Damage of the blood vessels in retina due to diabetes is called diabetic retinopathy(DR).Hemorrhages is thefirst clinically visible symptoms of DR.This paper presents a new technique to extract and classify the hemorrh...Damage of the blood vessels in retina due to diabetes is called diabetic retinopathy(DR).Hemorrhages is thefirst clinically visible symptoms of DR.This paper presents a new technique to extract and classify the hemorrhages in fundus images.The normal objects such as blood vessels,fovea and optic disc inside retinal images are masked to distinguish them from hemorrhages.For masking blood vessels,thresholding that separates blood vessels and background intensity followed by a newfilter to extract the border of vessels based on orienta-tions of vessels are used.For masking optic disc,the image is divided into sub-images then the brightest window with maximum variance in intensity is selected.Then the candidate dark regions are extracted based on adaptive thresholding and top-hat morphological techniques.Features are extracted from each candidate region based on ophthalmologist selection such as color and size and pattern recognition techniques such as texture and wavelet features.Three different types of Support Vector Machine(SVM),Linear SVM,Quadratic SVM and Cubic SVM classifier are applied to classify the candidate dark regions as either hemor-rhages or healthy.The efficacy of the proposed method is demonstrated using the standard benchmark DIARETDB1 database and by comparing the results with methods in silico.The performance of the method is measured based on average sensitivity,specificity,F-score and accuracy.Experimental results show the Linear SVM classifier gives better results than Cubic SVM and Quadratic SVM with respect to sensitivity and accuracy and with respect to specificity Quadratic SVM gives better result as compared to other SVMs.展开更多
BACKGROUND Factor XIII(FXIII)deficiency is a rare yet profound coagulopathy.FXIII plays a pivotal role in hemostasis,and deficiencies in this factor can precipitate unchecked or spontaneous hemorrhaging.Immunological ...BACKGROUND Factor XIII(FXIII)deficiency is a rare yet profound coagulopathy.FXIII plays a pivotal role in hemostasis,and deficiencies in this factor can precipitate unchecked or spontaneous hemorrhaging.Immunological assays for detecting FXIII inhibitors are indispensable for diagnosing acquired FXIII deficiency;however,the availability of suitable testing facilities is limited,resulting in prolonged turnaround times for these assays.CASE SUMMARY In this case study,a 53-year-old male devoid of significant medical history presented with recurrent intracranial hemorrhages and a hematoma in the right hip.Subsequent genetic analysis revealed a homozygous mutation in the ACE gene,confirming the diagnosis of acquired FXIII deficiency.CONCLUSION This case underscores the significance of considering acquired deficiencies in clotting factors when evaluating patients with unexplained bleeding episodes.展开更多
Dear Editor,W e present three anatomical forms of premacular hemorrhage with niveau formation:hemorrhage in posterior precortical vitreous pocket(intrapocket hemorrhage),sub-internal limiting membrane(ILM)hemorrhage,a...Dear Editor,W e present three anatomical forms of premacular hemorrhage with niveau formation:hemorrhage in posterior precortical vitreous pocket(intrapocket hemorrhage),sub-internal limiting membrane(ILM)hemorrhage,and premacular retrocortical hemorrhage.Niveau formation is the formation of a horizonal boundary between fluid and blood cells when they accumulate in a closed space,because blood cells with higher specific gravity settle in a standing position.展开更多
Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in ear...Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any case of pregnancy.展开更多
Third trimester bleeding is a common concern in obstetrics. The main objective of this work was to study the management of hemorrhages in the third trimester of pregnancy in the maternity ward of the Sominé Dolo ...Third trimester bleeding is a common concern in obstetrics. The main objective of this work was to study the management of hemorrhages in the third trimester of pregnancy in the maternity ward of the Sominé Dolo hospital in Mopti. Our prospective descriptive cross-sectional survey type study conducted at the maternity ward of Sominé Dolo hospital in Mopti over a period from January 1, 2017 to December 31, 2017 included 94 cases collected. During this period we had performed 1485 deliveries including 94 cases of pregnancies complicated by 3rd trimester hemorrhage, a frequency of 6.33%. The main cause of hemorrhage in the third trimester was represented by placenta preavia 42.6% followed by retroplacental hematoma 28.7%, uterine rupture 26.6% and association Placenta preavia and retroplacental hematoma 2.1%. The type of intervention depended on the cause of the hemorrhage and the maternal and fetal condition. More than half of the cases of uterine rupture 52% had benefited from a hysterorrhaphy during a laparotomy (n = 13/25) against 48% from hysterectomy (n = 12/25). Caesarean section was performed in 87.5% (n = 35/40) against 12.5% vaginal delivery (n = 5/40) in case of placenta preavia. In the end, in 74% of cases (n = 20/27) of retroplacental hematoma, first-line cesarean section was performed. The maternal prognosis was represented by a mortality rate of 12% (n = 11/94) and morbidity dominated by hypovolemic shock 48.9% (n = 22/94), infections 28.8% (n = 13/94) and coagulopathy 11.1% (n = 5/94). The fetal prognosis was very poor. More than half (55%) of the newborns had succumbed against 45% of the newly born. In 55.3% of cases neonatal mortality occurred antenatally. Neonatal morbidity was represented by prematurity, i.e. 20.2% (n = 19/94) and low birth weight, i.e. 22.3% (n = 21/94).展开更多
Background: The treatment of cerebellar hemorrhage (CH) may be different surgery or conservative according to the hematoma volume, compression of vital structures or hydrocephalus existence. In the present study, the ...Background: The treatment of cerebellar hemorrhage (CH) may be different surgery or conservative according to the hematoma volume, compression of vital structures or hydrocephalus existence. In the present study, the authors investigated the risk factors, the indications and the situation of external ventricular drainage (EVD) on the treatment line. Methods: 63 pure cerebellar hemorrhage patients were enrolled in the study. 36 cases underwent surgery;the other 27 were received conservative treatment. 15 and 13 cases received EVD in both groups. Hospital stay and mortality rates were investigated. Results: 4 cases in the conservative group underwent surgery secondary to treatment failure. Both of the groups had equal rates of morbidity and mortality. On the other hand, the group that received surgical intervention had shorter median hospital stay. The EVD does not seem to be life-saving at first but it gives time for preparing for surgery. Conclusions: We found that CH was strongly associated with early hydrocephalus and mortality. The early diagnosis and surgical evacuation of the mass are mandatory and life-saving if hematoma is larger than 10 ml. The EVD may not being a life-saving instrument but majorly it may be a time earning device if acute hydrocephalus present.展开更多
