Jake Barnes is not the only wounded character in The Sun Also Rises （1926）： All the major characters, except Bill, and several minor characters are also wounded. This paper examines how those wounded characters ref...Jake Barnes is not the only wounded character in The Sun Also Rises （1926）： All the major characters, except Bill, and several minor characters are also wounded. This paper examines how those wounded characters reflect on both Jake Barnes and Hemingway＇s philosophy that we are all wounded in life and must make choices that allow us to live as best we can without hurting others. By close reading, the author hopes to show how two characters, Belmonte and Brett Ashley, may have been undervalued by critics, and to also show Hemingway＇s essential ambiguity in portraying human relationships, leaving final judgments up to his readers.展开更多
When the troops are attacked by nuclear weapons, the number of the wounded and thetype and the condition of the wounds will change with the equivalence and the way of explosion, thenumber of soldiers taking part, the ...When the troops are attacked by nuclear weapons, the number of the wounded and thetype and the condition of the wounds will change with the equivalence and the way of explosion, thenumber of soldiers taking part, the area of the disposition of the troops, and the conditions of protectionof the personnel. Whether the wounded by nuclear weapons who is pouring in enormous amountcan be correctly classified in time has a very important relation in enhancing the effect of the first-aidand the treatment later on. We worked out a programme about the defined types and criteria of thewounded by nuclear weapons beforehand to be stored into the microcomputer. After nuclear cxplo-sion, it is necessary only to input the known data into the microcomputer from the key-board, thecomputer will immediately tell the number of the wounded of various types, the number of peopleand the time needed to perform the triage task and the surgical personnel needed to performthe operations, so that medical supporting programme can be selected or adjusted on time and the ef-ficiency and quality of the triage and first-aid work can be improved.展开更多
<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. &l...<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. <strong>Methods: </strong>This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. <strong>Results:</strong> Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. <strong>Conclusions:</strong> The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.展开更多
Objective: to explore the application value of the nursing emergency plan in the treatment of the reception group room of the medical station in the plateau area. Methods: review the rules of the nursing emergency pla...Objective: to explore the application value of the nursing emergency plan in the treatment of the reception group room of the medical station in the plateau area. Methods: review the rules of the nursing emergency plan formulated by our medical team in 2020 and its role in treating the mass injured in the receiving group room.Results: the treatment process of receiving the injured was intense, efficient and orderly. After rapid and effective hospital treatment, among 259 patients in 23 batches, 7 patients were transferred to the rear hospital after their vital signs were stable and the hospital for further treatment was recovered and discharged. All the others were recovered and discharged by our medical team, and none of them died or were disabled. Conclusion: under the plateau conditions, the success rate of treating the wounded patients can be improved by establishing the effective nursing emergency plan, standardizing the nursing management of the group room, and strengthening the specialized nursing and personalized nursing of the wounded.展开更多
[ Objective] The mechanism of antiseptic cream myogenic was revealed from the angle of cytokines to provide theoretical basis for clini- cal application. [ Method] Experiment with Wistar rats were studied, by detectin...[ Objective] The mechanism of antiseptic cream myogenic was revealed from the angle of cytokines to provide theoretical basis for clini- cal application. [ Method] Experiment with Wistar rats were studied, by detecting indicators such as the expression level of VEGF and bFGFmRNA of skin coloboma model rats wound tissue. [ Result] The results showed that： Antiseptic cream myogenic can improve VEGF and bFGFmRNA levels of the wound tissue,[Conclusion] Antiseptic cream myogenic can promote the proliferation and differentiation of vascular endothelial call and fibro- blast, and thus promote wound healing.展开更多
