Telencephalic stab wound injury induces regenerative angiogenesis and neurogenesis in zebrafish:unveiling the role of vascular endothelial growth factor signaling and microglia

After brain damage,regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals,suggesting a close link between these processes.However,the mechanisms by which these processes interact are not well understood.In this work,we aimed to study the correlation between angiogenesis and neurogenesis after a telencephalic stab wound injury.To this end,we used zebrafish as a relevant model of neuroplasticity and brain repair mechanisms.First,using the Tg(fli1:EGFP×mpeg1.1:mCherry)zebrafish line,which enables visualization of blood vessels and microglia respectively,we analyzed regenerative angiogenesis from 1 to 21 days post-lesion.In parallel,we monitored brain cell proliferation in neurogenic niches localized in the ventricular zone by using immunohistochemistry.We found that after brain damage,the blood vessel area and width as well as expression of the fli1 transgene and vascular endothelial growth factor(vegfaa and vegfbb)were increased.At the same time,neural stem cell proliferation was also increased,peaking between 3 and 5 days post-lesion in a manner similar to angiogenesis,along with the recruitment of microglia.Then,through pharmacological manipulation by injecting an anti-angiogenic drug(Tivozanib)or Vegf at the lesion site,we demonstrated that blocking or activating Vegf signaling modulated both angiogenic and neurogenic processes,as well as microglial recruitment.Finally,we showed that inhibition of microglia by clodronate-containing liposome injection or dexamethasone treatment impairs regenerative neurogenesis,as previously described,as well as injury-induced angiogenesis.In conclusion,we have described regenerative angiogenesis in zebrafish for the first time and have highlighted the role of inflammation in this process.In addition,we have shown that both angiogenesis and neurogenesis are involved in brain repair and that microglia and inflammation-dependent mechanisms activated by Vegf signaling are important contributors to these processes.This study paves the way for a better understanding of the effect of Vegf on microglia and for studies aimed at promoting angiogenesis to improve brain plasticity after brain injury.

Evaluation of follow-up and long-term outcomes of gunshot and stab wounds in a French civilian population

Purpose The data concerning long-term follow-up and outcomes of penetrating trauma are poorly detailed in the literature.The main objective of our study was to analyze the hospital and extra-hospital follow-up of penetrating trauma victims and to evaluate the late complications and long-term consequences of these traumas.Methods This work was a retrospective longitudinal monocentric observational study conducted at Laveran Military Hospital,from January 2007 to January 2017.All patients hospitalized for gunshot wound or stab wound management during this period were identified via a retrospective systematic query in the hospital information system using the ICD-10 codes.Epidemiological data,traumatism characteristics,hospital management,follow-up and traumatism consequences(i.e.,persistent disability)were analyzed.To improve evaluation of traumatism long-term consequences,extra-hospital follow-up data from general physicians(GP)were collected by phone call.During this interview,9 closed questions were asked to the GP.The survey evaluated:the date of the last consultation related to injury with the GP,the specific follow-up carried out by the GP,traumatism consequences,and recurrence of traumatism.Descriptive,univariate and multivariate with regression analysis were used for statistical analysis.Results A total number of 165 patients were included.Median(Q1,Q3)of hospital follow-up was 28(4,66)days.One hundred one patients(61.2%)went to their one-month consultation at hospital.GP follow-up was achieved for 76 patients(55.2%).Median(Q1,Q3)of GP follow-up was 47(21,75)months.Twenty-four patients(14.5%)have been totally lost to follow up.The overall follow-up identified 54 patients(32.7%)with long-term consequences,20 being psychiatric disorders and 30 organic injuries.Organic consequences were mainly peripheral nerve damages(n=20;12.1%).Most of the psychiatric consequences were diagnosed during GP follow-up(n=14;70%).Seventeen cases(10.3%)of recurrence were found and late mortality occurred in 4 patients(2.4%).High injury severity score,older age and gunshot wound were significantly linked to long-term consequences.Data collection and analysis were carried out in accordance with MR004 reference methodology.Conclusion This study showed a high rate of long-term consequences among patients managed for penetrating injury.If all organic lesions are diagnosed during hospital follow-up and jointly managed by hospital and extra-hospital physicians,most socio-psychiatric consequences were detected and followed by extra-hospital workers.However,for half of the patients,the extra-hospital follow-up could not be assessed.Thus,these consequences are very probably underestimated.It appears imperative to strengthen the compliance and adherence of these patients to the care network.Awareness and involvement of medical,paramedical teams and GP role seems essential to screen and manage these consequences.

