Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes

Background: Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter,leading to complex and compound eye injuries. However, few studies have comprehensively investigated the clinical features of different eye injury types or possible risk factors for poor prognosis.Methods: We retrospectively reviewed all consecutive records of explosive eye injuries(1449 eyes in 1115 inpatients)in 14 tertiary referral hospitals in China over 12 years(between January 1, 2008 and December 31, 2019). Data on demographics, eye injury types, ocular findings, treatments, and factors affecting visual prognosis were extracted from a standardized database of eye injuries and statistically analyzed.Results: Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies(IOFBs) resulted in 55.17% of open globe injuries(OGIs) and contusion caused 60.22% of close globe injuries(CGIs). Proliferative vitreous retinopathy(PVR) was more common in perforating(47.06%) and IOFB(26.84%)than in penetrating(8.79%) injuries, and more common with laceration(24.25%) than rupture(9.22%, P<0.01).However, no difference was observed between rupture and contusion. Ultimately, 9.59% of eyes were removed and the final vision was ≤4/200 in 45.82% of patients. Poor presenting vision [odds ratio(OR)=5.789], full-thickness laceration of the eyeball ≥5 mm(OR=3.665), vitreous hemorrhage(OR=3.474), IOFB(OR=3.510), non-mechanical eye injury(NMEI, OR=2.622), rupture(OR=2.362), traumatic optic neuropathy(OR=2.102), retinal detachment(RD,OR=2.033), endophthalmitis(OR=3.281), contusion(OR=1.679), ciliary body detachment(OR=6.592), zone Ⅲ OGI(OR=1.940), and PVR(OR=1.615) were significant negative predictors for poor visual outcomes(P<0.05).Conclusions: Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. In lethal level Ⅰ explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. In level Ