BACKGROUND Malignant fibrous histiocytoma(MFH)is one of the most common soft tissue sarcomas among adults.It is characterized by large size,high grade,and biological aggressiveness.There are many reports of MFH after ...BACKGROUND Malignant fibrous histiocytoma(MFH)is one of the most common soft tissue sarcomas among adults.It is characterized by large size,high grade,and biological aggressiveness.There are many reports of MFH after local stimulation,such as bone fracture,implants,and chronic osteomyelitis.In this paper,we report a patient who developed MFH 6 years after amputation,suggesting that wound healing and mechanical force play a role in the local stimulation of this disease.CASE SUMMARY A 66-year-old man complained of persistent pain in his residual mid-thigh.He had undergone amputation surgery due to a traffic accident 6 years prior.Physical examination showed tenderness but no abnormalities in appearance.Xray radiographs and magnetic resonance imaging supported the diagnosis of a tumor,and a biopsy confirmed that the lesion was MFH.The patient received neoadjuvant chemotherapy and left hip disarticulation.During the 6-mo followup,there were no symptoms of recurrence.CONCLUSION Postsurgery MFH has been reported before,and many studies have attributed it to the biological effects of implants.Our case report shows that this disease can develop without an implant and thus highlights the importance of local stimulation.The wound-healing process and mechanical force can both promote this tumor,but whether they directly cause MFH needs further investigation.展开更多
Background:Limb loss has a drastic impact on a patient’s life.Severe trauma to the extremities is common in current military conflicts.Among other aspects,"life before limb"damage control surgery hinders im...Background:Limb loss has a drastic impact on a patient’s life.Severe trauma to the extremities is common in current military conflicts.Among other aspects,"life before limb"damage control surgery hinders immediate replantation within the short post-traumatic timeframe,which is limited in part by the ischemic time for successful replantation.Ex vivo limb perfusion is currently being researched in animal models and shows promising results for its application in human limb replantation and allotransplantation.Presentation of the hypothesis:The current lack of replantation possibilities in military operations with high rates of amputation can be addressed with the development of a portable ex vivo limb perfusion device,as there are several opportunities present with the introduction of this technique on the horizon.We hypothesize that ex vivo limb perfusion will enable overcoming the critical ischemic time,provide surgical opportunities such as preparation of the stump and limb,allow for spare-part surgery,enable rigorous antibiotic treatment of the limb,reduce ischemiareperfusion injuries,enable a tissue function assessment before replantation,and enable the development of large limb transplant programs.Testing the hypothesis:Data from in vivo studies in porcine models are limited by the relatively short perfusion time of 24 h.In the military setting,notably longer perfusion times need to be realized.Therefore,future animal studies must focus especially on long-term perfusion,since this represents the military setting,considering the time for stabilization of the patient until evacuation to a tertiary treatment center.Implications of the hypothesis:The development and clinical introduction of ex vivo limb perfusion in the military setting could lead to a drastic reduction in the number of limb amputations among service members.Ex vivo limb perfusion enables replantation surgery in Role 4 facilities and changes the clinical setting from a highly urgent,lifethreatening situation to a highly methodical,well-prepared starting point for optimal treatment of the wounded service member.With its introduction,the principle of"life before limb"will change to"life before limb before elective replantation/allotransplantation after ex vivo limb perfusion".展开更多
BACKGROUND To report the application of supermicroscopy combined with arterio-venolization without venous anastomosis for replantation of digits following traumatic amputation in young children.CASE SUMMARY In March 2...BACKGROUND To report the application of supermicroscopy combined with arterio-venolization without venous anastomosis for replantation of digits following traumatic amputation in young children.CASE SUMMARY In March 2016,we treated two children aged 2 years and 7 years with traumatic digit amputation,no venous anastomosis,and bilateral digital inherent arteries on the palmar side.Supermicroscopy combined with an arteriovenous technique was adopted to improve the replantation surgery.Postoperative management involved auxiliary treatments such as anticoagulation,composure,antiinflammatory drugs,and insulation.After treatment,the amputated fingers survived completely without major complications,with good recovery.CONCLUSION Supermicroscopy combined with arterio-venolization is a safe and effective approach to treat traumatic digit amputation in young children without venous anastomosis.展开更多
Background: In combat operations, patients with traumatic injuries require expeditious evacuation to improve survival. Studies have shown that long transport times are associated with increased morbidity and mortality...Background: In combat operations, patients with traumatic injuries require expeditious evacuation to improve survival. Studies have shown that long transport times are associated with increased morbidity and mortality. Limited data exist on the influence of transport time on patient outcomes with specific injury types. The objective of this study was to determine the impact of the duration of time from the initial request for medical evacuation to arrival at a medical treatment facility on morbidity and mortality in casualties with traumatic extremity amputation and noncompressible torso injury(NCTI).Methods: We completed a retrospective review of MEDEVAC patient care records for United States military personnel who sustained traumatic amputations and NCTI during Operation Enduring Freedom between January 2011 and March 2014. We grouped patients as traumatic amputation and NCTI(AMP+NCTI), traumatic amputation only(AMP),and neither AMP nor NCTI(Non-AMP/NCTI). Analysis was performed using chi-squared tests, Fisher's