Aortoduodenal fistula following aortic reconstruction of a pseudoaneurysm caused by stab wound 12 years ago

Gastrointestinal bleeding due to aortoenteric fistula is extremely rare.Aortoenteric fistula is difficult to be diagnosed timely and entails a significant morbidity and mortality.Herein,we present an uncommon case of gastrointestinal bleeding caused by aortoduodenal fistula,which was a complication of a successful aortic reconstruction 4 months ago for an aortic pseudoaneurysm resulted from a stab wound 12 years ago.An urgent laparotomy confirmed an aortoduodenal fistula and repaired the defects in aorta and duodenum,but a prolonged shock led to the patient's death.In summary,early diagnosis and surgical intervention for aortoenteric fistula are vital for survival.

A Case of Suicide with Multiple Stab Wounds

Multiple stab wounds are very common features of homicidal stabbing.The common findings differentiating homicidal and suicidal stabbing are well described in the medical literature.Among the features mentioned are location,shape,and direction of the wounds.These features are vital in differentiating suicide from homicide.However,this case has an unusual presentation.We discuss the importance of interpretation and differentiation of the stab wounds to determine the manner of death and facilitate the investigation.A 29‑year‑old male presented with multiple stab wounds.There was no witness at the time of the incident.The body was discovered in his room with pools of blood.A knife was present on his body.No tentative cuts were present on the body.Scene investigation and postmortem examination determined the cause and manner of death.

Transarterial coil embolization in treatment of gross hematuria following self-inflicted stab wound in a horseshoe kidney

Horseshoe kidney is an uncommon anomaly of the urinary system with an increased risk of injury during penetrating and blunt abdominal traumas. Selfinflicted abdominal stab wound, a rare type of abdominal injury, accounts for only a small percentage of suicidal attempts and may be infrequently encountered by physicians in trauma centers. Psychiatric disorders and alcohol or drug abuse are common risk factors in cases of self-stabbing. Here we report a rare case of self-stabbing of a horseshoe kidney. The case was a 19-year-old man with self-inflicted abdominal stab wound who was referred to our departmentof radiology due to re-occmTed gross hematuria three days after exploratory laparotomy and surgical repair of injured abdominal organs. A horseshoe kidney was incidentally found in the patient＇s abdominal computed tomography. Renal angiography revealed active contrast extravasation from one of the segmental arteries. Selective transarterial embolization with a coil was successfully performed to control the hematuria.

一种新型开塞露容器的设计

目的开塞露在临床使用时,存在易刺伤、逆流、残留量较多等问题。根据肛门直肠解剖结构及力学特性,设计一种新型开塞露容器,以减少肛管刺伤,提高开塞露溶剂利用率。方法新型开塞露容器包括容器塞、防刺球、导管、容器主体四部分。容器塞和防刺球采用葫芦形状的大小球组合;将导管管腔设计为Y字形,并在导管头端增加一个滚动小球;开塞露容器主体形状为燕尾状。通过Solid Works软件,进行容器各部参数赋值及仿真分析,生成模型。最后通过命令计算新型开塞露容器模型体积、长度、压强等,以此来计算开塞露容器的回流量及残留量,并与市售开塞露进行对比。结果新型开塞露的尖端压强为1.6 MPa,回流量为0.09 mL,残流量为2.5 mL,疼痛评分为1分,具有防刺伤、防逆流的作用。结论本文设计的新型开塞露具有明显优势,实用性更强,可以减少肛管刺伤,提高开塞露溶剂利用率。