Neuronal cell death is a common outcome of multiple pathophysiological processes and a key factor in neurological dysfunction after subarachnoid hemorrhage.Neuronal ferroptosis in particular plays an important role in...Neuronal cell death is a common outcome of multiple pathophysiological processes and a key factor in neurological dysfunction after subarachnoid hemorrhage.Neuronal ferroptosis in particular plays an important role in early brain injury.Bromodomain-containing protein 4,a member of the bromo and extraterminal domain family of proteins,participated in multiple cell death pathways,but the mechanisms by which it regulates ferroptosis remain unclear.The primary aim of this study was to investigate how bromodomain-containing protein 4 affects neuronal ferroptosis following subarachnoid hemorrhage in vivo and in vitro.Our findings revealed that endogenous bromodomain-containing protein 4 co-localized with neurons,and its expression was decreased 48 hours after subarachnoid hemorrhage of the cerebral cortex in vivo.In addition,ferroptosis-related pathways were activated in vivo and in vitro after subarachnoid hemorrhage.Targeted inhibition of bromodomain-containing protein 4 in neurons increased lipid peroxidation and intracellular ferrous iron accumulation via ferritinophagy and ultimately led to neuronal ferroptosis.Using cleavage under targets and tagmentation analysis,we found that bromodomain-containing protein 4 enrichment in the Raf-1 promoter region decreased following oxyhemoglobin stimulation in vitro.Furthermore,treating bromodomain-containing protein 4-knockdown HT-22 cell lines with GW5074,a Raf-1 inhibitor,exacerbated neuronal ferroptosis by suppressing the Raf-1/ERK1/2 signaling pathway.Moreover,targeted inhibition of neuronal bromodomain-containing protein 4 exacerbated early and long-term neurological function deficits after subarachnoid hemorrhage.Our findings suggest that bromodomain-containing protein 4 may have neuroprotective effects after subarachnoid hemorrhage,and that inhibiting ferroptosis could help treat subarachnoid hemorrhage.展开更多
Alzheimer’s disease is a multi-amyloidosis disease characterized by amyloid-βdeposits in brain blood vessels,microaneurysms,and senile plaques.How amyloid-βdeposition affects axon pathology has not been examined ex...Alzheimer’s disease is a multi-amyloidosis disease characterized by amyloid-βdeposits in brain blood vessels,microaneurysms,and senile plaques.How amyloid-βdeposition affects axon pathology has not been examined extensively.We used immunohistochemistry and immunofluorescence staining to analyze the forebrain tissue slices of Alzheimer’s disease patients.Widespread axonal amyloidosis with distinctive axonal enlargement was observed in patients with Alzheimer’s disease.On average,amyloid-β-positive axon diameters in Alzheimer’s disease brains were 1.72 times those of control brain axons.Furthermore,axonal amyloidosis was associated with microtubule-associated protein 2 reduction,tau phosphorylation,lysosome destabilization,and several blood-related markers,such as apolipoprotein E,alpha-hemoglobin,glycosylated hemoglobin type A1C,and hemin.Lysosome destabilization in Alzheimer’s disease was also clearly identified in the neuronal soma,where it was associated with the co-expression of amyloid-β,Cathepsin D,alpha-hemoglobin,actin alpha 2,and collagen type IV.This suggests that exogenous hemorrhagic protein intake influences neural lysosome stability.Additionally,the data showed that amyloid-β-containing lysosomes were 2.23 times larger than control lysosomes.Furthermore,under rare conditions,axonal breakages were observed,which likely resulted in Wallerian degeneration.In summary,axonal enlargement associated with amyloidosis,micro-bleeding,and lysosome destabilization is a major defect in patients with Alzheimer’s disease.This finding suggests that,in addition to the well-documented neural soma and synaptic damage,axonal damage is a key component of neuronal defects in Alzheimer’s disease.展开更多
Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have rev...Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have revealed that gut microbiota can communicate bidirectionally with the brain through the gut microbiota–brain axis.This axis indicates that gut microbiota is closely related to the development and prognosis of intracerebral hemorrhage and its associated secondary white matter injury.The NACHT,LRR,and pyrin domain-containing protein 3(NLRP3)inflammasome plays a crucial role in this context.This review summarizes the dysbiosis of gut microbiota following intracerebral hemorrhage and explores the mechanisms by which this imbalance may promote the activation of the NLRP3 inflammasome.These mechanisms include metabolic pathways(involving short-chain fatty acids,lipopolysaccharides,lactic acid,bile acids,trimethylamine-N-oxide,and tryptophan),neural pathways(such as the vagus nerve and sympathetic nerve),and immune pathways(involving microglia and T cells).We then discuss the relationship between the activated NLRP3 inflammasome and secondary white matter injury after intracerebral hemorrhage.The activation of the NLRP3 inflammasome can exacerbate secondary white matter injury by disrupting the blood–brain barrier,inducing neuroinflammation,and interfering with nerve regeneration.Finally,we outline potential treatment strategies for intracerebral hemorrhage and its secondary white matter injury.Our review highlights the critical role of the gut microbiota–brain axis and the NLRP3 inflammasome in white matter injury following intracerebral hemorrhage,paving the way for exploring potential therapeutic approaches.展开更多
AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after pri...AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after primary pterygium excision.METHODS:This randomized,parallel-controlled study with allocation concealment enrolled 40 patients with primary pterygium.Participants were randomly assigned to two groups using the sealed envelope method:the DCS group(n=20)and the AM group(n=18),receiving DCS and AM grafts respectively.Slit-lamp photography of the operative eyes was performed preoperatively and at 1,3,5,7,10,30,90,and 180d postoperatively.Best-corrected visual acuity(BCVA)and symptom scores were recorded simultaneously.In vivo confocal microscopy was conducted at 3 and 6mo postoperatively.RESULTS:All participants exhibited improved postoperative symptoms.The mean age was 60±9y(male/female ratio:6/14)in the DCS group and 56±12y(male/female ratio:7/11)in the AM group.The average epithelial healing time was 9.89±3.54d in the DCS group and 8.17±1.34d in the AM group(P=0.084).One recurrence case was observed in each group.Postoperative graft hemorrhage was significantly more severe in the DCS group than in the AM group only at 30d postoperatively(P=0.011).In vivo confocal microscopy revealed conjunctival epithelial cell growth in both groups at 90d postoperatively,while clear corneo-conjunctival cell boundaries were observed until 180d postoperatively.CONCLUSION:DCS used in primary pterygium surgery has a safety profile comparable to AM.It promotes rapid postoperative conjunctival healing,achieves a relatively low pterygium recurrence rate,and yields outcomes similar to AM.DCS provides a novel biomaterial option for conjunctival reconstruction after pterygium excision and the treatment of other conjunctival injuries.展开更多