In modern wars bullet wounds caused by steel balls represent one of the majorkinds of combat wounds,and developing the criteria for necrosis of tissues in steel-ball-wounded organisms is therefore of great significanc...In modern wars bullet wounds caused by steel balls represent one of the majorkinds of combat wounds,and developing the criteria for necrosis of tissues in steel-ball-wounded organisms is therefore of great significance for both military and clini-cal applications.Severe injuries can be readily recognized by naked eyes,but slighterones are often difficult to be identified by visual examination or experience.Moreoverit seems to be unlikely to establish consiatent criteria for visual examination展开更多
Okra has attracted increasing interests to be used as functional food ingredients due to various human health benefits such as the inhibition ofα-glucosidase andα-amylase in this paper.Results showed that theα-gluc...Okra has attracted increasing interests to be used as functional food ingredients due to various human health benefits such as the inhibition ofα-glucosidase andα-amylase in this paper.Results showed that theα-glucosidase(andα-amylase)inhibition capacity of polyphenols in wounded okra significantly increased by 31.6%(and 28.6%)when the wounding intensity was 1.87 cm2/g.The UPLC-MS analysis indicated that quercetin and catechin derivatives were the major polyphenols in wounded okra,of which quercetin 3-O-gentiobioside and epigallocatechin dimer were the most abundant compounds.Fluorescence quenching confirmed that wound and healing process promoted the affinity betweenα-glucosidase(andα-amylase)and polyphenols,which interacted with enzymes in a mixed type manner.Molecular docking suggested that quercetin-3-O-gentiobioside,quercetin-3-O-glucosyl-xyloside,isoquercitrin,querce-tin-3-O-(malonyl)-glucoside,epigallocatechin,and epigallocatechin dimer can interact with the activity cavities of enzymes by amino acids residues(Arg195,Leu162,and His305).The results of this study support the potentials of wounded okra to inhibitα-glucosidase andα-amylase in the food industries,without associated risks to consumers.展开更多
Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion. Here we would like to analyze the treatment process for the wounded, and share the experiences of orga- nization and manag...Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion. Here we would like to analyze the treatment process for the wounded, and share the experiences of orga- nization and management for emergency rescue operation.展开更多
Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the ...Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.展开更多
Objective:: To understand wounding characteristics in dogs wounded by super velocity projectile with a purpose of providing a basis for prevention and treatment of such wounds. Methods: A specially-made explosive gun ...Objective:: To understand wounding characteristics in dogs wounded by super velocity projectile with a purpose of providing a basis for prevention and treatment of such wounds. Methods: A specially-made explosive gun was used to shoot aluminium bullet weighing 3.0 g and 1.4 g to injure both legs of dogs at velocities of 2*!330 m/s, 3*!200 m/s and 4*!250 m/s, respectively, and the soap specially made was also shot. At the same time, steel ball of 1.03 g was shot with a Type 53 smooth chamber gun at a speed of 1*!280 m/s. Within 30 min after wounding, debridement and pathological anatomy were performed and specimens were taken for light microscope observation. Results: When the dogs were wounded by the 3 g bullet at speed of 2*!330 m/s, the entrance of the left leg was penetrated explosively with a defect area of 225 cm 2, and the femur trunk was also injured and the residual femur had comminution fracture. The exit of the right leg was blindly wounded with a defect area of 63 cm 2, but only the skin was not penetrated. Both testes and part pelvis were injured too. Under light microscope, degenerative myofibers and bleeding of the spatium between the myofibers could be found at the place 4 cm away from the wounding track. Furthermore, serious bleeding of the bladder and blood vessels of the brain could be observed. The lungs showed changes of blast injury. Vacuolar change was presented in the cytoplasm of hepatocytes. Injuries of the animals in other two experimental groups were similar to those described above, but the defect area of the wounded track was 124 cm 2 in the group of 4*!250 m/s. Injuries caused by the steel ball were milder than caused by the explosive gun. The volume of the residual cavity in the soap was 5*!000 ml. Conclusions: The super-velocity projectile causes destructive damage to the local tissues and multi-organ injuries. Therefore, the practical medical care needs not only amputation but also management of multi-organ injuries.展开更多
Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle an...Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.展开更多
Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficu...Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.展开更多
BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds pre...BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problem...Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problems.In this work,monodispersed CeO_(2)@CuS nanocomposites(NCs)were successfully prepared with tannin(TA)as the reductant and linker.Due to abundant oxygen vacancies in CeO_(2)and the polyphenolic structure of TA,the TA-CeO_(2)@CuS NCs exhibited a remarkable antioxidant ability to scavenge excessive reactive oxygen species(ROS),which would likely induce serious inflammation.In addition,the TA-CeO_(2)@CuS NCs demonstrated excellent antibacterial capability with near-infrared ray(NIR)irradiation,and the released copper ions could promote the regeneration of blood vessels.These synergistic effects indicated that the synthesized TA-CeO_(2)@CuS NCs could serve as a promising biomaterial for multimodal wound therapy.展开更多
Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.A...Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.展开更多
BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,b...BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,biological,or artificial dressings.Biological and artificial dressings,such as hydrogels,are preferred for their biocompatibility.Platelet concentrates,such as platelet-rich plasma(PRP)and platelet-rich fibrin(PRF),stand out for accelerating tissue repair and minimizing risks of allergies and rejection.This study developed PRF and PRP-based dressings to treat skin wounds in an animal model,evaluating their functionality and efficiency in accelerating the tissue repair process.AIM To develop wound dressings based on platelet concentrates and evaluating their efficiency in treating skin wounds in Wistar rats.METHODS Wistar rats,both male and female,were subjected to the creation of a skin wound,distributed into groups(n=64/group),and treated with Carbopol(negative control);PRP+Carbopol;PRF+Carbopol;or PRF+CaCl_(2)+Carbopol,on days zero(D0),D3,D7,D14,and D21.PRP and PRF were obtained only from male rats.On D3,D7,D14,and D21,the wounds were analyzed for area,contraction rate,and histopathology of the tissue repair process.RESULTS The PRF-based dressing was more effective in accelerating wound closure early in the tissue repair process(up to D7),while PRF+CaCl_(2) seemed to delay the process,as wound closure was not complete by D21.Regarding macroscopic parameters,animals treated with PRF+CaCl_(2) showed significantly more crusting(necrosis)early in the repair process(D3).In terms of histopathological parameters,the PRF group exhibited significant collagenization at the later stages of the repair process(D14 and D21).By D21,fibroblast proliferation and inflammatory infiltration were higher in the PRP group.Animals treated with PRF+CaCl_(2) experienced a more pronounced inflammatory response up to D7,which diminished from D14 onwards.CONCLUSION The PRF-based dressing was effective in accelerating the closure of cutaneous wounds in Wistar rats early in the process and in aiding tissue repair at the later stages.展开更多
Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance ...Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance wearable sensors to offer prompt feedback.Existing devices have limitations in measuring pH and the concentration of pH-dependent electroactive species simultaneously,which is crucial for obtaining a comprehensive understanding of wound status and optimizing biosensors.Therefore,improving materials and analysis system accuracy is essential.This article introduces the first example of a flexible array capable of detecting pyocyanin,a bacterial virulence factor,while correcting dynamic pH fluctuations.We demonstrate that this combined sensor enhances accuracy by mitigating the impact of pH variability on pyocyanin sensor response.Customized screen-printable inks were developed to enhance analytical performance.The analytical performances of two sensitive sensor systems(i.e.,fully-printed porous graphene/multiwalled carbon nanotube(CNT)and polyaniline/CNT composites for pyocyanin and pH sensors)are evaluated.Partial least square regression is employed to analyze nonzero-order data arrays from square wave voltammetric and potentiometric measurements of pyocyanin and pH sensors to establish a predictive model for pyocyanin concentration in complex fluids.This sensitive and effective strategy shows potential for personalized applications due to its affordability,ease of use,and ability to adjust for dynamic pH changes.展开更多
Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomime...Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.展开更多