Thoracic Spinal Cord Stab Injury: A Case Report and Literature Review

Thoracic spinal cord stab injuries are rare lesions. A 17-year-old boy was stabbed on his back by his classmate when he bent forward to pick up his cloth from the ground. On admission, he presented with: complete paraplegia with muscle strength of zero on all muscle groups, complete anesthesia from dermatome 10 and below, acute urinary retention, and a four-centimeter wound on the thoracolumbar region from which cerebrospinal fluid mixed with blood was oozing out. A high-dose methylprednisolone protocol was started (30 mg/kg in one hour and then 5.4 mg/kg over 23 hours) an indwelling urinary catheter placed and sterile dressing of the wound done. Antibiotics and analgesics were also administered. The computed tomography scanning revealed a spinal cord transection at T10-T11 level with incarceration of the broken knife blade. An emergency thoracic laminectomy was performed. Removal of the broken knife blade revealed complete spinal cord transection with a compressive hematoma within the spinal cord which was removed by smooth suction. The spinal dura was sutured and the wound closed in many layers. On day 14 after surgery, sensitivity was recovered with 3 on 5 muscle strength in both lower limbs except for both feet where motor function remained null. Urinary retention and fecal incontinence persisted. The patient was discharged from our service for a rehabilitation center. At 32-month follow-up, neurological examination was unchanged although patient noticed a slight improvement of sphincter disturbances.

甜瓜新镰刀菌果腐病病原菌Fusarium asiaticum的生物学特性研究及抗病品种筛选

由镰刀菌属引起的甜瓜果腐病是全球甜瓜生产的重要真菌性病害之一,2020年从浙江宁海发病甜瓜上分离获得一株亚洲镰刀菌(Fusarium asiaticum)Fa-25,可引起浙江省的甜瓜果腐病,为明确该亚洲镰刀菌的生物学特性,开展Fa-25的最适生长条件和致病力的探究。结果表明,亚洲镰刀菌Fa-25的最适生长温度为28℃,比较适合的碳源为葡萄糖和乳糖,比较适合的氮源为KNO3、甘氨酸、亮氨酸和丙氨酸,尿素则不利于生长。该病原菌喜光,菌丝致死温度为35℃,最适的pH为6。利用亚洲镰刀菌Fa-25对瓜类果实进行刺伤接种,筛选到柏格、HXC12和P80这3个较抗的甜瓜材料。此外,Fa-25还可对西瓜和黄瓜产生致病力。

蛇床子素对机械性脑损伤小鼠的抗炎抗凋亡作用研究

目的研究蛇床子素(osthole,Ost)对小鼠机械性脑损伤后细胞凋亡及炎症细胞浸润的影响。方法建立针刺伤小鼠机械性脑损伤模型,随机分为假手术组、模型组、蛇床子素10、20、30 mg·kg-1治疗组。主要检测各组小鼠脑组织含水量;RT-PCR法检测皮层损伤灶凋亡因子Bax,Bcl-2,活化半胱胺酸蛋白酶蛋白-3(Caspase-3)mRNA的表达变化;免疫组织化学染色法检测损伤灶周围中性粒细胞(MPO)及小胶质细胞(Iba-1)浸润情况以及Caspase-3阳性细胞表达情况。结果蛇床子素20,30 mg·kg-1治疗组能够明显降低脑组织含水量;提高Bax/Bcl-2比值,降低凋亡因子Caspase-3 mRNA表达;蛇床子素30 mg·kg-1治疗组能够明显减少大脑皮层损伤灶周围中性粒细胞及小胶质细胞的浸润,并且明显减少凋亡细胞数量。结论蛇床子素对开放性脑损伤的小鼠具有一定的治疗作用,可能是通过减少炎症细胞浸润,并且减少细胞凋亡发挥治疗作用。