exact tests,Cochran-Armitage Trend tests, Shapiro-Wilks tests, Wilcoxon and Kruskal-Wallis techniques and Cox proportional hazards regression modeling.Results: We reviewed 1267 records, of which 669 had an injury severity score(ISS) of 10 or greater and were included in the analysis. In the study population, 15.5% sustained only amputation injuries(n=104, AMP only), 10.8% sustained amputation and NCTI(n=72, AMP+NCTI), and 73.7% did not sustain either an amputation or an NCTI(n=493,Non-AMP/NCTI). AMP+NCTI had the highest mortality(16.7%) with transport time greater than 60 min. While the AMP+NCTI group had decreasing survival with longer transport times, AMP and Non-AMP/NCTI did not exhibit the same trend.Conclusions: A decreased transport time from the point of injury to a medical treatment facility was associated with decreased mortality in patients who suffered a combination of amputation injury and NCTI. No significant association between transport time and outcomes was found in patients who did not sustain NCTI. Priority for rapid evacuation of combat casualties should be given to those with NCTI.展开更多
Circumcision remains a frequently performed surgical procedure and could be associated with various complications, ranging from mild to catastrophic. Penile amputation is a rare and severe complication usually complex...Circumcision remains a frequently performed surgical procedure and could be associated with various complications, ranging from mild to catastrophic. Penile amputation is a rare and severe complication usually complex and challenging to manage. We describe three cases of penile amputation injuries following circumcision referred within a week at the urological service of the Yaoundé Central Hospital. The first case was a 5-year-old who had complete penile amputation during circumcision by a nurse assistant at a rural health center. The second was a 7-year-old boy who sustained total penile glans amputation while undergoing circumcision by a nurse under local anesthesia at a rural health facility. The third involved a 6-year-old who had total penile amputation with loss of the amputated stump during circumcision by a traditional practitioner at home. Non-microsurgical penile re-implantations were done with diverse outcomes. The preservation of the amputated stump, the ischemic time and the severity of injury are factors affecting surgical outcome. The aim of this study is to evaluate our management experience and outcome of penile amputation injuries in resource-limited settings. Microsurgical replantation remains the gold standard in the management of penile amputation injuries. However, in resource-limited settings macroscopic replantation could be used as an alternative remedy to salvage the amputated penis.展开更多
Dear Editor,Chronic pain is a significant concern after major lower limb amputations that often preclude prosthetic fitting,decrease ambulation,and impact the quality of life[1,2].In the last decade,targeted muscle re...Dear Editor,Chronic pain is a significant concern after major lower limb amputations that often preclude prosthetic fitting,decrease ambulation,and impact the quality of life[1,2].In the last decade,targeted muscle reinnervation(TMR)has been proposed as a surgical strategy for treating or preventing symptomatic neuromas and phantomlimb phenomena in major amputees[1].This technique involves the transfer of an amputated mixed-motor and sensory nerve to a nearby recipient motor nerve[1,2].Unlike most surgical strategies that aim to hide or protect the neuroma,TMR gives the amputated nerves“somewhere to go and something to do”[2].In a randomized clinical trial on neuroma and phantom pain,Dumanian et al.[1]demonstrated that TMR reduces amputationrelated chronic pain at 1-year post-intervention when compared with the excision and muscle-burying technique,which remains the current gold standard.Valerio et al.[2]also proposed applying TMR at the time of major limb amputation for preventing chronic pain and found that TMR patients experienced less residual limb pain(RLP)and phantom limb pain(PLP)when compared with untreated amputee controls.展开更多
Objective: to explore the role of narrative breast-feeding in clinical nursing of traumatic amputees. Methods: from January 2019 to January 2019, 68 amputees were divided into control group and observation group with ...Objective: to explore the role of narrative breast-feeding in clinical nursing of traumatic amputees. Methods: from January 2019 to January 2019, 68 amputees were divided into control group and observation group with 34 cases in each group. The control group received routine orthopedic hospitalization, while the observation group received narrative hospitalization on the basis of routine hospitalization. Anxiety, depression and quality of life scale were used to compare the patients anxiety, depression and quality of life. The narrative results of lactation, anxiety, depression and quality of life in the observation group were better than those in the control group (p0.05). The narrative conclusion of breast feeding can improve the negative emotions of traumatic amputees, promote their self-management and improve their quality of life.展开更多
Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileu...Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].展开更多
Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated...Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated with increased levels of circulato ry pro-inflammatory marke rs up to 1 year postTBI(Eagle et al.,2023).展开更多
The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cel...The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.展开更多
Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microgl...Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.展开更多
Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the curr...Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the current understanding of the bidirectional relationship between blood-brain barrier disruption and neuroinflammation in traumatic brain injury,along with emerging combination therapeutic strategies.Literature review indicates that blood-brain barrier disruption and neuroinflammatory responses are key pathological features following traumatic brain injury.In the acute phase after traumatic brain injury,the pathological characteristics include primary blood-brain barrier disruption and the activation of inflammatory cascades.In the subacute phase,the pathological features are characterized by repair mechanisms and inflammatory modulation.In the chronic phase,the pathological features show persistent low-grade inflammation and incomplete recovery of the blood-brain barrier.Various physiological changes,such as structural alterations of the blood-brain barrier,inflammatory cascades,and extracellular matrix remodeling,interact with each other and are influenced by genetic,age,sex,and environmental factors.The dynamic balance between blood-brain barrier permeability and neuroinflammation is regulated by hormones,particularly sex hormones and stress-related hormones.Additionally,the role of gastrointestinal hormones is receiving increasing attention.Current treatment strategies for traumatic brain injury include various methods such as conventional drug combinations,multimodality neuromonitoring,hyperbaric oxygen therapy,and non-invasive brain stimulation.Artificial intelligence also shows potential in treatment decision-making and personalized therapy.Emerging sequential combination strategies and precision medicine approaches can help improve treatment outcomes;however,challenges remain,such as inadequate research on the mechanisms of the chronic phase traumatic brain injury and difficulties with technology integration.Future research on traumatic brain injury should focus on personalized treatment strategies,the standardization of techniques,costeffectiveness evaluations,and addressing the needs of patients with comorbidities.A multidisciplinary approach should be used to enhance treatment and improve patient outcomes.展开更多
Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,...Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.展开更多
Background:Repetitive mild traumatic brain injury(rmTBI)is a significant risk factor for neurodegeneration,characterized by pathological protein deposition and persistent neuroinflammation.Research has observed increa...Background:Repetitive mild traumatic brain injury(rmTBI)is a significant risk factor for neurodegeneration,characterized by pathological protein deposition and persistent neuroinflammation.Research has observed increased interleukin-33(IL-33)levels in the peripheral blood of patients with rmTBI,suggesting IL-33 may participate in regulating the pathological development of rmTBI.The study aims to elucidate the impact and mechanism of IL-33 in the progression of neuropathology following rmTBI,and to explore its potential as a therapeutic target to improve the neurological outcome.Methods:The study employed an rmTBI mouse model using the wild-type(WT)and IL-33 knockout mice.Cognitive function was assessed via the Y-maze and Barnes tests.The main cell type expressing IL-33 and its receptor,suppression of tumorigenicity 2(ST2),was then investigated in the mouse brain through immunofluorescence colocalization.As the primary neural cell responsible for ST2 expression,microglia were studied in vitro using the BV2 cell line.The effects of lipid droplets(LDs)accumulation and amyloid-beta(Aβ)phagocytosis were measured to elucidate the impact of IL-33 on BV2 cells'phagocytosis.Additionally,HT22 neuronal apoptosis was assessed by flow cytometry.Finally,the cognitive effects of intranasal administration of IL-33 were evaluated in mice.Results:IL-33 KO mice exhibited pronounced cognitive impairment after rmTBI.In the mouse brain,astrocytes were identified as the primary source of IL-33 secretion,while microglia predominantly expressed ST2.Transcriptome sequencing revealed that IL-33 significantly influenced phagocytosis function.IL-33 mitigated LDs accumulation in BV2 cells and enhanced Aβphagocytosis in vitro.In addition,the culture medium of BV2 cells with activated IL-33/ST2 signaling reduced HT22 neuronal apoptosis and axonal damage.Furthermore,intranasal administration of IL-33 was observed to be effective in alleviating neurodegeneration and cognitive outcome of rmTBI mice.Conclusions:Dysfunction of the IL-33/ST2 axis following rmTBI leads to cognitive dysfunction via impairing microglial phagocytosis capacity and promoting neuronal damage.IL-33 would be a promising therapeutic target for alleviating neurodegeneration following rmTBI.展开更多
BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in m...BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in many biological processes that supports cellular homeostasis,including the inhibition of apoptosis by preventing mitochondrial BAX localization(Lin et al.,2022)and the promotion of the degradation of hyperphosphorylated tau aggregates by its interactions with SQSTM1(p62)(Hamano and Mutoh,2022).展开更多
The neuroinflammatory response mediated by microglial activation plays an important role in the secondary nerve injury of traumatic brain injury.The post-transcriptional modification of N^(6)-methyladenosine is ubiqui...The neuroinflammatory response mediated by microglial activation plays an important role in the secondary nerve injury of traumatic brain injury.The post-transcriptional modification of N^(6)-methyladenosine is ubiquitous in the immune response of the central nervous system.The fat mass and obesity-related protein catalyzes the demethylation of N^(6)-methyladenosine modifications on mRNA and is widely expressed in various tissues,participating in the regulation of multiple diseases’biological processes.However,the role of fat mass and obesity in microglial activation and the subsequent neuroinflammatory response after traumatic brain injury is unclear.In this study,we found that the expression of fat mass and obesity was significantly down-regulated in both lipopolysaccharide-treated BV2 cells and a traumatic brain injury mouse model.After fat mass and obesity interference,BV2 cells exhibited a pro-inflammatory phenotype as shown by the increased proportion of CD11b^(+)/CD86^(+)cells and the secretion of pro-inflammatory cytokines.Fat mass and obesity-mediated N^(6)-methyladenosine demethylation accelerated the degradation of ADAM17 mRNA,while silencing of fat mass and obesity enhanced the stability of ADAM17 mRNA.Therefore,down-regulation of fat mass and obesity expression leads to the abnormally high expression of ADAM17 in microglia.These results indicate that the activation of microglia and neuroinflammatory response regulated by fat mass and obesity-related N^(6)-methyladenosine modification plays an important role in the pro-inflammatory process of secondary injury following traumatic brain injury.展开更多
Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela ...Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.展开更多
BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To an...BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To analyze the influencing factors of psychological resilience of patients with traumatic fractures and the effect of psychological resilience on posttraumatic growth(PTG).METHODS This study included 188 patients with traumatic fractures admitted to the First People’s Hospital of Shangqiu from November 2022 to November 2023.The participants were categorized based on the patient’s psychological resilience assessed by the Connor-Davidson Resilience Scale(CD-RISC)into the better resilience group(CD-RISC score≥60 points,n=80)and the poor resilience group(CD-RISC score<60 points,n=108).Patients’sleep quality was assessed with the Pittsburgh Sleep Quality Index(PSQI).The identification of the influencing factors of psychological resilience in patients with traumatic fractures was realized by binary Logistic regression(with factors such as sex,age,injury cause,trauma severity,fracture site,personality,and PSQI included for analysis).The determination of the PTG status of all participants used the Chinese version of the Posttraumatic Growth Inventory(C-PTGI).Furthermore,a Spearman correlation analysis was conducted to analyze the association between psychological resilience and PTG.RESULTS The psychological resilience of patients with traumatic fractures was related to age,sex,trauma severity,and personality.The better resilience group demonstrated statistically lower PSQI scores than the poor resilience group(P<0.05).The Logistic regression analysis revealed sex,age,trauma severity,personality,and sleep quality as influencing factors of CD-RISC scores in patients with traumatic fractures(all P<0.05).The score of each C-PTGI dimension and the total score(relating to others,new possibilities,personal strength,spiritual change,and appreciation of life)were higher in the better resilience group than in the poor resilience group(all P<0.05).Spearman correlation analysis indicated a positive association of the CD-RISC score in patients with traumatic fractures with the scores of all dimensions of C-PTGI and the total C-PTGI score(all P<0.05).CONCLUSION The factors influencing the psychological resilience of patients with traumatic fractures include age,sex,trauma severity,personality,and sleep quality,and psychological resilience is closely associated with PTG.展开更多
BACKGROUND Traumatic subdural effusion is a common complication of traumatic brain injury,especially after decompressive craniectomy(DC).For neurosurgeons,early diagnosis and timely treatment are particularly importan...BACKGROUND Traumatic subdural effusion is a common complication of traumatic brain injury,especially after decompressive craniectomy(DC).For neurosurgeons,early diagnosis and timely treatment are particularly important,which can help improve patient prognosis and enhance quality of life.CASE SUMMARY A 47 year old male underwent DC for traumatic brain herniation.After surgery,he developed stubborn subdural effusion(SDE)on the contralateral side and underwent multiple subdural drilling and drainage surgeries,but only temporarily improved the patient’s symptoms.After the final cranioplasty,the contralateral SDE completely disappeared.The patient did not experience any new contralateral neurological dysfunction,and the Glasgow prognostic score was 11 points(E4V1M6).CONCLUSION For neurosurgeons,accurate assessment of the condition is necessary when treating patients with stubborn SDE after DC surgery,and timely cranioplasty can be performed to avoid multiple surgeries.This is a safe and effective surgical method for treating traumatic subdural effusion.展开更多
Traumatic penumbra(TP)is a region with recoverable potential around the primary lesion of brain injury.Rapid and accurate imaging for identifying TP is essential for treating traumatic brain injury(TBI).In this study,...Traumatic penumbra(TP)is a region with recoverable potential around the primary lesion of brain injury.Rapid and accurate imaging for identifying TP is essential for treating traumatic brain injury(TBI).In this study,we first established traumatic brain injuries(TBIs)in rats using a modified Feeney method,followed by label-free imaging of brain tissue sections with multiphoton fluorescence microscopy.The results showed that the technique effectively imaged normal and traumatic brain tissues,and revealed pathological features such as extracellular matrix changes,vascular cell proliferation,and intracellular edema in the traumatic penumbra.Compared with normal brain tissue,the extracellular matrix in the TP was sparse,cells were disorganized,and hyperplastic vascular cells emitted higher two-photon excited fluorescence(TPEF)signals.Our research demonstrates the potential of multiphoton fluorescence technology in the rapid diagnosis and therapeutic evaluation of TBI.展开更多
文摘BACKGROUND Malignant fibrous histiocytoma(MFH)is one of the most common soft tissue sarcomas among adults.It is characterized by large size,high grade,and biological aggressiveness.There are many reports of MFH after local stimulation,such as bone fracture,implants,and chronic osteomyelitis.In this paper,we report a patient who developed MFH 6 years after amputation,suggesting that wound healing and mechanical force play a role in the local stimulation of this disease.CASE SUMMARY A 66-year-old man complained of persistent pain in his residual mid-thigh.He had undergone amputation surgery due to a traffic accident 6 years prior.Physical examination showed tenderness but no abnormalities in appearance.Xray radiographs and magnetic resonance imaging supported the diagnosis of a tumor,and a biopsy confirmed that the lesion was MFH.The patient received neoadjuvant chemotherapy and left hip disarticulation.During the 6-mo followup,there were no symptoms of recurrence.CONCLUSION Postsurgery MFH has been reported before,and many studies have attributed it to the biological effects of implants.Our case report shows that this disease can develop without an implant and thus highlights the importance of local stimulation.The wound-healing process and mechanical force can both promote this tumor,but whether they directly cause MFH needs further investigation.
