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Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury 被引量:1
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作者 Rongrong Wang Jinzhu Bai 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第1期35-42,共8页
Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve ... Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury. 展开更多
关键词 blood-spinal cord barrier drug therapy MICROCIRCULATION microvascular blood flow NEUROPROTECTION pharmacological intervention PHARMACOTHERAPY spinal cord injury trauma
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Follow-up strategy for early detection of delayed pseudoaneurysms in patients with blunt traumatic spleen injury: A single-center retrospective study
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作者 Sung Hoon Cho Gun Woo Kim +1 位作者 Suyeong Hwang Kyoung Hoon Lim 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第10期3163-3170,共8页
BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard t... BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms. 展开更多
关键词 Blunt trauma Spleen injury Delayed pseudoaneurysm ANGIOEMBOLIZATION Nonoperative management
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Unusual Brain Trauma Injury
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作者 Diallo Moussa Traoré Youssouf +5 位作者 Kanikomo Drissa Diarra Sounkalo Izoudine B. Koumaré Sogoba Youssouf Sogoba Boubacar Diallo Oumar 《Open Journal of Modern Neurosurgery》 2024年第3期218-227,共10页
Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of th... Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of this pathology in our practice, describe the different mechanisms and report the craniocerebral lesions caused by this type of trauma. Materials and Method: This was a descriptive study with retrospective collection spread over a period of 3 years. After selecting the files, the patients and/or their companions were contacted by telephone to inquire about them and then returned to the consultation for reassessment. Disease history and information were obtained from patients’ medical records. Result: The frequency of this pathology was 1.78% and his incidence was 0.4 cases per month. The average age of the patients was 13.47 years. All the victims were male. 41.17% of patients were in school. The mechanisms of trauma were the hoof blow 47.1%, the horn blow 29.4% and the stone blow 11.7% respectively. 23.5% of patients were confused and 11.7% children were in coma. One patient presented an anisocoria. The motor deficit was present in 5 cases. CT-scan made it possible to highlight a skull depressing fracture 58.8% and confirm a craniocerebral wound in 35.3%. The average time between patient admission to hospital and completion of surgery was 24.5 hours. The surgery had consisted of the trimming of cranio-cerebral wounds, exploration, duroplasty and lifting of skull depressing fracture. After 15 months of follow-up, the evolution was favorable in 53.3%, the morbidity was 33.4% and the mortality 17.6%. Conclusion: These are rare but serious conditions because they are fatal and disabling. An early and multidisciplinary management can hope to have a good favorable. 展开更多
关键词 Brain trauma injury Insolite UNUSUAL Skull Depressing Fracture Hoof Kick Horn Blows Stone Bows Motorcycle Gear Lever
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The usefulness of diffusion tensor imaging in detection of diffuse axonal injury in a patient with head trauma 被引量:1
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作者 Hyeok Gyu Kwon Sung Ho Jang 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第6期475-478,共4页
Diffuse axonal injury is the predominant mechanism of injuries in patients with traumatic brain injury. Neither conventional brain computed tomography nor magnetic resonance imaging has shown sufficient sensitivity in... Diffuse axonal injury is the predominant mechanism of injuries in patients with traumatic brain injury. Neither conventional brain computed tomography nor magnetic resonance imaging has shown sufficient sensitivity in the diagnosis of diffuse axonal injury. In the current study, we attempted to demonstrate the usefulness of diffusion tensor imaging in the detection of lesion sites of diffuse axonal injury in a patient with head trauma who had been misdiagnosed as having a stroke. A 44-year-old man fell from a height of about 2 m. Brain magnetic resonance imaging (32 months after onset) showed leukomalactic lesions in the isthmus of the corpus callosum and the left temporal lobe. He presented with mild quadriparesis, intentional tremor of both hands, and trunkal ataxia. From diffusion tensor imaging results of 33 months after traumatic brain injury onset, we found diffuse axonal injury in the right corticospinal tract (centrum semiovale, pons), both fomices (columns and crus), and both inferior cerebellar peduncles (cerebellar portions). We think that diffusion tensor imaging could be a useful tool in the detection of lesion sites of diffuse axonal injury in patients with head trauma. 展开更多