Histopathological analysis of chronic wounds is crucial for clinicians to accurately assess wound healing progress and detect potential malignancy.However,traditional pathological tissue sections require specific stai...Histopathological analysis of chronic wounds is crucial for clinicians to accurately assess wound healing progress and detect potential malignancy.However,traditional pathological tissue sections require specific staining procedures involving carcinogenic chemicals.This study proposes an interdisciplinary approach merging materials science,medicine,and artificial intelligence(AI)to develop a virtual staining technique and intelligent evaluation model based on deep learning for chronic wound tissue pathology.This innovation aims to enhance clinical diagnosis and treatment by offering personalized AI-driven therapeutic strategies.By establishing a mouse model of chronic wounds and using a series of hydrogel wound dressings,tissue pathology sections were periodically collected for manual staining and healing assessment.We focused on leveraging the pix2pix image translation framework within deep learning networks.Through CNN models implemented in Python using PyTorch,our study involves learning and feature extraction for region segmentation of pathological slides.Comparative analysis between virtual staining and manual staining results,along with healing diagnosis conclusions,aims to optimize AI models.Ultimately,this approach integrates new metrics such as image recognition,quantitative analysis,and digital diagnostics to formulate an intelligent wound assessment model,facilitating smart monitoring and personalized treatment of wounds.In blind evaluation by pathologists,minimal disparities were found between virtual and conventional histologically stained images of murine wound tissue.The evaluation used pathologists’average scores on real stained images as a benchmark.The scores for virtual stained images were 71.1%for cellular features,75.4%for tissue structures,and 77.8%for overall assessment.Metrics such as PSNR(20.265)and SSIM(0.634)demonstrated our algorithms’superior performance over existing networks.Eight pathological features such as epidermis,hair follicles,and granulation tissue can be accurately identified,and the images were found to be more faithful to the actual tissue feature distribution when compared to manually annotated data.展开更多
文摘Jake Barnes is not the only wounded character in The Sun Also Rises （1926）： All the major characters, except Bill, and several minor characters are also wounded. This paper examines how those wounded characters reflect on both Jake Barnes and Hemingway＇s philosophy that we are all wounded in life and must make choices that allow us to live as best we can without hurting others. By close reading, the author hopes to show how two characters, Belmonte and Brett Ashley, may have been undervalued by critics, and to also show Hemingway＇s essential ambiguity in portraying human relationships, leaving final judgments up to his readers.
文摘When the troops are attacked by nuclear weapons, the number of the wounded and thetype and the condition of the wounds will change with the equivalence and the way of explosion, thenumber of soldiers taking part, the area of the disposition of the troops, and the conditions of protectionof the personnel. Whether the wounded by nuclear weapons who is pouring in enormous amountcan be correctly classified in time has a very important relation in enhancing the effect of the first-aidand the treatment later on. We worked out a programme about the defined types and criteria of thewounded by nuclear weapons beforehand to be stored into the microcomputer. After nuclear cxplo-sion, it is necessary only to input the known data into the microcomputer from the key-board, thecomputer will immediately tell the number of the wounded of various types, the number of peopleand the time needed to perform the triage task and the surgical personnel needed to performthe operations, so that medical supporting programme can be selected or adjusted on time and the ef-ficiency and quality of the triage and first-aid work can be improved.
文摘<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. <strong>Methods: </strong>This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. <strong>Results:</strong> Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. <strong>Conclusions:</strong> The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.
文摘Objective: to explore the application value of the nursing emergency plan in the treatment of the reception group room of the medical station in the plateau area. Methods: review the rules of the nursing emergency plan formulated by our medical team in 2020 and its role in treating the mass injured in the receiving group room.Results: the treatment process of receiving the injured was intense, efficient and orderly. After rapid and effective hospital treatment, among 259 patients in 23 batches, 7 patients were transferred to the rear hospital after their vital signs were stable and the hospital for further treatment was recovered and discharged. All the others were recovered and discharged by our medical team, and none of them died or were disabled. Conclusion: under the plateau conditions, the success rate of treating the wounded patients can be improved by establishing the effective nursing emergency plan, standardizing the nursing management of the group room, and strengthening the specialized nursing and personalized nursing of the wounded.