文摘Background:Limb loss has a drastic impact on a patient’s life.Severe trauma to the extremities is common in current military conflicts.Among other aspects,"life before limb"damage control surgery hinders immediate replantation within the short post-traumatic timeframe,which is limited in part by the ischemic time for successful replantation.Ex vivo limb perfusion is currently being researched in animal models and shows promising results for its application in human limb replantation and allotransplantation.Presentation of the hypothesis:The current lack of replantation possibilities in military operations with high rates of amputation can be addressed with the development of a portable ex vivo limb perfusion device,as there are several opportunities present with the introduction of this technique on the horizon.We hypothesize that ex vivo limb perfusion will enable overcoming the critical ischemic time,provide surgical opportunities such as preparation of the stump and limb,allow for spare-part surgery,enable rigorous antibiotic treatment of the limb,reduce ischemiareperfusion injuries,enable a tissue function assessment before replantation,and enable the development of large limb transplant programs.Testing the hypothesis:Data from in vivo studies in porcine models are limited by the relatively short perfusion time of 24 h.In the military setting,notably longer perfusion times need to be realized.Therefore,future animal studies must focus especially on long-term perfusion,since this represents the military setting,considering the time for stabilization of the patient until evacuation to a tertiary treatment center.Implications of the hypothesis:The development and clinical introduction of ex vivo limb perfusion in the military setting could lead to a drastic reduction in the number of limb amputations among service members.Ex vivo limb perfusion enables replantation surgery in Role 4 facilities and changes the clinical setting from a highly urgent,lifethreatening situation to a highly methodical,well-prepared starting point for optimal treatment of the wounded service member.With its introduction,the principle of"life before limb"will change to"life before limb before elective replantation/allotransplantation after ex vivo limb perfusion".
文摘BACKGROUND To report the application of supermicroscopy combined with arterio-venolization without venous anastomosis for replantation of digits following traumatic amputation in young children.CASE SUMMARY In March 2016,we treated two children aged 2 years and 7 years with traumatic digit amputation,no venous anastomosis,and bilateral digital inherent arteries on the palmar side.Supermicroscopy combined with an arteriovenous technique was adopted to improve the replantation surgery.Postoperative management involved auxiliary treatments such as anticoagulation,composure,antiinflammatory drugs,and insulation.After treatment,the amputated fingers survived completely without major complications,with good recovery.CONCLUSION Supermicroscopy combined with arterio-venolization is a safe and effective approach to treat traumatic digit amputation in young children without venous anastomosis.
基金Department of Defense Joint Program Committee(JPC-6)
文摘Background: In combat operations, patients with traumatic injuries require expeditious evacuation to improve survival. Studies have shown that long transport times are associated with increased morbidity and mortality. Limited data exist on the influence of transport time on patient outcomes with specific injury types. The objective of this study was to determine the impact of the duration of time from the initial request for medical evacuation to arrival at a medical treatment facility on morbidity and mortality in casualties with traumatic extremity amputation and noncompressible torso injury(NCTI).Methods: We completed a retrospective review of MEDEVAC patient care records for United States military personnel who sustained traumatic amputations and NCTI during Operation Enduring Freedom between January 2011 and March 2014. We grouped patients as traumatic amputation and NCTI(AMP+NCTI), traumatic amputation only(AMP),and neither AMP nor NCTI(Non-AMP/NCTI). Analysis was performed using chi-squared tests, Fisher's exact tests,Cochran-Armitage Trend tests, Shapiro-Wilks tests, Wilcoxon and Kruskal-Wallis techniques and Cox proportional hazards regression modeling.Results: We reviewed 1267 records, of which 669 had an injury severity score(ISS) of 10 or greater and were included in the analysis. In the study population, 15.5% sustained only amputation injuries(n=104, AMP only), 10.8% sustained amputation and NCTI(n=72, AMP+NCTI), and 73.7% did not sustain either an amputation or an NCTI(n=493,Non-AMP/NCTI). AMP+NCTI had the highest mortality(16.7%) with transport time greater than 60 min. While the AMP+NCTI group had decreasing survival with longer transport times, AMP and Non-AMP/NCTI did not exhibit the same trend.Conclusions: A decreased transport time from the point of injury to a medical treatment facility was associated with decreased mortality in patients who suffered a combination of amputation injury and NCTI. No significant association between transport time and outcomes was found in patients who did not sustain NCTI. Priority for rapid evacuation of combat casualties should be given to those with NCTI.