关键词 traumatic brain injury diffuse axonal injury diffusion tensor imaging head trauma
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Delta shock index predicts injury severity,interventions,and outcomes in trauma patients:A 10-year retrospective observational study
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作者 Mohammad Asim Ayman El-Menyar +7 位作者 Khalid Ahmed Mushreq Al-Ani Saji Mathradikkal Abubaker Alaieb Abdel Aziz Hammo Ibrahim Taha Ahmad Kloub Hassan Al-Thani 《World Journal of Critical Care Medicine》 2024年第4期62-72,共11页
BACKGROUND Most trauma occurs among young male subjects in Qatar.We examined the predictive values of the delta shock index(DSI),defined as the change in the shock index(SI)value from the scene to the initial reading ... BACKGROUND Most trauma occurs among young male subjects in Qatar.We examined the predictive values of the delta shock index(DSI),defined as the change in the shock index(SI)value from the scene to the initial reading in the emergency unit(i.e.,subtracting the calculated SI at admission from SI at the scene),at a Level 1 trauma center.AIM To explore whether high DSI is associated with severe injuries,more interventions,and worse outcomes[i.e.,blood transfusion,exploratory laparotomy,ventilator-associated pneumonia,hospital length of stay(HLOS),and in-hospital mortality]in trauma patients.METHODS A retrospective analysis was conducted after data were extracted from the National Trauma Registry between 2011 and 2021.Patients were grouped based on DSI as low(≤0.1)or high(>0.1).Data were analyzed and compared usingχ2 and Student’s t-tests.Correlations between DSI and injury severity score(ISS),revised trauma score(RTS),abbreviated injury scale(AIS),Glasgow coma scale(GCS),trauma score-ISS(TRISS),HLOS,and number of transfused blood units(NTBU),were assessed using correlation coefficient analysis.The diagnostic testing accuracy for predicting mortality was determined using the validity measures of the DSI.Logistic regression analysis was performed to identify predictors of mortality.RESULTS This analysis included 13212 patients with a mean age of 33±14 years,and 24%had a high DSI.Males accounted for 91%of the study population.The trauma activation level was higher in patients with a high DSI(38%vs 15%,P=0.001).DSI correlated with RTS(r=-0.30),TRISS(r=-0.30),NTBU(r=0.20),GCS(r=-0.24),ISS(r=0.22),and HLOS(r=0.14)(P=0.001 for all).High DSI was associated with significantly higher rates of intubation,laparotomy,ventilator-associated pneumonia,massive transfusion activation,and mortality than low DSI.For mortality prediction,a high DSI had better specificity,negative predictive value,and negative likelihood ratio(77%,99%,and 0.49%,respectively).After adjusting for age,emergency medical services time,GCS score,and ISS,multivariable regression analysis showed that DSI was an independent predictor of mortality(odds ratio=1.9;95%confidence interval:1.35-2.76).CONCLUSION In addition to sex-biased observations,almost one-quarter of the study cohort had a higher DSI and were mostly young.High DSI correlated significantly with the other injury severity scores,which require more time and imaging to be ready to use.Therefore,DSI is a practical,simple bedside tool for triaging and prognosis in young patients with trauma. 展开更多
关键词 Delta shock index trauma injury severity scores Interventions OUTCOMES
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Structural and functional connectivity in traumatic brain injury 被引量:3
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作者 Hui Xiao Yang Yang +1 位作者 Ji-hui Xi Zi-qian Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2015年第12期2062-2071,共10页
