants with high risk in China. A large, cross-sectional multicenter study was conducted from January 2017 to December 2018 in the neonatal intensive care units (NICUs) of 7 tertiary medical centers in China. Neonates with high risk were included, and cEEG monitoring was conducted. Data were collected between January 1, 2017, and January 31, 2020. The data were analyzed between January 2021 and January 2022. The incidence of neonatal seizures, categorized by etiology, and seizure burden. A total of 20 310 neonates with high risk were included (10 495 [51.7%] male; mean [SD] postmenstrual age, 37.7 [3.7] weeks), and seizures were observed in 3423 infants (16.9%). The highest proportion of seizures was attributed to acute neonatal encephalopathy (1448 [42.3%]). The incidence of seizures decreased with postmenstrual age and birth weight, with the highest occurrence observed in neonates with postmenstrual age of less than 28 weeks (237 of 879 [27.0%]) or birth weight of less than 1.0 kg (269 of 914 [29.4%]). Preterm infants had a higher proportion of moderate and severe seizure burdens compared with full-term infants (moderate severity: 248 of 1199 [20.7%] vs 454 of 2224 [20.4%]), but no significant differences were observed in etiology. Seizure burden was highest with genetic syndromes (49 of 188 [26.1%]), central nervous system malformations (33 of 127 [26.0%]), and inborn errors of metabolism (27 of 113 [23.9%]). During hospitalization, 7.8% of neonates with seizures died (267 neonates), with 81.3% of these cases having a moderate or severe seizure burden (217 neonates). Mortality was generally higher in preterm vs full-term infants (98 of 1199 [8.2%] vs 169 of 2224 [7.6%]) and increased with the severity of seizure burden (217 of 267 neonates with moderate or severe burden [81.3%]). This cross-sectional study of neonatal seizures underscores the substantial burden seizures pose to high-risk infants with brain injury in China, particularly those who are born prematurely or who have congenital conditions.

Epidemiological features of traumatic spinal cord injury in China: A systematic review and meta-analysis.

Traumatic spinal cord injury (TSCI) is a highly fatal and disabling event, and its incidence rate is increasing in China. Therefore, we collated the epidemiological factors of TSCI in different regions of China to update the earlier systematic review published in 2018. We searched four English and three Chinese electronic databases from 1978 to October 1, 2022. From the included reports, information on sample characteristics, incidence, injury characteristics, prognostic factors, and economic burden was extracted. The selection of data was based on the PRISMA statement. The quality of the included studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) tool. The results of the meta-analysis were presented in the form of pooled frequency and forest plots. A total of 59 reports (60 studies) from 23 provinces were included, of which 41 were in the Chinese language. The random pooled incidence of TSCI in China was estimated to be 65.15 per million (95% CI: 47.20-83.10 per million), with a range of 6.7 to 569.7 per million. The pooled male-to-female ratio was 1.95:1. The pooled mean age of the cases at the time of injury was 45.4 years. Motor vehicle accidents (MVAs) and high falls were found to be the leading causes of TSCI. Incomplete quadriplegia and AISA/Frankel grade D were the most common types of TSCI. Cervical level injury was the most prevalent. The pooled in-hospital mortality and complication rates for TSCI in China were 3% (95% CI: 2-4%) and 35% (95% CI: 23-47%). Respiratory problems were the most common complication and the leading cause of death. Compared with previous studies, the epidemiological data on TSCI in China has changed significantly. A need to update the data over time is essential to implement appropriate preventive measures and formulate interventions according to the characteristics of the Chinese population.

Effects of the establishment of trauma centres on the mortality rate among seriously injured patients: a propensity score matching retrospective study

BackgroundLittle evidence suggests that trauma centres are associated with a lower risk of mortality in severely injured patients (Injury Severity Score (ISS) ≥16) with multiple injuries in China. The objective of this study was to determine the association between the establishment of trauma centres and mortality among severely injured patients with multiple injuries and to identify some risk factors associated with mortality.MethodsA retrospective single-centre study was performed including trauma patients admitted to the First Affiliated Hospital of Nanchang University (FAHNU) between January 2016 and December 2021. To determine whether the establishment of a trauma centre was an independent predictor of mortality, logistic regression analysis and propensity score matching (PSM) were performed.ResultsAmong 431 trauma patients, 172 were enrolled before the trauma centre was built, while 259 were included after the trauma centre was built. A higher frequency of older age and traffic accident injury was found in patients diagnosed after the trauma centre was built. The times for the completion of CT examinations, emergency operations and blood transfusions in the “after trauma centre” group were shorter than those in the “before trauma centre” group. However, the total expenditure of patients was increased. In the overall group, univariate and multivariate logistic regression analyses showed that a higher ISS was an independent predictor for worse mortality (OR = 17.859, 95% CI, 8.207–38.86, P < 0.001), while the establishment of a trauma centre was favourable for patient survival (OR = 0.492), which was also demonstrated by PSM. After determining the cut-off value of time for the completion of CT examination, emergency operation and blood transfusion, we found that the values were within the “golden one hour”, and it was better for patients when the time was less than the cut-off value.ConclusionOur study showed that for severely injured patients, the establishment of a trauma centre was favourable for a lower mortality rate. Furthermore, the completion of a CT examination, emergency surgery and blood transfusion in a timely manner and a lower ISS were associated with a decreased mortality rate.

Optimizing Rehabilitation Strategies for Sports Injuries: A Comprehensive Analysis of Evidence-Based Interventions and Rehabilitation Protocols

Athletes commonly become injured during competition, emphasizing the necessity for appropriate recovery. This research examines if standard sporting injury treatments and rehabilitation work in China. The issue Despite the high occurrence of sports injuries in China, rehabilitation therapy efficacy research is scarce. Interview-based research addresses such problems. This research examines how different therapy and rehabilitation programs help Chinese athletes recover from competition-related injuries. The researchers interviewed wounded athletes to acquire data. Structured interviews were conducted to collect qualitative data from participants regarding their rehabilitation therapies' efficacy, adherence, and results. The study revealed fresh information on the efficacy of evidence-based treatments and rehabilitation methods for Chinese sports injuries. The interviews revealed how different rehabilitation methods impacted on the athletes' recoveries and what variables influenced program adherence and positive results. Based on the findings, medical practitioners, sports trainers, and Chinese athletes should prioritize scientifically backed rehabilitation regimens. Using this data to create individualized rehabilitation programs for athletes with sports-related injuries may improve their chances of a complete and quick recovery. In conclusion, an interview-based study in China revealed the effectiveness of evidence-based sports injury treatment and rehabilitation. The study will help the Chinese sports community better rehabilitate and recover faster.