基金funded by the Northeast Agricultural University Talent Fund
文摘[ Objective] The mechanism of antiseptic cream myogenic was revealed from the angle of cytokines to provide theoretical basis for clini- cal application. [ Method] Experiment with Wistar rats were studied, by detecting indicators such as the expression level of VEGF and bFGFmRNA of skin coloboma model rats wound tissue. [ Result] The results showed that： Antiseptic cream myogenic can improve VEGF and bFGFmRNA levels of the wound tissue,[Conclusion] Antiseptic cream myogenic can promote the proliferation and differentiation of vascular endothelial call and fibro- blast, and thus promote wound healing.
文摘In modern wars bullet wounds caused by steel balls represent one of the majorkinds of combat wounds,and developing the criteria for necrosis of tissues in steel-ball-wounded organisms is therefore of great significance for both military and clini-cal applications.Severe injuries can be readily recognized by naked eyes,but slighterones are often difficult to be identified by visual examination or experience.Moreoverit seems to be unlikely to establish consiatent criteria for visual examination
基金subsidized by the Jiangsu Agriculture Science and Technology Innovation Fund(CX(18)3070)the China National Post-doctoral Program for Innovative Talents(BX20220137)+1 种基金the Jiangsu Excellent Postdoctoral Program(2022ZB495)which has enabled us to accomplish this study.
文摘Okra has attracted increasing interests to be used as functional food ingredients due to various human health benefits such as the inhibition ofα-glucosidase andα-amylase in this paper.Results showed that theα-glucosidase(andα-amylase)inhibition capacity of polyphenols in wounded okra significantly increased by 31.6%(and 28.6%)when the wounding intensity was 1.87 cm2/g.The UPLC-MS analysis indicated that quercetin and catechin derivatives were the major polyphenols in wounded okra,of which quercetin 3-O-gentiobioside and epigallocatechin dimer were the most abundant compounds.Fluorescence quenching confirmed that wound and healing process promoted the affinity betweenα-glucosidase(andα-amylase)and polyphenols,which interacted with enzymes in a mixed type manner.Molecular docking suggested that quercetin-3-O-gentiobioside,quercetin-3-O-glucosyl-xyloside,isoquercitrin,querce-tin-3-O-(malonyl)-glucoside,epigallocatechin,and epigallocatechin dimer can interact with the activity cavities of enzymes by amino acids residues(Arg195,Leu162,and His305).The results of this study support the potentials of wounded okra to inhibitα-glucosidase andα-amylase in the food industries,without associated risks to consumers.
文摘Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion. Here we would like to analyze the treatment process for the wounded, and share the experiences of orga- nization and management for emergency rescue operation.
文摘Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.
文摘Objective:: To understand wounding characteristics in dogs wounded by super velocity projectile with a purpose of providing a basis for prevention and treatment of such wounds. Methods: A specially-made explosive gun was used to shoot aluminium bullet weighing 3.0 g and 1.4 g to injure both legs of dogs at velocities of 2*!330 m/s, 3*!200 m/s and 4*!250 m/s, respectively, and the soap specially made was also shot. At the same time, steel ball of 1.03 g was shot with a Type 53 smooth chamber gun at a speed of 1*!280 m/s. Within 30 min after wounding, debridement and pathological anatomy were performed and specimens were taken for light microscope observation. Results: When the dogs were wounded by the 3 g bullet at speed of 2*!330 m/s, the entrance of the left leg was penetrated explosively with a defect area of 225 cm 2, and the femur trunk was also injured and the residual femur had comminution fracture. The exit of the right leg was blindly wounded with a defect area of 63 cm 2, but only the skin was not penetrated. Both testes and part pelvis were injured too. Under light microscope, degenerative myofibers and bleeding of the spatium between the myofibers could be found at the place 4 cm away from the wounding track. Furthermore, serious bleeding of the bladder and blood vessels of the brain could be observed. The lungs showed changes of blast injury. Vacuolar change was presented in the cytoplasm of hepatocytes. Injuries of the animals in other two experimental groups were similar to those described above, but the defect area of the wounded track was 124 cm 2 in the group of 4*!250 m/s. Injuries caused by the steel ball were milder than caused by the explosive gun. The volume of the residual cavity in the soap was 5*!000 ml. Conclusions: The super-velocity projectile causes destructive damage to the local tissues and multi-organ injuries. Therefore, the practical medical care needs not only amputation but also management of multi-organ injuries.