Traumatic brain injury survivors often experience cognitive deficits and neuropsychiatric symptoms.However,the neurobiological mechanisms underlying specific impairments are not fully understood.Advances in neuroimagi... Traumatic brain injury survivors often experience cognitive deficits and neuropsychiatric symptoms.However,the neurobiological mechanisms underlying specific impairments are not fully understood.Advances in neuroimaging techniques(such as diffusion tensor imaging and functional MRI)have given us new insights on structural and functional connectivity patterns of the human brain in both health and disease.The connectome derived from connectivity maps reflects the entire constellation of distributed brain networks.Using these powerful neuroimaging approaches,changes at the microstructural level can be detected through regional and global properties of neuronal networks.Here we will review recent developments in the study of brain network abnormalities in traumatic brain injury,mainly focusing on structural and functional connectivity.Some connectomic studies have provided interesting insights into the neurological dysfunction that occurs following traumatic brain injury.These techniques could eventually be helpful in developing imaging biomarkers of cognitive and neurobehavioral sequelae,as well as predicting outcome and prognosis. 展开更多
关键词 nerve regeneration traumatic brain injury brain trauma CONNECTIVITY diffusion tensorimaging resting-state fMRI CONNECTOME default mode network COGNITION neural regeneration
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Factors related to improved American Spinal Injury Association grade of acute traumatic spinal cord injury 被引量:6
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作者 Ci Tian Yang Lv +4 位作者 Shu Li Dai-Dai Wang Yi Bai Fang Zhou Qing-Bian Ma 《World Journal of Clinical Cases》 SCIE 2020年第20期4807-4815,共9页
BACKGROUND Acute traumatic spinal cord injury(ATSCI)usually results in disability,yet data on contemporary national trends of ATSCI incidence are limited.AIM To provide a systematic and basic theoretical basis for imp... BACKGROUND Acute traumatic spinal cord injury(ATSCI)usually results in disability,yet data on contemporary national trends of ATSCI incidence are limited.AIM To provide a systematic and basic theoretical basis for improving the treatment of acute spinal cord injury.METHODS Data from the Peking University Third Hospital Inpatient Sample databases were analyzed.A total of 304 patients with ATSCI were included from 2012 to 2017.The epidemiological data,treatment,complications and clinical outcomes of these patients were reviewed.RESULTS Of the 304 patients,257(84.5%)were male,and 75%of the patients were 55 years old or younger.135 patients had improved follow-up American Spinal Injury Association(ASIA)grades(44.4%).Only 14 patients with ASIA grade A improved.A statistically significant difference in prognosis between patients who underwent surgery within 72 h and those who underwent surgery after 72 h was observed(P<0.05).Surgery within 72 h resulted in better prognosis.The Steroid group and the Non-Steroid group showed a significant difference in outcome among patients with ASIA grades A and B(P<0.05).Patients with pneumonia had a poorer prognosis than patients without pneumonia(P<0.05).Surgery within 72 h resulted in better prognosis.CONCLUSION This study found that there was no significant difference in hospitalization time and prognosis between the Steroid group and the Non-Steroid group,but the patients with severe spinal cord injury(ASIA grades A and B)who underwent surgery combined with steroid therapy had a better prognosis than those who underwent surgery alone.The disastrous consequences of ATSCI and lack of consensus on the management strategy are obvious.Further improvements in treatment planns are needed in order to obtain more reliable functional outcomes. 展开更多
关键词 Acute spinal cord injury trauma Surgery American Spinal injury Association STEROIDS Prognosis
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Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury 被引量:5
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作者 Simon Dulz Vasilis Dimopoulos +4 位作者 Toam Katz Robert Kromer Eileen Bigdon Martin Stephan Spitzer Christos Skevas 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2021年第10期1589-1594,共6页
AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe inj... AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe injury(OGI).METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12 mo follow-up and a median age at of 48.6 y(range: 3-104 y) were identified. Final best corrected visual acuity(BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score Ⅰ(P<0.0001) or Ⅱ(P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >Ⅲ. OGI associated RD was observed in 36/102 patients(35.3%), whereas post traumatic RD(defined as RD following 14 d after OGI) occurred in 37 patients(36.3%). OGI associated RD did not correlate with the OTS and the zone of injury(P=0.193), yet post traumatic RD correlated significantly with zone Ⅲ injuries(P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone Ⅲ injury with lower final BCVA and a higher number of surgeries, but only zone Ⅲ could be significantly associated with a higher rate of RD. 展开更多