文摘Circumcision remains a frequently performed surgical procedure and could be associated with various complications, ranging from mild to catastrophic. Penile amputation is a rare and severe complication usually complex and challenging to manage. We describe three cases of penile amputation injuries following circumcision referred within a week at the urological service of the Yaoundé Central Hospital. The first case was a 5-year-old who had complete penile amputation during circumcision by a nurse assistant at a rural health center. The second was a 7-year-old boy who sustained total penile glans amputation while undergoing circumcision by a nurse under local anesthesia at a rural health facility. The third involved a 6-year-old who had total penile amputation with loss of the amputated stump during circumcision by a traditional practitioner at home. Non-microsurgical penile re-implantations were done with diverse outcomes. The preservation of the amputated stump, the ischemic time and the severity of injury are factors affecting surgical outcome. The aim of this study is to evaluate our management experience and outcome of penile amputation injuries in resource-limited settings. Microsurgical replantation remains the gold standard in the management of penile amputation injuries. However, in resource-limited settings macroscopic replantation could be used as an alternative remedy to salvage the amputated penis.
文摘Dear Editor,Chronic pain is a significant concern after major lower limb amputations that often preclude prosthetic fitting,decrease ambulation,and impact the quality of life[1,2].In the last decade,targeted muscle reinnervation(TMR)has been proposed as a surgical strategy for treating or preventing symptomatic neuromas and phantomlimb phenomena in major amputees[1].This technique involves the transfer of an amputated mixed-motor and sensory nerve to a nearby recipient motor nerve[1,2].Unlike most surgical strategies that aim to hide or protect the neuroma,TMR gives the amputated nerves“somewhere to go and something to do”[2].In a randomized clinical trial on neuroma and phantom pain,Dumanian et al.[1]demonstrated that TMR reduces amputationrelated chronic pain at 1-year post-intervention when compared with the excision and muscle-burying technique,which remains the current gold standard.Valerio et al.[2]also proposed applying TMR at the time of major limb amputation for preventing chronic pain and found that TMR patients experienced less residual limb pain(RLP)and phantom limb pain(PLP)when compared with untreated amputee controls.
文摘Objective: to explore the role of narrative breast-feeding in clinical nursing of traumatic amputees. Methods: from January 2019 to January 2019, 68 amputees were divided into control group and observation group with 34 cases in each group. The control group received routine orthopedic hospitalization, while the observation group received narrative hospitalization on the basis of routine hospitalization. Anxiety, depression and quality of life scale were used to compare the patients anxiety, depression and quality of life. The narrative results of lactation, anxiety, depression and quality of life in the observation group were better than those in the control group (p0.05). The narrative conclusion of breast feeding can improve the negative emotions of traumatic amputees, promote their self-management and improve their quality of life.
文摘Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].
文摘Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated with increased levels of circulato ry pro-inflammatory marke rs up to 1 year postTBI(Eagle et al.,2023).
基金supported by Grant 3195 from Paralyzed Veterans of America Research Foundation (to BRK)
文摘The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.
基金supported by the Natural Science Foundation of Yunnan Province,No.202401AS070086(to ZW)the National Key Research and Development Program of China,No.2018YFA0801403(to ZW)+1 种基金Yunnan Science and Technology Talent and Platform Plan,No.202105AC160041(to ZW)the Natural Science Foundation of China,No.31960120(to ZW)。
文摘Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.
基金supported by Open Scientific Research Program of Military Logistics,No.BLB20J009(to YZhao).