Stroke can be categorized as ischemic and hemorrhagic on the basis of its origin.The pathophysiology following a stroke is complex,and is characterized by ongoing inflammation,neuronal injury,and the accumulation of r...Stroke can be categorized as ischemic and hemorrhagic on the basis of its origin.The pathophysiology following a stroke is complex,and is characterized by ongoing inflammation,neuronal injury,and the accumulation of reactive oxygen species in the brain,all of which reflect a dynamic process of change.This complexity hinders achievement of significant therapeutic outcomes with standard stroke treatment procedures,limiting post-stroke recovery.This review presents an innovative post-stroke therapeutic approach that utilizes nanomedicines to modify the cerebral microenvironment.It highlights the primary roles of chronic inflammation and nerve repair issues in causing prolonged impairment in stroke patients.Traditional therapies show limited effectiveness in achieving neuroprotection,immunoregulation,and neural regeneration during the subacute and chronic phases of stroke.Therefore,effective stroke management requires the use of specific therapeutic strategies tailored to the pathological characteristics of each phase.Various types of nanomedicines possess distinct physicochemical properties and can be selected on the basis of the specific therapeutic needs.Surface-modification technologies have significantly enhanced the ability of nanomedicines to penetrate the blood-brain barrier and improve their targeting capabilities in drug administration.However,the stability,biocompatibility,and long-term safety of nanomedicines require further optimization for clinical application.Nanomedicines represent a novel approach to stroke treatment through targeted delivery and multifaceted regulatory mechanisms.These medicines provide distinct advantages,particularly in addressing chronic inflammation and promoting nerve regeneration.As a result,nanomedicines are expected to significantly improve rehabilitation outcomes and quality of life for stroke patients in the future,emerging as a crucial modality for stroke treatment.展开更多
Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strate...Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.展开更多
Hemorrhagic shock(HS)is a leading cause of death worldwide,particularly within the first 24 h post-injury.Current treatments are limited,especially in low-resource settings.Therapeutic hypothermia(TH)offers potential ...Hemorrhagic shock(HS)is a leading cause of death worldwide,particularly within the first 24 h post-injury.Current treatments are limited,especially in low-resource settings.Therapeutic hypothermia(TH)offers potential benefits by reducing metabolic demands and protecting organs,but its application in HS is challenged by cooling difficulties and side effects.This study introduces a novel nasal gel formulation of N6-cyclohexyladenosine(CHA),an adenosine A1 receptor agonist,designed to enhance brain delivery while minimizing peripheral side effects.In a mouse model of HS,administration of CHA nasal gel significantly improved survival rates,reduced metabolic rates,and protected major organs without worsening coagulopathy.Metabolomics analysis revealed a shift towards fatty acid oxidation and increased antioxidant capacity.These findings demonstrate that CHA nasal gel effectively induces TH,offering a safe and innovative treatment strategy for HS,particularly in resource-limited environments.展开更多
Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based c...Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based chain rescue is crucial in managing severe trauma.A patient with chest and abdominal injuries and hemorrhagic shock was transferred from an ambulance to our hospital.Our trauma team-initiated pre-hospital first aid,utilized an emergency green channel,and conducted rapid ultrasound,collaborating across disciplines.The patient eventually recovered and was discharged.展开更多
Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune respons...Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair.This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression.In the acute phase(within 5-7 days),regulatory T cells exert neuroprotective effects primarily by reducing inflammation.In the chronic phase(7 days post-onset),these cells support neuroregeneration and functional recovery.The review also explores the emerging role of regulatory T cells in the brain-gut axis,a key mediator of the systemic immune responses following stroke,and discusses its relevance in modulating post-stroke inflammation and repair.Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells,administration of pharmacological agents,and induction of mucosal tolerance.All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells.Nevertheless,despite the promising preclinical results,the translation of regulatory T cell-based therapies into clinical practice is associated with challenges related to optimal timing,dosage,and long-term efficacy.Overall,targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.展开更多
Lassa fever(LF)is an acute viral hemorrhagic illness caused by the Lassa virus(LASV),an enveloped,spherical virus belonging to the Arenaviridae family.LASV possess a single-stranded RNA genome of negative polarity and...Lassa fever(LF)is an acute viral hemorrhagic illness caused by the Lassa virus(LASV),an enveloped,spherical virus belonging to the Arenaviridae family.LASV possess a single-stranded RNA genome of negative polarity and exhibits high genetic diversity,corresponding to the geographical distribution of its seven principal distinct clades across West Africa[1].LASV was first isolated in 1969 from an American missionary nurse stationed in the rural town of Lassa,Borno State,Nigeria,following her return from a brief vacation in the United States[2].展开更多
Modulations of mitochondrial dysfunction,which involve a series of dynamic processes such as mitochondrial biogenesis,mitochondrial fusion and fission,mitochondrial transport,mitochondrial autophagy,mitochondrial apop...Modulations of mitochondrial dysfunction,which involve a series of dynamic processes such as mitochondrial biogenesis,mitochondrial fusion and fission,mitochondrial transport,mitochondrial autophagy,mitochondrial apoptosis,and oxidative stress,play an important role in the onset and progression of stroke.With a better understanding of the critical role of mitochondrial dysfunction modulations in post-stroke neurological injury,these modulations have emerged as a potential target for stroke prevention and treatment.Additionally,since effective treatments for stroke are extremely limited and natural products currently offer some outstanding advantages,we focused on the findings and mechanisms of action related to the use of natural products for targeting mitochondrial dysfunction in the treatment of stroke.Natural products achieve neuroprotective through multi-target regulation of mitochondrial dysfunction encompassing the following processes:(1)Mitochondrial biogenesis:Cordyceps and hydroxysafflor yellow A activate the peroxisome proliferator-activated receptor gamma coactivator 1-alpha/nuclear respiratory factor pathway,promote mitochondrial DNA replication and respiratory chain protein synthesis,and thereby restore energy supply in the ischemic penumbra.