文摘Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.
基金supports received from Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)+3 种基金the Natural Science Foundation of Liaoning Province(Grant No.2024-MS-075)the National Natural Science Foundation of China(32201179)National Key R&D Program of China(2023YFC2508200)Liaoning Provincial Natural Science Foundation Joint Fund(General Support Program Project)(2023-MSBA-093).
文摘Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.
基金National Natural Science Foundation of China,No.81873934and Jinan Science and Technology Planning Project,No.202225065.
文摘BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金supported by Key Scientific and Technological Project of Henan Province(No.242102231060)Doctoral Scientific Research Foundation of Zhoukou Normal University(No.ZKNUC2021041)the Program of Innovative Research Team(in Science and Technology)in University of Henan Province(No.23IRTSTHN008)。
文摘Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problems.In this work,monodispersed CeO_(2)@CuS nanocomposites(NCs)were successfully prepared with tannin(TA)as the reductant and linker.Due to abundant oxygen vacancies in CeO_(2)and the polyphenolic structure of TA,the TA-CeO_(2)@CuS NCs exhibited a remarkable antioxidant ability to scavenge excessive reactive oxygen species(ROS),which would likely induce serious inflammation.In addition,the TA-CeO_(2)@CuS NCs demonstrated excellent antibacterial capability with near-infrared ray(NIR)irradiation,and the released copper ions could promote the regeneration of blood vessels.These synergistic effects indicated that the synthesized TA-CeO_(2)@CuS NCs could serve as a promising biomaterial for multimodal wound therapy.
基金supported in part by the National Nature Science Foundation of China(92268206,81830064)the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-I2M-5-059)+4 种基金the Military Medical Research Projects(145AKJ260015000X,2022-JCJQ-ZB-09600)the Military Key Basic Research of Foundational Strengthening Program(2020-JCJQ-ZD-256-021)the Science Foundation of National Defense Science and Technology for Excellent Young(2022-JCJQ-ZQ-017)the Military Medical Research and Development Projects(AWS17J005,2019-126)the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province(YSPTZX202317).
文摘Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.
文摘BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,biological,or artificial dressings.Biological and artificial dressings,such as hydrogels,are preferred for their biocompatibility.Platelet concentrates,such as platelet-rich plasma(PRP)and platelet-rich fibrin(PRF),stand out for accelerating tissue repair and minimizing risks of allergies and rejection.This study developed PRF and PRP-based dressings to treat skin wounds in an animal model,evaluating their functionality and efficiency in accelerating the tissue repair process.AIM To develop wound dressings based on platelet concentrates and evaluating their efficiency in treating skin wounds in Wistar rats.METHODS Wistar rats,both male and female,were subjected to the creation of a skin wound,distributed into groups(n=64/group),and treated with Carbopol(negative control);PRP+Carbopol;PRF+Carbopol;or PRF+CaCl_(2)+Carbopol,on days zero(D0),D3,D7,D14,and D21.PRP and PRF were obtained only from male rats.On D3,D7,D14,and D21,the wounds were analyzed for area,contraction rate,and histopathology of the tissue repair process.RESULTS The PRF-based dressing was more effective in accelerating wound closure early in the tissue repair process(up to D7),while PRF+CaCl_(2) seemed to delay the process,as wound closure was not complete by D21.Regarding macroscopic parameters,animals treated with PRF+CaCl_(2) showed significantly more crusting(necrosis)early in the repair process(D3).In terms of histopathological parameters,the PRF group exhibited significant collagenization at the later stages of the repair process(D14 and D21).By D21,fibroblast proliferation and inflammatory infiltration were higher in the PRP group.Animals treated with PRF+CaCl_(2) experienced a more pronounced inflammatory response up to D7,which diminished from D14 onwards.CONCLUSION The PRF-based dressing was effective in accelerating the closure of cutaneous wounds in Wistar rats early in the process and in aiding tissue repair at the later stages.