两种不同脑损伤后星形胶质细胞反应性变化的比较研究

目的 探讨不同类型脑损伤后星形胶质细胞 (AST)活化的时空分布及形态学变化特征。方法 本实验建立Wistar大鼠短暂性全脑缺血 30min再灌注模型及脑皮质针刺伤模型 ,采用胶质纤维酸性蛋白 (GFAP)单克隆抗体免疫组化方法及图像分析技术对两种脑损伤后AST的反应进行对比观察。结果 ①脑缺血 1d后可见AST活化 ,5d即达高峰。脑皮质针刺伤后AST的活化开始于第 5～ 7天 ,第 14天达高峰。②两种脑损伤后不同部位反应性AST的形态有明显差异。结论 本实验表明不同类型脑损伤后AST的反应不同 ,活化AST在形态上的差异可能与神经营养因子的运输 ,神经的修复与再生等功能相适应。

重庆市36所医院医务人员职业暴露情况分析

目的了解重庆地区医务人员职业暴露现况,探讨防范对策。方法对2011年5月1日至9月30日参与调查的36所医院医务人员发生的职业暴露进行统计分析。结果本次调查共发生职业暴露554例,其中锐器伤456例,血液、体液暴露98例。二级医院比三级医院更易发生职业暴露;人群分布以护士为主,占总数的67.69%,发生地点主要在病房(41.52%)。锐器伤最常发生在锐器的使用后、处置前;血液、体液暴露中37.76%发生在面部。结论本地区医院对职业暴露重视程度不够,建立、健全相关制度,落实防护措施,加大经济投入,加强教育培训,提高医务人员意识,有利于提高职业暴露上报率和保证医务人员的职业安全。

护理工作中针刺伤的防护

近年来,针刺伤已经成为护理人员面临的主要职业危害之一。它不仅会造成多种血源性疾病的传播,还给护士的心理带来很大的影响,因此针刺伤的防护已经引起了广泛关注。本文综述了护士发生针刺伤的原因以及防护措施,以期对护理人员针刺伤的防护起到一定的指导作用。

513例腹部开放性刀刺伤治疗的回顾性分析

目的探讨腹部开放性刀刺伤治疗方法的选择。方法回顾性分析513例腹部开放性刀刺伤患者的临床资料,按治疗方式分为保守治疗组(主要给予对症支持治疗)97例、剖腹探查组313例、阴性探查组103例(探查后无明显阳性),比较分析三组患者的临床资料。结果阴性探查占探查病例的24.8%。保守治疗病例中,2例转剖腹探查,占保守病例2.1%,余均治愈出院。腹部开放性刀刺伤以小肠损伤最常见,占总病例27.3%,其次为胃损伤占14.2%。结论腹部开放性刀刺伤病例可结合患者生命体征、腹部体征、腹腔穿刺以及影像学检查结果综合分析,在严密的监测下进行保守治疗,但必须严格掌握适应证。

护士针刺伤风险因素分析与干预对策

目的 分析护士处置医疗废物时针刺伤发生的原因并提出相关的防范措施,为临床护士预防针刺伤提供参考。方法 2014年9~10月在我院感染科等六个病区对护士处置医疗废物的过程进行“三现”调查,找出可能发生针刺伤的要因及真因,采用5W1 h方法拟定对策、选择实施时间,并予以实施,比较干预前后护士针刺伤的发生情况。结果 严格执行预防针刺伤管理制度和预防针刺伤操作规范后,护士针刺伤发生率较实施之前明显降低,差异有统计学意义（P〈0.05）。结论通过对针刺伤高危因素特点的综合分析,制定出相应的防范对策并加以实施,能有效减少针刺伤的发生。