(2)Mitochondrial dynamics balance:Ginsenoside Rb3 promotes Opa1-mediated neural stem cell migration and diffusion for recovery of damaged brain tissue.(3)Mitochondrial autophagy:Gypenoside XVII selectively eliminates damaged mitochondria via the phosphatase and tensin homolog-induced kinase 1/Parkin pathway and blocks reactive oxygen species and the NOD-like receptor protein 3 inflammasome cascade,thereby alleviating blood-brain barrier damage.(4)Anti-apoptotic mechanisms:Ginkgolide K inhibits Bax mitochondrial translocation and downregulates caspase-3/9 activity,reducing neuronal programmed death induced by ischemia-reperfusion.(5)Oxidative stress regulation:Scutellarin exerts antioxidant properties and improves neurological function by modulating the extracellular signal-regulated kinase 5-Kruppel-like factor 2-endothelial nitric oxide synthase signaling pathway.(6)Intercellular mitochondrial transport:Neuroprotective effects of Chrysophanol are associated with accelerated mitochondrial transfer from astrocytes to neurons.Existing studies have confirmed that natural products exhibit neuroprotective effects through multidimensional interventions targeting mitochondrial dysfunction in both ischemic and hemorrhagic stroke models.However,their clinical translation still faces challenges,such as the difficulty in standardization due to component complexity,insufficient cross-regional clinical data,and the lack of long-term safety evaluations.Future research should aim to integrate new technologies,such as single-cell sequencing and organoid models,to deeply explore the mitochondria-targeting mechanisms of natural products and validate their efficacy through multicenter clinical trials,providing theoretical support and translational pathways for the development of novel anti-stroke drugs.展开更多
AIM:To evaluate the clinical features,diagnosis,treatment,and outcome of peripheral exudative hemorrhagic chorioretinopathy(PEHCR),a variant of polypoidal choroidal vasculopathy(PCV),in a case series of Chinese patien...AIM:To evaluate the clinical features,diagnosis,treatment,and outcome of peripheral exudative hemorrhagic chorioretinopathy(PEHCR),a variant of polypoidal choroidal vasculopathy(PCV),in a case series of Chinese patients.METHODS:This study was retrospectively conducted from September 2018 to March 2025.Clinical examinations included color fundus photography,B-scan ultrasonography,fluorescein angiography(FA),indocyanine green angiography(ICGA),swept-source optical coherence tomography(SS-OCT),and optical coherence tomography angiography(OCTA),and two active or inactive subgroups and misdiagnosed cases were analyzed.RESULTS:Totally 19 patients(21 eyes)with a mean age of 54.3±9.4(range,36–68)y were included,with a majority of women(n=13,68.4%).The mean follow-up period was 13±1.4(range:1–57)mo.Decreased visual acuity was the most frequent initial manifestation(17 eyes,84.2%),and lesions were mainly distributed in the inferotemporal or temporal quadrant(14 eyes,66.7%),with choroidal polyps and branching neovascular networks revealed by OCTA and ICGA.Nine patients had been previously misdiagnosed with choroidal melanoma,and 6 of them had massive vitreous hemorrhage(VH).PEHCR manifested along a spectrum ranging from active or inactive subretinal hemorrhagic forms to chronic fibrotic or atrophic forms.One patient experienced natural regression.Ten eyes received a mean of 4.7±1.1(range:3–7)intravitreal anti-vascular endothelial growth factor(VEGF)injections,two eyes underwent vitrectomy,and six eyes were treated with vitrectomy combined with anti-VEGF therapy.Best-corrected visual acuity(logMAR)in treated eyes(18 eyes)improved to 0.31±0.25 from the baseline of 1.50±0.75(P<0.001).CONCLUSION:PEHCR is a variant of PCV.Chinese patients with PEHCR have a relatively younger age of onset.Anti-VEGF injections and/or vitrectomy are treatment options for lesion regression or dense VH to gain better visual outcomes.展开更多
Germinal matrix hemorrhage in preterm neonates often leads to white matter injury,contributing to long-term neurodevelopmental impairments.As resident brain immune cells,microglia play a complex role in injury respons...Germinal matrix hemorrhage in preterm neonates often leads to white matter injury,contributing to long-term neurodevelopmental impairments.As resident brain immune cells,microglia play a complex role in injury response,including inflammation and repair.Although colony-stimulating factor 1 receptor inhibitors such as PLX5622 enable the selective depletion of microglia,their therapeutic potential in neonatal germinal matrix hemorrhage remains underexplored.Here,we used a collagenase-induced germinal matrix hemorrhage model in postnatal day 5 mice,and intraperitoneally administered PLX562272 hours post-germinal matrix hemorrhage to achieve targeted,temporary microglial depletion during the peak injury response.We then assessed the effects of this delayed intervention on oligodendrocyte lineage cell maturation,white matter integrity,and neurobehavioral outcomes.Additionally,RNA sequencing data from a germinal matrix hemorrhage rat model were analyzed using weighted gene co-expression network analysis to identify the critical phases for interventions.RNA sequencing data revealed a critical period in which key synaptic functions declined while immune responses intensified post-germinal matrix hemorrhage,thus pinpointing the critical response phases for potential interventions.Delayed PLX5622 treatment effectively depleted activated microglia,protecting against white matter injury and enhancing oligodendrocyte lineage cell maturation and myelination in subcortical white matter regions.Moreover,magnetic resonance imaging analysis revealed reduced brain lesion volumes in treated mice.Behaviorally,PLX5622-treated mice exhibited significant improvements in motor coordination and reduced hyperactivity compared with vehicle-treated germinal matrix hemorrhage model mice.These findings suggest that,when timed to avoid interference with initial oligodendrocyte lineage cell proliferation,targeted microglial depletion with PLX5622 significantly mitigates white matter damage and improves neurobehavioral outcomes in neonatal germinal matrix hemorrhage.The present study highlights the therapeutic potential of selectively modulating microglial reactivity to support neurodevelopment in preterm infants with brain injury.展开更多
Subarachnoid hemorrhage(SAH) is a devastating condition that affects a total of 8 million people worldwide each year(Lauzier and Athiraman, 2024). Etiologies of SAH can be traumatic or nontraumatic, with the majority ...Subarachnoid hemorrhage(SAH) is a devastating condition that affects a total of 8 million people worldwide each year(Lauzier and Athiraman, 2024). Etiologies of SAH can be traumatic or nontraumatic, with the majority of non-traumatic SAH occurring due to intracranial aneurysm rupture(Rutledge et al., 2014).展开更多
基金supported by the ministry of education and the deanship of scientific research-Najran University-Kingdom of Saudi Arabia for their financial and technical support under code number NU/-/SERC/10/640.