文摘Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the current understanding of the bidirectional relationship between blood-brain barrier disruption and neuroinflammation in traumatic brain injury,along with emerging combination therapeutic strategies.Literature review indicates that blood-brain barrier disruption and neuroinflammatory responses are key pathological features following traumatic brain injury.In the acute phase after traumatic brain injury,the pathological characteristics include primary blood-brain barrier disruption and the activation of inflammatory cascades.In the subacute phase,the pathological features are characterized by repair mechanisms and inflammatory modulation.In the chronic phase,the pathological features show persistent low-grade inflammation and incomplete recovery of the blood-brain barrier.Various physiological changes,such as structural alterations of the blood-brain barrier,inflammatory cascades,and extracellular matrix remodeling,interact with each other and are influenced by genetic,age,sex,and environmental factors.The dynamic balance between blood-brain barrier permeability and neuroinflammation is regulated by hormones,particularly sex hormones and stress-related hormones.Additionally,the role of gastrointestinal hormones is receiving increasing attention.Current treatment strategies for traumatic brain injury include various methods such as conventional drug combinations,multimodality neuromonitoring,hyperbaric oxygen therapy,and non-invasive brain stimulation.Artificial intelligence also shows potential in treatment decision-making and personalized therapy.Emerging sequential combination strategies and precision medicine approaches can help improve treatment outcomes;however,challenges remain,such as inadequate research on the mechanisms of the chronic phase traumatic brain injury and difficulties with technology integration.Future research on traumatic brain injury should focus on personalized treatment strategies,the standardization of techniques,costeffectiveness evaluations,and addressing the needs of patients with comorbidities.A multidisciplinary approach should be used to enhance treatment and improve patient outcomes.
文摘Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.
基金supported by the National Natural Science Foundation of China(82271401,82071394)the Tianjin Health Research Project(TJWJ2024RC002)。
文摘Background:Repetitive mild traumatic brain injury(rmTBI)is a significant risk factor for neurodegeneration,characterized by pathological protein deposition and persistent neuroinflammation.Research has observed increased interleukin-33(IL-33)levels in the peripheral blood of patients with rmTBI,suggesting IL-33 may participate in regulating the pathological development of rmTBI.The study aims to elucidate the impact and mechanism of IL-33 in the progression of neuropathology following rmTBI,and to explore its potential as a therapeutic target to improve the neurological outcome.Methods:The study employed an rmTBI mouse model using the wild-type(WT)and IL-33 knockout mice.Cognitive function was assessed via the Y-maze and Barnes tests.The main cell type expressing IL-33 and its receptor,suppression of tumorigenicity 2(ST2),was then investigated in the mouse brain through immunofluorescence colocalization.As the primary neural cell responsible for ST2 expression,microglia were studied in vitro using the BV2 cell line.The effects of lipid droplets(LDs)accumulation and amyloid-beta(Aβ)phagocytosis were measured to elucidate the impact of IL-33 on BV2 cells'phagocytosis.Additionally,HT22 neuronal apoptosis was assessed by flow cytometry.Finally,the cognitive effects of intranasal administration of IL-33 were evaluated in mice.Results:IL-33 KO mice exhibited pronounced cognitive impairment after rmTBI.In the mouse brain,astrocytes were identified as the primary source of IL-33 secretion,while microglia predominantly expressed ST2.Transcriptome sequencing revealed that IL-33 significantly influenced phagocytosis function.IL-33 mitigated LDs accumulation in BV2 cells and enhanced Aβphagocytosis in vitro.In addition,the culture medium of BV2 cells with activated IL-33/ST2 signaling reduced HT22 neuronal apoptosis and axonal damage.Furthermore,intranasal administration of IL-33 was observed to be effective in alleviating neurodegeneration and cognitive outcome of rmTBI mice.Conclusions:Dysfunction of the IL-33/ST2 axis following rmTBI leads to cognitive dysfunction via impairing microglial phagocytosis capacity and promoting neuronal damage.IL-33 would be a promising therapeutic target for alleviating neurodegeneration following rmTBI.
基金supported by the award W81XWH1910309 (to HF) from the Department of Defensethe award R01-AG075092-01 (to HF)+2 种基金the award RF1AG063521 from the National Institute of Aging at the National Institutes of Healththe Neurological Research Institute Seed grant (to HF) from The Ohio State Universitythe Summer Undergraduate Research Fellowship (to NS) from The Ohio State University Chronic Brain Injury Discovery Theme
文摘BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in many biological processes that supports cellular homeostasis,including the inhibition of apoptosis by preventing mitochondrial BAX localization(Lin et al.,2022)and the promotion of the degradation of hyperphosphorylated tau aggregates by its interactions with SQSTM1(p62)(Hamano and Mutoh,2022).
基金supported by grants from the Major Projects of Health Science Research Foundation for Middle-Aged and Young Scientist of Fujian Province,China,No.2022ZQNZD01010010the National Natural Science Foundation of China,No.82371390Fujian Province Scientific Foundation,No.2023J01725(all to XC).