不同年龄大鼠大脑皮质损伤后的星形胶质细胞反应

对幼年（３月龄）、成年（１２月龄）与老年（２７月龄）三组雄性Ｗｉｓｔａｒ大鼠的躯感皮质进行针刺后，在１～２１ｄ时间内用光镜与电镜观察损伤后的星形胶质细胞反应，探讨年龄因素对星形胶质细胞反应的影响。结果表明：反应性星形细胞在水肿、细胞分裂、吞噬、肥大与胶质界膜形成等方面均表现出程度上和发生时间上的年龄差异。幼年大鼠的星形细胞不仅水肿更为显著且出现更早，并且表现出向变性与最后死亡以及向代偿性合成增强两个方向发展、三组动物的星形细胞分裂活动以术后３ｄ最明显，尤以幼年组更多见，并出现活跃的吞噬现象．

根据双刃刺器刺创口推断刺器宽度

解决根据皮肤创口推断刺器宽度的问题。实验在自愿捐献的12具男性尸体的胸部，用不同宽度和厚度的双刃匕首致创221个。应用法医学、解剖学及数理统计的理论和技术对创口形成机理、影响因素及其与刺器宽度的相关关系进行分析，得出了以下结论：刺器厚度与创口长度无明显相关，刺器宽度与创口长相关，创口回缩程度与创口方向及刺器宽度相关。并建立了两个最优回归方程，提出了一个根据皮肤双刃利器创口推断刺器宽度的方法。

冰片外用对大鼠后肢穿刺伤急性疼痛的抑制作用

目的研究冰片外用对大鼠外伤引起的急性疼痛的抑制作用及机制。方法将45只SD大鼠随机分为假手术组、手术组及外用冰片组3组,假手术组仅对手术部位进行皮肤脱毛,建立手术组及外用冰片组大鼠后肢穿刺伤疼痛模型,外用冰片组术后创面外用冰片粉末300 mg。观察外用冰片组和手术组术后不同时间点继发机械痛阈、继发热痛阈水平和脊髓背角Fos蛋白阳性细胞数量(FPIN)的差异。结果假手术组在整个实验过程中痛阈变化与基础值比较差异无统计学意义(P>0.05)。外用冰片组术后继发机械痛阈、继发热痛阈值均高于手术组,FPIN(22.6±6.7)低于手术组(36.2±5.8),差异均有统计学意义(P<0.05)。结论冰片外用于损伤部位,通过抑制损伤处伤害性感受器的传入信号对外伤后引发的急性疼痛产生抑制作用。

濒死的失血休克型心脏穿透伤急诊室剖胸成功1例报告

患者男,23岁,被刀刺伤,左胸第4肋间4 cm伤口,血压0/0 kPa,处于濒死状态。伤后16 min经左前外侧切口第4肋间行急诊室剖胸术,探查见:胸腔积血2 500 ml,心包4 cm伤口,心脏2 cm伤口,左肺上叶5 cm伤口。4 min内成功地用心包做垫片缝合心脏3针。病人8 d后痊愈出院。

脊髓锐器伤的临床疗效及预后观察

目的探讨脊髓锐器伤的临床特点、治疗方案及脊髓功能的预后规律。方法定期随访、回顾性分析我科2003年4月～2006年6月收治的8例脊髓锐器伤的治疗、预后转归情况。8例中男性7例,女性1例;年龄10～32岁,平均21.4岁。均为不完全性脊髓损伤。入院后经甲泼尼龙、神经节苷脂、高压氧及脱水综合治疗,术前和术后进行神经功能评分和影像学观察。结果经过平均5.4个月治疗后,所有患者下肢感觉、运动功能恢复满意,生活完全自理。平均随访17个月,其中4例下肢感觉恢复正常,4例残留部分感觉障碍;5例运动完全正常,3例遗有部分运动功能障碍,轻度跛行。结论脊髓锐器伤多为不完全性脊髓横断伤,局部创伤小、出血少、离断的神经组织无明显移位、纤维瘢痕组织增生少,脊髓功能恢复好;脊髓功能的恢复在伤后3周左右达高峰;药物促进离断后无明显移位的轴突原位修复、残留神经纤维的代偿可能是脊髓锐器伤后脊髓神经功能恢复的主要机制。