文摘Damage of the blood vessels in retina due to diabetes is called diabetic retinopathy(DR).Hemorrhages is thefirst clinically visible symptoms of DR.This paper presents a new technique to extract and classify the hemorrhages in fundus images.The normal objects such as blood vessels,fovea and optic disc inside retinal images are masked to distinguish them from hemorrhages.For masking blood vessels,thresholding that separates blood vessels and background intensity followed by a newfilter to extract the border of vessels based on orienta-tions of vessels are used.For masking optic disc,the image is divided into sub-images then the brightest window with maximum variance in intensity is selected.Then the candidate dark regions are extracted based on adaptive thresholding and top-hat morphological techniques.Features are extracted from each candidate region based on ophthalmologist selection such as color and size and pattern recognition techniques such as texture and wavelet features.Three different types of Support Vector Machine(SVM),Linear SVM,Quadratic SVM and Cubic SVM classifier are applied to classify the candidate dark regions as either hemor-rhages or healthy.The efficacy of the proposed method is demonstrated using the standard benchmark DIARETDB1 database and by comparing the results with methods in silico.The performance of the method is measured based on average sensitivity,specificity,F-score and accuracy.Experimental results show the Linear SVM classifier gives better results than Cubic SVM and Quadratic SVM with respect to sensitivity and accuracy and with respect to specificity Quadratic SVM gives better result as compared to other SVMs.
基金Supported by the Medical and Health Science Foundation of Zhejiang,No.2023KY186Hangzhou Science and Technology Development Plan Guide Project,No.20220919Y023the Hangzhou Medical Key Discipline Construction Program,No.2021.
文摘BACKGROUND Factor XIII(FXIII)deficiency is a rare yet profound coagulopathy.FXIII plays a pivotal role in hemostasis,and deficiencies in this factor can precipitate unchecked or spontaneous hemorrhaging.Immunological assays for detecting FXIII inhibitors are indispensable for diagnosing acquired FXIII deficiency;however,the availability of suitable testing facilities is limited,resulting in prolonged turnaround times for these assays.CASE SUMMARY In this case study,a 53-year-old male devoid of significant medical history presented with recurrent intracranial hemorrhages and a hematoma in the right hip.Subsequent genetic analysis revealed a homozygous mutation in the ACE gene,confirming the diagnosis of acquired FXIII deficiency.CONCLUSION This case underscores the significance of considering acquired deficiencies in clotting factors when evaluating patients with unexplained bleeding episodes.
文摘Dear Editor,W e present three anatomical forms of premacular hemorrhage with niveau formation:hemorrhage in posterior precortical vitreous pocket(intrapocket hemorrhage),sub-internal limiting membrane(ILM)hemorrhage,and premacular retrocortical hemorrhage.Niveau formation is the formation of a horizonal boundary between fluid and blood cells when they accumulate in a closed space,because blood cells with higher specific gravity settle in a standing position.
文摘Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any case of pregnancy.
文摘Third trimester bleeding is a common concern in obstetrics. The main objective of this work was to study the management of hemorrhages in the third trimester of pregnancy in the maternity ward of the Sominé Dolo hospital in Mopti. Our prospective descriptive cross-sectional survey type study conducted at the maternity ward of Sominé Dolo hospital in Mopti over a period from January 1, 2017 to December 31, 2017 included 94 cases collected. During this period we had performed 1485 deliveries including 94 cases of pregnancies complicated by 3rd trimester hemorrhage, a frequency of 6.33%. The main cause of hemorrhage in the third trimester was represented by placenta preavia 42.6% followed by retroplacental hematoma 28.7%, uterine rupture 26.6% and association Placenta preavia and retroplacental hematoma 2.1%. The type of intervention depended on the cause of the hemorrhage and the maternal and fetal condition. More than half of the cases of uterine rupture 52% had benefited from a hysterorrhaphy during a laparotomy (n = 13/25) against 48% from hysterectomy (n = 12/25). Caesarean section was performed in 87.5% (n = 35/40) against 12.5% vaginal delivery (n = 5/40) in case of placenta preavia. In the end, in 74% of cases (n = 20/27) of retroplacental hematoma, first-line cesarean section was performed. The maternal prognosis was represented by a mortality rate of 12% (n = 11/94) and morbidity dominated by hypovolemic shock 48.9% (n = 22/94), infections 28.8% (n = 13/94) and coagulopathy 11.1% (n = 5/94). The fetal prognosis was very poor. More than half (55%) of the newborns had succumbed against 45% of the newly born. In 55.3% of cases neonatal mortality occurred antenatally. Neonatal morbidity was represented by prematurity, i.e. 20.2% (n = 19/94) and low birth weight, i.e. 22.3% (n = 21/94).
文摘Background: The treatment of cerebellar hemorrhage (CH) may be different surgery or conservative according to the hematoma volume, compression of vital structures or hydrocephalus existence. In the present study, the authors investigated the risk factors, the indications and the situation of external ventricular drainage (EVD) on the treatment line. Methods: 63 pure cerebellar hemorrhage patients were enrolled in the study. 36 cases underwent surgery;the other 27 were received conservative treatment. 15 and 13 cases received EVD in both groups. Hospital stay and mortality rates were investigated. Results: 4 cases in the conservative group underwent surgery secondary to treatment failure. Both of the groups had equal rates of morbidity and mortality. On the other hand, the group that received surgical intervention had shorter median hospital stay. The EVD does not seem to be life-saving at first but it gives time for preparing for surgery. Conclusions: We found that CH was strongly associated with early hydrocephalus and mortality. The early diagnosis and surgical evacuation of the mass are mandatory and life-saving if hematoma is larger than 10 ml. The EVD may not being a life-saving instrument but majorly it may be a time earning device if acute hydrocephalus present.
基金supported by the National Natural Science Foundation of China,Nos.82371310(to YJ),82271306(to JP)the Sichuan Science and Technology Support Program,Nos.2023YFH0069(to JP),2023NSFSC0028(to YJ),2023NSFSC1559(to YJ),2022YFS0615(to JP),2022NSFSC1421(to JP)+1 种基金Scientific Research Project of Sichuan Provincial Health Commission,No.23LCYJ040(to YJ)Youth Foundation of Southwestern Medical University and Southwest Medical University Project,Nos.2020ZRQNA038(to JP),2021ZKZD013(to JP),2021LZXNYD-P01(to YJ),2023QN014(to JP).