关键词 intraocular foreign body ocular trauma score open globe injury RETINA retinal and vitreous surgery retinal detachment trauma
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Motor recovery via aberrant pyramidal tract in a patient with traumatic brain injury A diffusion tensor tractography study 被引量:1
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作者 Sang Seok Yeo Sung Ho Jang 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第1期90-94,共5页
The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrha... The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrhage in the left corona radiata. His motor function recovered almost to the normal state at 10 months after onset. Through diffusion tensor tractography, the pyramidal tract in the affected (left) hemisphere showed discontinuation at the pontine level at 13 months after onset. An aberrant pyramidal tract was observed, which originated from the primary motor cortex and the supplementary motor area and descended through the corona radiata, then through the posterior limb of the internal capsule and the medial lemniscus pathway from the midbrain to the pons, finally entered into the pyramidal tract area at the pontomedullary junction, it suggests that the motor functions of the right extremities in this patient had recovered by this aberrant pyramidal tract. 展开更多
关键词 neural regeneration neuroimaging diffusion tensor imaging diffusion tensor tractography transcranial magnetic stimulation pyramidal tract aberrant pyramidal tract motor paralysis motorrecovery traumatic brain injury head trauma intracerebral hemorrhage grant-supported paper photographs-containing paper NEUROREGENERATION
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Necroptosis plays a crucial role in the exacerbation of retinal injury after blunt ocular trauma
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作者 Yu Huan Xiu-Quan Wu +6 位作者 Tao Chen Ya-Nan Dou Bo Jia Xin He Dong-Yu Wei Zhou Fei Fei Fei 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第4期922-928,共7页
Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss.To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma,we e... Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss.To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma,we established a weight drop injury model of blunt ocular trauma in male Beagle dogs.Hematoxylin-eosin staining,immunofluorescence staining,western blotting,and TUNEL assays were performed to investigate retinal injury within 14 days after blunt ocular trauma.Compared with the control group,the thicknesses of the inner and outer nuclear layers,as well as the number of retinal ganglion cells,gradually decreased within 14 days after injury.The number of bipolar cells in the inner nuclear layer began to decrease 1 day after injury,while the numbers of cholinergic and amacrine cells in the inner nuclear layer did not decrease until 7 days after injury.Moreover,retinal cell necroptosis increased with time after injury;it progressed from the ganglion cell layer to the outer nuclear layer.Visual electrophysiological findings indicated that visual impairment began on the first day after injury and worsened over time.Additionally,blunt ocular trauma induced nerve regeneration and Müller glial hyperplasia;it also resulted in the recruitment of microglia to the retina and polarization of those microglia to the M1 phenotype.These findings suggest that necroptosis plays an important role in exacerbating retinal injury after blunt ocular trauma via gliosis and neuroinflammation.Such a role has important implications for the development of therapeutic strategies. 展开更多
关键词 Beagle dogs blunt ocular trauma GLIOSIS M1 microglia Müller cells NECROPTOSIS NEUROINFLAMMATION retinal ganglion cells retinal injury weight drop injury
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Isolated traumatic gallbladder injury: A case report
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作者 Dong-Liang Liu Jun-Yong Pan +3 位作者 Tian-Cong Huang Cheng-Zong Li Wen-Du Feng Gao-Xiong Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第11期2639-2645,共7页
BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,whic... BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI. 展开更多
关键词 Isolated gallbladder injury Blunt abdominal trauma Gall bladder trauma Case report
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Prognostic Factors to Reduce ICU Overtriage in Elderly Patients with Isolated Mild Traumatic Brain Injury
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作者 Tomas Jacome Chris LaBorde +1 位作者 Richard Lewis Danielle Tatum 《Surgical Science》 2023年第7期517-532,共16页