基金the Talent Management Project of Prince of Songkla University
文摘Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance wearable sensors to offer prompt feedback.Existing devices have limitations in measuring pH and the concentration of pH-dependent electroactive species simultaneously,which is crucial for obtaining a comprehensive understanding of wound status and optimizing biosensors.Therefore,improving materials and analysis system accuracy is essential.This article introduces the first example of a flexible array capable of detecting pyocyanin,a bacterial virulence factor,while correcting dynamic pH fluctuations.We demonstrate that this combined sensor enhances accuracy by mitigating the impact of pH variability on pyocyanin sensor response.Customized screen-printable inks were developed to enhance analytical performance.The analytical performances of two sensitive sensor systems(i.e.,fully-printed porous graphene/multiwalled carbon nanotube(CNT)and polyaniline/CNT composites for pyocyanin and pH sensors)are evaluated.Partial least square regression is employed to analyze nonzero-order data arrays from square wave voltammetric and potentiometric measurements of pyocyanin and pH sensors to establish a predictive model for pyocyanin concentration in complex fluids.This sensitive and effective strategy shows potential for personalized applications due to its affordability,ease of use,and ability to adjust for dynamic pH changes.
基金supported by the National Natural Science Foundation of China(No.82272297).
文摘Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.
基金supported by the Fundamental Research Funds for the Central Universities(No.20720230037)the National Natural Science Foundation of China(No.52273305)+2 种基金Natural Science Foundation of Fujian Province of China(No.2023J05012)State Key Laboratory of Vaccines for Infectious Diseases,Xiang An Biomedicine Laboratory(Nos.2023XAKJ0103071,2023XAKJ0102061)Natural Science Foundation of Xiamen,China(No.3502Z20227010).
文摘Histopathological analysis of chronic wounds is crucial for clinicians to accurately assess wound healing progress and detect potential malignancy.However,traditional pathological tissue sections require specific staining procedures involving carcinogenic chemicals.This study proposes an interdisciplinary approach merging materials science,medicine,and artificial intelligence(AI)to develop a virtual staining technique and intelligent evaluation model based on deep learning for chronic wound tissue pathology.This innovation aims to enhance clinical diagnosis and treatment by offering personalized AI-driven therapeutic strategies.By establishing a mouse model of chronic wounds and using a series of hydrogel wound dressings,tissue pathology sections were periodically collected for manual staining and healing assessment.We focused on leveraging the pix2pix image translation framework within deep learning networks.Through CNN models implemented in Python using PyTorch,our study involves learning and feature extraction for region segmentation of pathological slides.Comparative analysis between virtual staining and manual staining results,along with healing diagnosis conclusions,aims to optimize AI models.Ultimately,this approach integrates new metrics such as image recognition,quantitative analysis,and digital diagnostics to formulate an intelligent wound assessment model,facilitating smart monitoring and personalized treatment of wounds.In blind evaluation by pathologists,minimal disparities were found between virtual and conventional histologically stained images of murine wound tissue.The evaluation used pathologists’average scores on real stained images as a benchmark.The scores for virtual stained images were 71.1%for cellular features,75.4%for tissue structures,and 77.8%for overall assessment.Metrics such as PSNR(20.265)and SSIM(0.634)demonstrated our algorithms’superior performance over existing networks.Eight pathological features such as epidermis,hair follicles,and granulation tissue can be accurately identified,and the images were found to be more faithful to the actual tissue feature distribution when compared to manually annotated data.