文摘Neuronal cell death is a common outcome of multiple pathophysiological processes and a key factor in neurological dysfunction after subarachnoid hemorrhage.Neuronal ferroptosis in particular plays an important role in early brain injury.Bromodomain-containing protein 4,a member of the bromo and extraterminal domain family of proteins,participated in multiple cell death pathways,but the mechanisms by which it regulates ferroptosis remain unclear.The primary aim of this study was to investigate how bromodomain-containing protein 4 affects neuronal ferroptosis following subarachnoid hemorrhage in vivo and in vitro.Our findings revealed that endogenous bromodomain-containing protein 4 co-localized with neurons,and its expression was decreased 48 hours after subarachnoid hemorrhage of the cerebral cortex in vivo.In addition,ferroptosis-related pathways were activated in vivo and in vitro after subarachnoid hemorrhage.Targeted inhibition of bromodomain-containing protein 4 in neurons increased lipid peroxidation and intracellular ferrous iron accumulation via ferritinophagy and ultimately led to neuronal ferroptosis.Using cleavage under targets and tagmentation analysis,we found that bromodomain-containing protein 4 enrichment in the Raf-1 promoter region decreased following oxyhemoglobin stimulation in vitro.Furthermore,treating bromodomain-containing protein 4-knockdown HT-22 cell lines with GW5074,a Raf-1 inhibitor,exacerbated neuronal ferroptosis by suppressing the Raf-1/ERK1/2 signaling pathway.Moreover,targeted inhibition of neuronal bromodomain-containing protein 4 exacerbated early and long-term neurological function deficits after subarachnoid hemorrhage.Our findings suggest that bromodomain-containing protein 4 may have neuroprotective effects after subarachnoid hemorrhage,and that inhibiting ferroptosis could help treat subarachnoid hemorrhage.
基金supported by the National Natural Science Foundation of China,No.81472235(to HF)the Shanghai Jiao Tong University Medical and Engineering Project,Nos.YG2021QN53(to HF),YG2017MS71(to HF)+1 种基金the International Cooperation Project of the National Natural Science Foundation of China,No.82020108017(to DC)the Innovation Group Project of the National Natural Science Foundation of China,No.81921002(to DC).
文摘Alzheimer’s disease is a multi-amyloidosis disease characterized by amyloid-βdeposits in brain blood vessels,microaneurysms,and senile plaques.How amyloid-βdeposition affects axon pathology has not been examined extensively.We used immunohistochemistry and immunofluorescence staining to analyze the forebrain tissue slices of Alzheimer’s disease patients.Widespread axonal amyloidosis with distinctive axonal enlargement was observed in patients with Alzheimer’s disease.On average,amyloid-β-positive axon diameters in Alzheimer’s disease brains were 1.72 times those of control brain axons.Furthermore,axonal amyloidosis was associated with microtubule-associated protein 2 reduction,tau phosphorylation,lysosome destabilization,and several blood-related markers,such as apolipoprotein E,alpha-hemoglobin,glycosylated hemoglobin type A1C,and hemin.Lysosome destabilization in Alzheimer’s disease was also clearly identified in the neuronal soma,where it was associated with the co-expression of amyloid-β,Cathepsin D,alpha-hemoglobin,actin alpha 2,and collagen type IV.This suggests that exogenous hemorrhagic protein intake influences neural lysosome stability.Additionally,the data showed that amyloid-β-containing lysosomes were 2.23 times larger than control lysosomes.Furthermore,under rare conditions,axonal breakages were observed,which likely resulted in Wallerian degeneration.In summary,axonal enlargement associated with amyloidosis,micro-bleeding,and lysosome destabilization is a major defect in patients with Alzheimer’s disease.This finding suggests that,in addition to the well-documented neural soma and synaptic damage,axonal damage is a key component of neuronal defects in Alzheimer’s disease.
基金supported by the Guangdong Basic and Applied Basic Research Foundation,No.2023A1515030045(to HS)Presidential Foundation of Zhujiang Hospital of Southern Medical University,No.yzjj2022ms4(to HS)。
文摘Intracerebral hemorrhage is the most dangerous subtype of stroke,characterized by high mortality and morbidity rates,and frequently leads to significant secondary white matter injury.In recent decades,studies have revealed that gut microbiota can communicate bidirectionally with the brain through the gut microbiota–brain axis.This axis indicates that gut microbiota is closely related to the development and prognosis of intracerebral hemorrhage and its associated secondary white matter injury.The NACHT,LRR,and pyrin domain-containing protein 3(NLRP3)inflammasome plays a crucial role in this context.This review summarizes the dysbiosis of gut microbiota following intracerebral hemorrhage and explores the mechanisms by which this imbalance may promote the activation of the NLRP3 inflammasome.These mechanisms include metabolic pathways(involving short-chain fatty acids,lipopolysaccharides,lactic acid,bile acids,trimethylamine-N-oxide,and tryptophan),neural pathways(such as the vagus nerve and sympathetic nerve),and immune pathways(involving microglia and T cells).We then discuss the relationship between the activated NLRP3 inflammasome and secondary white matter injury after intracerebral hemorrhage.The activation of the NLRP3 inflammasome can exacerbate secondary white matter injury by disrupting the blood–brain barrier,inducing neuroinflammation,and interfering with nerve regeneration.Finally,we outline potential treatment strategies for intracerebral hemorrhage and its secondary white matter injury.Our review highlights the critical role of the gut microbiota–brain axis and the NLRP3 inflammasome in white matter injury following intracerebral hemorrhage,paving the way for exploring potential therapeutic approaches.
基金Supported by grants from the National Natural Science Foundation of China(No.82171018,No.82371022)Beijing Hospitals Authority’s Ascent Plan(No.DFL20240202)+2 种基金The Youth Beijing Scholars Program(No.022)High Level Public Health Technical Talents Construction Project from Beijing(Jie Y)Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(No.2023YFC2410401).
文摘AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after primary pterygium excision.METHODS:This randomized,parallel-controlled study with allocation concealment enrolled 40 patients with primary pterygium.Participants were randomly assigned to two groups using the sealed envelope method:the DCS group(n=20)and the AM group(n=18),receiving DCS and AM grafts respectively.Slit-lamp photography of the operative eyes was performed preoperatively and at 1,3,5,7,10,30,90,and 180d postoperatively.Best-corrected visual acuity(BCVA)and symptom scores were recorded simultaneously.In vivo confocal microscopy was conducted at 3 and 6mo postoperatively.RESULTS:All participants exhibited improved postoperative symptoms.The mean age was 60±9y(male/female ratio:6/14)in the DCS group and 56±12y(male/female ratio:7/11)in the AM group.The average epithelial healing time was 9.89±3.54d in the DCS group and 8.17±1.34d in the AM group(P=0.084).One recurrence case was observed in each group.Postoperative graft hemorrhage was significantly more severe in the DCS group than in the AM group only at 30d postoperatively(P=0.011).In vivo confocal microscopy revealed conjunctival epithelial cell growth in both groups at 90d postoperatively,while clear corneo-conjunctival cell boundaries were observed until 180d postoperatively.CONCLUSION:DCS used in primary pterygium surgery has a safety profile comparable to AM.It promotes rapid postoperative conjunctival healing,achieves a relatively low pterygium recurrence rate,and yields outcomes similar to AM.DCS provides a novel biomaterial option for conjunctival reconstruction after pterygium excision and the treatment of other conjunctival injuries.