Introduction: Elderly patients with mild traumatic brain injury (mTBI) are frequently admitted to an intensive care unit (ICU), which is potentially both harmful and unnecessary. It is not known which patients may be ... Introduction: Elderly patients with mild traumatic brain injury (mTBI) are frequently admitted to an intensive care unit (ICU), which is potentially both harmful and unnecessary. It is not known which patients may be safely observed in a non-ICU setting, potentially improving ICU utilization. The purpose of this study was to identify factors that predict which geriatric patients with traumatic brain injury may be admitted to a level of care other than the ICU. Methods: Adults ≥65+ years admitted with positive radiologic study demonstrating isolated mTBI (defined as Glasgow Coma Scale (GCS) 13 - 15) that was initially managed nonoperatively between January 2011-December 2016 were identified. Primary outcomes evaluated included over triage and Glasgow Outcome Scale (GOS). Results: 207 were identified. Most patients presented with GCS 15 (77.8%) and were admitted to ICU (85.5%). 27% (n = 55) met overtriage criteria. The most common TBI was subdural hemorrhage (SDH) (48.8%) followed by subarachnoid hemorrhage (SAH) (22.2%). Hemorrhage progression developed in 8.7% of subjects, but there was no difference across TBI type. 21.7% of patients developed a ≥2 point decrease in GCS during their hospital stay. Upon discharge, 89.9% had a GOS ≥ 4 - 5. Presence/type of a single intracranial hemorrhage (ICH) was not significantly associated with outcome, but presence of bilateral or multiple lesions was significantly associated with poor outcome (p = 0.04). Conclusions: Overtriage of patients to an ICU is costly, resource intensive, and avoidable. Here, we suggest a conservative framework to assist the determination of which patients can be safely observed in non-ICU setting. Future studies should determine if this framework is generalizable to the entire geriatric population who present with mTBI. 展开更多
关键词 traumatic Brain injury Geriatric trauma Overtriage Intensive Care Unit OUTCOMES
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Blunt Abdominal Trauma Leading to Pancreatic Injury in Childhood. Delay in Diagnosis Leads to Poor Outcomes—A Case Presentation
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作者 Zohaib A. Siddiqui Fahd Husain Midhat N. Siddiqui 《International Journal of Clinical Medicine》 2016年第12期809-813,共5页
This case report illustrates the difficulty in diagnosing paediatric patients with life threatening pancreatic injuries. A high index of suspicion is essential as late diagnosis significantly affects outcomes. A 9-yea... This case report illustrates the difficulty in diagnosing paediatric patients with life threatening pancreatic injuries. A high index of suspicion is essential as late diagnosis significantly affects outcomes. A 9-year-old child presented with epigastric pain following an accident on his pushbike. The patient was examined in paediatric accident and emergency (A/E) and was discharged. He returned twice more to A/E and on the third visit, 5 days after the initial incident, a CT scan was performed. This showed a classical injury to the body of the pancreas with a collection in the lesser sac. The patient was transferred to the regional hepato-pancreato-biliary unit (HPB unit) and underwent surgery. Pancreatic injuries can be difficult to detect clinically and patients may be well on initial presentation with normal observations and routine bloods. Early CT scanning confirms the diagnosis and results in early specialist referral and better outcomes. 展开更多
关键词 Paediatric trauma Blunt Abdominal injury Pancreatic injury
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Pentraxin 3 contributes to neurogenesis after traumatic brain injury in mice 被引量:7
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作者 Chao Zhou Hong Chen +6 位作者 Jian-Feng Zheng Zong-Duo Guo Zhi-Jian Huang Yue Wu Jian-Jun Zhong Xiao-Chuan Sun Chong-Jie Cheng 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第12期2318-2326,共9页