文摘The neuroinflammatory response mediated by microglial activation plays an important role in the secondary nerve injury of traumatic brain injury.The post-transcriptional modification of N^(6)-methyladenosine is ubiquitous in the immune response of the central nervous system.The fat mass and obesity-related protein catalyzes the demethylation of N^(6)-methyladenosine modifications on mRNA and is widely expressed in various tissues,participating in the regulation of multiple diseases’biological processes.However,the role of fat mass and obesity in microglial activation and the subsequent neuroinflammatory response after traumatic brain injury is unclear.In this study,we found that the expression of fat mass and obesity was significantly down-regulated in both lipopolysaccharide-treated BV2 cells and a traumatic brain injury mouse model.After fat mass and obesity interference,BV2 cells exhibited a pro-inflammatory phenotype as shown by the increased proportion of CD11b^(+)/CD86^(+)cells and the secretion of pro-inflammatory cytokines.Fat mass and obesity-mediated N^(6)-methyladenosine demethylation accelerated the degradation of ADAM17 mRNA,while silencing of fat mass and obesity enhanced the stability of ADAM17 mRNA.Therefore,down-regulation of fat mass and obesity expression leads to the abnormally high expression of ADAM17 in microglia.These results indicate that the activation of microglia and neuroinflammatory response regulated by fat mass and obesity-related N^(6)-methyladenosine modification plays an important role in the pro-inflammatory process of secondary injury following traumatic brain injury.
文摘Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.
文摘BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To analyze the influencing factors of psychological resilience of patients with traumatic fractures and the effect of psychological resilience on posttraumatic growth(PTG).METHODS This study included 188 patients with traumatic fractures admitted to the First People’s Hospital of Shangqiu from November 2022 to November 2023.The participants were categorized based on the patient’s psychological resilience assessed by the Connor-Davidson Resilience Scale(CD-RISC)into the better resilience group(CD-RISC score≥60 points,n=80)and the poor resilience group(CD-RISC score<60 points,n=108).Patients’sleep quality was assessed with the Pittsburgh Sleep Quality Index(PSQI).The identification of the influencing factors of psychological resilience in patients with traumatic fractures was realized by binary Logistic regression(with factors such as sex,age,injury cause,trauma severity,fracture site,personality,and PSQI included for analysis).The determination of the PTG status of all participants used the Chinese version of the Posttraumatic Growth Inventory(C-PTGI).Furthermore,a Spearman correlation analysis was conducted to analyze the association between psychological resilience and PTG.RESULTS The psychological resilience of patients with traumatic fractures was related to age,sex,trauma severity,and personality.The better resilience group demonstrated statistically lower PSQI scores than the poor resilience group(P<0.05).The Logistic regression analysis revealed sex,age,trauma severity,personality,and sleep quality as influencing factors of CD-RISC scores in patients with traumatic fractures(all P<0.05).The score of each C-PTGI dimension and the total score(relating to others,new possibilities,personal strength,spiritual change,and appreciation of life)were higher in the better resilience group than in the poor resilience group(all P<0.05).Spearman correlation analysis indicated a positive association of the CD-RISC score in patients with traumatic fractures with the scores of all dimensions of C-PTGI and the total C-PTGI score(all P<0.05).CONCLUSION The factors influencing the psychological resilience of patients with traumatic fractures include age,sex,trauma severity,personality,and sleep quality,and psychological resilience is closely associated with PTG.
文摘BACKGROUND Traumatic subdural effusion is a common complication of traumatic brain injury,especially after decompressive craniectomy(DC).For neurosurgeons,early diagnosis and timely treatment are particularly important,which can help improve patient prognosis and enhance quality of life.CASE SUMMARY A 47 year old male underwent DC for traumatic brain herniation.After surgery,he developed stubborn subdural effusion(SDE)on the contralateral side and underwent multiple subdural drilling and drainage surgeries,but only temporarily improved the patient’s symptoms.After the final cranioplasty,the contralateral SDE completely disappeared.The patient did not experience any new contralateral neurological dysfunction,and the Glasgow prognostic score was 11 points(E4V1M6).CONCLUSION For neurosurgeons,accurate assessment of the condition is necessary when treating patients with stubborn SDE after DC surgery,and timely cranioplasty can be performed to avoid multiple surgeries.This is a safe and effective surgical method for treating traumatic subdural effusion.
基金funded by the Science and Technology Research Program of Chongqing Municipal Education Commission(KJZD-K202301105,KJQN202201107)the Scienti¯c and Technological Transformative Program of Chongqing Banan District(KY202208161124020).
文摘Traumatic penumbra(TP)is a region with recoverable potential around the primary lesion of brain injury.Rapid and accurate imaging for identifying TP is essential for treating traumatic brain injury(TBI).In this study,we first established traumatic brain injuries(TBIs)in rats using a modified Feeney method,followed by label-free imaging of brain tissue sections with multiphoton fluorescence microscopy.The results showed that the technique effectively imaged normal and traumatic brain tissues,and revealed pathological features such as extracellular matrix changes,vascular cell proliferation,and intracellular edema in the traumatic penumbra.Compared with normal brain tissue,the extracellular matrix in the TP was sparse,cells were disorganized,and hyperplastic vascular cells emitted higher two-photon excited fluorescence(TPEF)signals.Our research demonstrates the potential of multiphoton fluorescence technology in the rapid diagnosis and therapeutic evaluation of TBI.