基金supported by the National Natural Science Foundation of China,Nos.82272616(to ZL),82271325(to WS)the Natural Science Foundation of Beijing,No.7252076(to YR).
文摘Stroke can be categorized as ischemic and hemorrhagic on the basis of its origin.The pathophysiology following a stroke is complex,and is characterized by ongoing inflammation,neuronal injury,and the accumulation of reactive oxygen species in the brain,all of which reflect a dynamic process of change.This complexity hinders achievement of significant therapeutic outcomes with standard stroke treatment procedures,limiting post-stroke recovery.This review presents an innovative post-stroke therapeutic approach that utilizes nanomedicines to modify the cerebral microenvironment.It highlights the primary roles of chronic inflammation and nerve repair issues in causing prolonged impairment in stroke patients.Traditional therapies show limited effectiveness in achieving neuroprotection,immunoregulation,and neural regeneration during the subacute and chronic phases of stroke.Therefore,effective stroke management requires the use of specific therapeutic strategies tailored to the pathological characteristics of each phase.Various types of nanomedicines possess distinct physicochemical properties and can be selected on the basis of the specific therapeutic needs.Surface-modification technologies have significantly enhanced the ability of nanomedicines to penetrate the blood-brain barrier and improve their targeting capabilities in drug administration.However,the stability,biocompatibility,and long-term safety of nanomedicines require further optimization for clinical application.Nanomedicines represent a novel approach to stroke treatment through targeted delivery and multifaceted regulatory mechanisms.These medicines provide distinct advantages,particularly in addressing chronic inflammation and promoting nerve regeneration.As a result,nanomedicines are expected to significantly improve rehabilitation outcomes and quality of life for stroke patients in the future,emerging as a crucial modality for stroke treatment.
文摘Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.
基金supported by grants from the National Natural Science Foundation of China(No.81981340417 to LiSu)Natural Science Foundation of Jiangsu Province Outstanding Youth Fund(No.BK20240134 to Yuanqing Gao).
文摘Hemorrhagic shock(HS)is a leading cause of death worldwide,particularly within the first 24 h post-injury.Current treatments are limited,especially in low-resource settings.Therapeutic hypothermia(TH)offers potential benefits by reducing metabolic demands and protecting organs,but its application in HS is challenged by cooling difficulties and side effects.This study introduces a novel nasal gel formulation of N6-cyclohexyladenosine(CHA),an adenosine A1 receptor agonist,designed to enhance brain delivery while minimizing peripheral side effects.In a mouse model of HS,administration of CHA nasal gel significantly improved survival rates,reduced metabolic rates,and protected major organs without worsening coagulopathy.Metabolomics analysis revealed a shift towards fatty acid oxidation and increased antioxidant capacity.These findings demonstrate that CHA nasal gel effectively induces TH,offering a safe and innovative treatment strategy for HS,particularly in resource-limited environments.
基金Jiangsu Provincial Hospital Association Hospital Management Innovation Research Fund(Project Ni.:JSYGY-3-2025-267)。
文摘Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based chain rescue is crucial in managing severe trauma.A patient with chest and abdominal injuries and hemorrhagic shock was transferred from an ambulance to our hospital.Our trauma team-initiated pre-hospital first aid,utilized an emergency green channel,and conducted rapid ultrasound,collaborating across disciplines.The patient eventually recovered and was discharged.
基金supported by National Key R&D Program:Key Special Project on Research for the Prevention and Treatment of Common Diseases-2022 Annual Project,Nos.2022YFC2504900,2022YFC2504902(both to ZL).
文摘Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage.These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair.This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression.In the acute phase(within 5-7 days),regulatory T cells exert neuroprotective effects primarily by reducing inflammation.In the chronic phase(7 days post-onset),these cells support neuroregeneration and functional recovery.The review also explores the emerging role of regulatory T cells in the brain-gut axis,a key mediator of the systemic immune responses following stroke,and discusses its relevance in modulating post-stroke inflammation and repair.Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells,administration of pharmacological agents,and induction of mucosal tolerance.All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells.Nevertheless,despite the promising preclinical results,the translation of regulatory T cell-based therapies into clinical practice is associated with challenges related to optimal timing,dosage,and long-term efficacy.Overall,targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.
文摘Lassa fever(LF)is an acute viral hemorrhagic illness caused by the Lassa virus(LASV),an enveloped,spherical virus belonging to the Arenaviridae family.LASV possess a single-stranded RNA genome of negative polarity and exhibits high genetic diversity,corresponding to the geographical distribution of its seven principal distinct clades across West Africa[1].LASV was first isolated in 1969 from an American missionary nurse stationed in the rural town of Lassa,Borno State,Nigeria,following her return from a brief vacation in the United States[2].
基金supported by the National Natural Science Foundation of China,No.82204663(to TZ)the Natural Science Foundation of Shandong Province,No.ZR2022QH058(to TZ).
文摘Modulations of mitochondrial dysfunction,which involve a series of dynamic processes such as mitochondrial biogenesis,mitochondrial fusion and fission,mitochondrial transport,mitochondrial autophagy,mitochondrial apoptosis,and oxidative stress,play an important role in the onset and progression of stroke.With a better understanding of the critical role of mitochondrial dysfunction modulations in post-stroke neurological injury,these modulations have emerged as a potential target for stroke prevention and treatment.Additionally,since effective treatments for stroke are extremely limited and natural products currently offer some outstanding advantages,we focused on the findings and mechanisms of action related to the use of natural products for targeting mitochondrial dysfunction in the treatment of stroke.Natural products achieve neuroprotective through multi-target regulation of mitochondrial dysfunction encompassing the following processes:(1)Mitochondrial biogenesis:Cordyceps and hydroxysafflor yellow A activate the peroxisome proliferator-activated receptor gamma coactivator 1-alpha/nuclear respiratory factor pathway,promote mitochondrial DNA replication and respiratory chain protein synthesis,and thereby restore energy supply in the ischemic penumbra.(2)Mitochondrial dynamics balance:Ginsenoside Rb3 promotes Opa1-mediated neural stem cell migration and diffusion for recovery of damaged brain tissue.(3)Mitochondrial autophagy:Gypenoside XVII selectively eliminates damaged mitochondria via the phosphatase and tensin homolog-induced kinase 1/Parkin pathway and blocks reactive oxygen species and the NOD-like receptor protein 3 inflammasome cascade,thereby alleviating blood-brain barrier damage.(4)Anti-apoptotic mechanisms:Ginkgolide K inhibits Bax mitochondrial translocation and downregulates caspase-3/9 activity,reducing neuronal programmed death induced by ischemia-reperfusion.(5)Oxidative stress regulation:Scutellarin exerts antioxidant properties and improves neurological function by modulating the extracellular signal-regulated kinase 5-Kruppel-like factor 2-endothelial nitric oxide synthase signaling pathway.(6)Intercellular mitochondrial transport:Neuroprotective effects of Chrysophanol are associated with accelerated mitochondrial transfer from astrocytes to neurons.Existing studies have confirmed that natural products exhibit neuroprotective effects through multidimensional interventions targeting mitochondrial dysfunction in both ischemic and hemorrhagic stroke models.However,their clinical translation still faces challenges,such as the difficulty in standardization due to component complexity,insufficient cross-regional clinical data,and the lack of long-term safety evaluations.Future research should aim to integrate new technologies,such as single-cell sequencing and organoid models,to deeply explore the mitochondria-targeting mechanisms of natural products and validate their efficacy through multicenter clinical trials,providing theoretical support and translational pathways for the development of novel anti-stroke drugs.