Emerging evidence indicates that pentraxin 3 is an acute-phase protein that is linked with the immune response to inflammation.It is also a newly discovered marker of anti-inflammatory A2 reactive astrocytes,and poten... Emerging evidence indicates that pentraxin 3 is an acute-phase protein that is linked with the immune response to inflammation.It is also a newly discovered marker of anti-inflammatory A2 reactive astrocytes,and potentially has multiple protective effects in stroke;however,its role in the adult brain after traumatic brain injury is unknown.In the present study,a moderate model of traumatic brain injury in mice was established using controlled cortical impact.The models were intraventricularly injected with recombinant pentraxin 3(the recombinant pentraxin 3 group)or an equal volume of vehicle(the control group).The sham-operated mice underwent craniotomy,but did not undergo the controlled cortical impact.The potential neuroprotective and neuroregenerative roles of pentraxin 3 were investigated on days 14 and 21 after traumatic brain injury.Western blot assay showed that the expression of endogenous pentraxin 3 was increased after traumatic brain injury in mice.Furthermore,the neurological severity test and wire grip test revealed that recombinant pentraxin 3 treatment reduced the neurological severity score and increased the wire grip score,suggesting an improved recovery of sensory-motor functions.The Morris water maze results demonstrated that recombinant pentraxin 3 treatment reduced the latency to the platform,increased the time spent in the correct quadrant,and increased the number of times traveled across the platform,thus suggesting an improved recovery of cognitive function.In addition,to investigate the effects of pentraxin 3 on astrocytes,specific markers of A2 astrocytes were detected in primary astrocyte cultures in vitro using western blot assay.The results demonstrated that pentraxin 3 administration activates A2 astrocytes.To explore the protective mechanisms of pentraxin 3,immunofluorescence staining was used.Intraventricular injection of recombinant pentraxin 3 increased neuronal maintenance in the peri-injured cortex and ipsilateral hippocampus,increased the number of doublecortin-positive neural progenitor cells in the subventricular and subgranular zones,and increased the number of bromodeoxyuridine(proliferation)and neuronal nuclear antigen(mature neuron)double-labeled cells in the hippocampus and peri-injured cortex.Pentraxin 3 administration also increased the number of neurospheres and the number of bromodeoxyuridine and doublecortin double-labeled cells in neurospheres,and enhanced the proliferation of neural progenitor cells in primary neural progenitor cell cultures in vitro.In conclusion,recombinant pentraxin 3 administration activated A2 astrocytes,and consequently improved the recovery of neural function by increasing neuronal survival and enhancing neurogenesis.All experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Chongqing Medical University,China on March 1,2016. 展开更多
关键词 brain injury brain trauma cells NEUROGENESIS PLASTICITY protein recovery REGENERATION
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Traumatic axonal injury of the cingulum in patients with mild traumatic brain injury: a diffusion tensor tractography study 被引量:4
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作者 Sung Ho Jang Seong Ho Kim Han Do Lee 《Neural Regeneration Research》 SCIE CAS CSCD 2019年第9期1556-1561,共6页
The cingulum,connecting the orbitofrontal cortex to the medial temporal lobe,involves in diverse cognition functions including attention,memory,and motivation.To investigate the relationship between the cingulum injur... The cingulum,connecting the orbitofrontal cortex to the medial temporal lobe,involves in diverse cognition functions including attention,memory,and motivation.To investigate the relationship between the cingulum injury and cognitive impairment in patients with chronic mild traumatic brain injury,we evaluated the integrity between the anterior cingulum and the basal forebrain using diffusion tensor tractography in 73 patients with chronic mild traumatic brain injury(39 males,34 females,age 43.29±11.42 years)and 40 healthy controls(22 males,18 females,age 40.11±16.81 years).The patients were divided into three subgroups based on the integrity between the anterior cingulum and the basal forebrain on diffusion tensor tractography:subgroup A(n=19 patients)– both sides of the anterior cingulum were intact;subgroup B(n=36 patients)– either side of the anterior cingulum was intact;and subgroup C(18 patients)– both sides of the anterior cingulum were discontinued.There were significant differences in total Memory Assessment Scale score between subgroups A and B and between subgroups A and C.There were no significant differences in diffusion tensor tractography parameters(fractional anisotropy,apparent diffusion coefficient,and fiber volume)between patients and controls.These findings suggest that the integrity between the anterior cingulum and the basal forebrain,but not diffusion tensor tractography parameter,can be used to predict the cognitive function of patients with chronic mild traumatic brain injury.This study was approved by Yeungnam University Hospital Institutional Review Board(approval No.YUMC-2014-01-425-010)on August 16,2017. 展开更多