基金Supported by the National Natural Science Foundation of China(No.82220108017,No.82141128)The Capital Health Research and Development of Special(No.2024-1-2052)+1 种基金Science&Technology Project of Beijing Municipal Science&Technology Commission(No.Z201100005520045)Sanming Project of Medicine in Shenzhen(No.SZSM202311018)。
文摘AIM:To evaluate the clinical features,diagnosis,treatment,and outcome of peripheral exudative hemorrhagic chorioretinopathy(PEHCR),a variant of polypoidal choroidal vasculopathy(PCV),in a case series of Chinese patients.METHODS:This study was retrospectively conducted from September 2018 to March 2025.Clinical examinations included color fundus photography,B-scan ultrasonography,fluorescein angiography(FA),indocyanine green angiography(ICGA),swept-source optical coherence tomography(SS-OCT),and optical coherence tomography angiography(OCTA),and two active or inactive subgroups and misdiagnosed cases were analyzed.RESULTS:Totally 19 patients(21 eyes)with a mean age of 54.3±9.4(range,36–68)y were included,with a majority of women(n=13,68.4%).The mean follow-up period was 13±1.4(range:1–57)mo.Decreased visual acuity was the most frequent initial manifestation(17 eyes,84.2%),and lesions were mainly distributed in the inferotemporal or temporal quadrant(14 eyes,66.7%),with choroidal polyps and branching neovascular networks revealed by OCTA and ICGA.Nine patients had been previously misdiagnosed with choroidal melanoma,and 6 of them had massive vitreous hemorrhage(VH).PEHCR manifested along a spectrum ranging from active or inactive subretinal hemorrhagic forms to chronic fibrotic or atrophic forms.One patient experienced natural regression.Ten eyes received a mean of 4.7±1.1(range:3–7)intravitreal anti-vascular endothelial growth factor(VEGF)injections,two eyes underwent vitrectomy,and six eyes were treated with vitrectomy combined with anti-VEGF therapy.Best-corrected visual acuity(logMAR)in treated eyes(18 eyes)improved to 0.31±0.25 from the baseline of 1.50±0.75(P<0.001).CONCLUSION:PEHCR is a variant of PCV.Chinese patients with PEHCR have a relatively younger age of onset.Anti-VEGF injections and/or vitrectomy are treatment options for lesion regression or dense VH to gain better visual outcomes.
基金supported by the National Key Research and Development Program of China,No.2022YFC2704801(to CZhu)the National Natural Science Foundation of China,Nos.U21A20347(to CZhu),82203969(to YX),82371472(to XZ)+3 种基金Health Commission of Henan Province,Nos.SBGJ202303039(to XZ),SBGJ202301009(to CZhu),YQRC2024018(to XZ),YQRC2024019(to YX)Henan Science and Technology Department,Nos.242102311054(to XZ),241111521300(to CZhu),GZS2023003(to XW)Swedish Research Council,Nos.2022-01019(to CZhu),2021-01950(to XW)Swedish Governmental Grants to Scientists Working in Healthcare,Nos.ALFGBG-1005209(to CZhu),ALFBG-1005257(to XW),ALFGBG-965197(to CZhu).
文摘Germinal matrix hemorrhage in preterm neonates often leads to white matter injury,contributing to long-term neurodevelopmental impairments.As resident brain immune cells,microglia play a complex role in injury response,including inflammation and repair.Although colony-stimulating factor 1 receptor inhibitors such as PLX5622 enable the selective depletion of microglia,their therapeutic potential in neonatal germinal matrix hemorrhage remains underexplored.Here,we used a collagenase-induced germinal matrix hemorrhage model in postnatal day 5 mice,and intraperitoneally administered PLX562272 hours post-germinal matrix hemorrhage to achieve targeted,temporary microglial depletion during the peak injury response.We then assessed the effects of this delayed intervention on oligodendrocyte lineage cell maturation,white matter integrity,and neurobehavioral outcomes.Additionally,RNA sequencing data from a germinal matrix hemorrhage rat model were analyzed using weighted gene co-expression network analysis to identify the critical phases for interventions.RNA sequencing data revealed a critical period in which key synaptic functions declined while immune responses intensified post-germinal matrix hemorrhage,thus pinpointing the critical response phases for potential interventions.Delayed PLX5622 treatment effectively depleted activated microglia,protecting against white matter injury and enhancing oligodendrocyte lineage cell maturation and myelination in subcortical white matter regions.Moreover,magnetic resonance imaging analysis revealed reduced brain lesion volumes in treated mice.Behaviorally,PLX5622-treated mice exhibited significant improvements in motor coordination and reduced hyperactivity compared with vehicle-treated germinal matrix hemorrhage model mice.These findings suggest that,when timed to avoid interference with initial oligodendrocyte lineage cell proliferation,targeted microglial depletion with PLX5622 significantly mitigates white matter damage and improves neurobehavioral outcomes in neonatal germinal matrix hemorrhage.The present study highlights the therapeutic potential of selectively modulating microglial reactivity to support neurodevelopment in preterm infants with brain injury.
文摘Subarachnoid hemorrhage(SAH) is a devastating condition that affects a total of 8 million people worldwide each year(Lauzier and Athiraman, 2024). Etiologies of SAH can be traumatic or nontraumatic, with the majority of non-traumatic SAH occurring due to intracranial aneurysm rupture(Rutledge et al., 2014).