关键词 mild traumatic BRAIN injury BRAIN trauma DIFFUSION TENSOR TRACTOGRAPHY DIFFUSION TENSOR imaging cognitive impairment CINGULUM memory GLASGOW Coma Scale neural regeneration
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Traumatic brain injury and palliative care:a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey 被引量:2
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作者 Kadriye Kahveci Metin Din?er +1 位作者 Cihan Doger Ayse Karhan Yarici 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第1期77-83,共7页
Traumatic brain injury(TBI),which is seen more in young adults,affects both patients and their families.The need for palliative care in TBI and the limits of the care requirement are not clear.The aim of this study ... Traumatic brain injury(TBI),which is seen more in young adults,affects both patients and their families.The need for palliative care in TBI and the limits of the care requirement are not clear.The aim of this study was to investigate the length of stay in the palliative care center(PCC),Turkey,the status of patients at discharge,and the need for palliative care in patients with TBI.The medical records of 49 patients with TBI receiving palliative care in PCC during 2013–2016 were retrospectively collected,including age and gender of patients,the length of stay in PCC,the cause of TBI,diagnosis,Glasgow Coma Scale score,Glas gow Outcome Scale score,Karnofsky Performance Status score,mobilization status,nutrition route(oral,percutaneous endoscopic gastrostomy),pressure ulcers,and discharge status.These patients were aged 45.4 ± 20.2 years.The median length of stay in the PCC was 34.0 days.These included TBI patients had a Glasg ow Coma Scale score ≤ 8,were not mobilized,received tracheostomy and percutaneous endoscopic gastrostomy nutrition,and had pressure ulcers.No difference was found between those who were discharged to their home or other places(rehabilitation centre,intensive care unit and death) in respect of mobilization,percutaneous endoscopic gastrostomy,tracheostomy and pressure ulcers.TBI patients who were followed up in PCC were determined to be relatively young patients(45.4 ± 20.2 years) with mobilization and nutrition problems and pressure ulcer formation.As TBI patients have complex health conditions that require palliative care from the time of admittance to intensive care unit,provision of palliative care services should be integrated with clinical applications. 展开更多
关键词 nerve regeneration trauma palliative care brain injury retrospective study neural regeneration
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Umbilical cord-derived mesenchymal stem cell transplantation combined with hyperbaric oxygen treatment for repair of traumatic brain injury 被引量:24
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作者 Hai-xiao Zhou Zhi-gang Liu +1 位作者 Xiao-jiao Liu Qian-xue Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2016年第1期107-113,共7页
Transplantation of umbilical cord-derived mesenchymal stem cells(UC-MSCs) for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen(HBO) treatment has long been widely used as an adjuncti... Transplantation of umbilical cord-derived mesenchymal stem cells(UC-MSCs) for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen(HBO) treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid(2.5–3.0 atm impact force). The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions. 展开更多
关键词 nerve regeneration traumatic brain injury umbilical cord mesenchymal stem cells transplantation hyperbaric oxygen rats craniocerebral trauma neurological function neural regeneration
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Effect of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats 被引量:2
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作者 Bulent Kilicoglu Erol Eroglu +2 位作者 Sibel Serin Kilicoglu Kemal Kismet Fusun Eroglu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第22期3593-3596,共4页
TO evaluate the effects of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats. METHODS: Five groups were allocated (n = 8) in the study. Group Ⅰ was taken as the control group, group Ⅱ as the... TO evaluate the effects of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats. METHODS: Five groups were allocated (n = 8) in the study. Group Ⅰ was taken as the control group, group Ⅱ as the hemorrhagic shock group, group Ⅲ as hemorrhagic shock + laparotomy, group Ⅳ as hemorrhagic shock + splenectomy and group V as splenectomy + omentectomy + hemorrhagic shock group. Hemorrhagic shock was induced by drawing blood and reducing mean arterial pressure (MAP) to 40 mmHg within 10 min. After a hypotensive period of 1 h, animals were resuscitated. Bronchoalveolar lavage (BAL) was performed to recover cells from the alveolar space with 40 mL of BAL fluid after resuscitation malondialdehyde (MDA) and L-γ-glutamyl-L-cysteinylglycine (GSH) levels were measured in serum, erythrocytes and lung tissue. RESULTS: Serum, erythrocyte, lung tissue MDA and GSH levels were significantly increased in hemorrhagic shock groups Ⅱ-Ⅴ (P 〈 0.05). Lymphocyte, neutrophil and alveolar macrophage counts in BAL fluid indicated a significant difference between control and shock groups (P 〈 0.05). CONCLUSION: The degree of trauma increases hemorrhagic shock-induced acute lung injury. 展开更多
关键词 Hemorrhagic shock Acute lung injury Abdominal trauma
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Morphometric changes in the cortex following acute mild traumatic brain injury 被引量:1
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作者 Meng-Jun Li Si-Hong Huang +1 位作者 Chu-Xin Huang Jun Liu 《Neural Regeneration Research》 SCIE CAS CSCD 2022年第3期587-593,共7页
Morphometric changes in cortical thickness(CT),cortical surface area(CSA),and cortical volume(CV) can reflect pathological changes after acute mild traumatic brain injury(m TBI).Most previous studies focused on change... Morphometric changes in cortical thickness(CT),cortical surface area(CSA),and cortical volume(CV) can reflect pathological changes after acute mild traumatic brain injury(m TBI).Most previous studies focused on changes in CT,CSA,and CV in subacute or chronic m TBI,and few studies have examined changes in CT,CSA,and CV in acute m TBI.Furthermore,acute m TBI patients typically show transient cognitive impairment,and few studies have reported on the relationship between cerebral morphological changes and cognitive function in patients with m TBI.This prospective cohort study included 30 patients with acute m TBI(15 males,15 females,mean age 33.7 years) and 27 matched healthy controls(12 males,15 females,mean age 37.7 years) who were recruited from the Second Xiangya Hospital of Central South University between September and December 2019.High-resolution T1-weighted images were acquired within 7 days after the onset of m TBI.The results of analyses using Free Surfer software revealed significantly increased CSA and CV in the right lateral occipital gyrus of acutestage m TBI patients compared with healthy controls,but no significant changes in CT.The acute-stage m TBI patients also showed reduced executive function and processing speed indicated by a lower score in the Digital Symbol Substitution Test,and reduced cognitive ability indicated by a longer time to complete the Trail Making Test-B.Both increased CSA and CV in the right lateral occipital gyrus were negatively correlated with performance in the Trail Making Test part A.These findings suggest that cognitive deficits and cortical alterations in CSA and CV can be detected in the acute stage of m TBI,and that increased CSA and CV in the right lateral occipital gyrus may be a compensatory mechanism for cognitive dysfunction in acute-stage m TBI patients.This study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University,China(approval No.086) on February 9,2019. 展开更多
关键词 acute mild brain trauma injury Alzheimer's disease cognitive function cortical surface area cortical thickness cortical volume Free Surfer surface-based morphometry
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Changes in platelet parameters and secondary brain injury in acute craniocerebral trauma
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作者 Xiaoping Tang Chao You +9 位作者 Hua Peng Tao Zhang Wenguo Tang Jian Qi Renguo Luo Yuanchuan Wang Ling Feng Zhangyang Gou Junwei Duan Shun Li 《Neural Regeneration Research》 SCIE CAS CSCD 2011年第20期1543-1547,共5页
Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Pl... Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Platelet parameters of 40 healthy subjects served as controls. Platelet number was decreased, while mean platelet volume and platelet distribution width values were increased, at 1 and 3 days after injury. Platelet number was lower and mean platelet volume and platelet distribution width were larger in patients with traumatic cerebral infarction and those in Glasgow Coma Scale score 〈 8 group. Platelet number was negatively correlated to volume of cerebral edema, but positively correlated to Glasgow Outcome Scale score. These data indicate that changes in platelet parameters may be utilized to indicate the state of central nervous system injury and patient prognosis . 展开更多
关键词 craniocerebral trauma PLATELET mean platelet volume platelet distribution width secondary brain injury
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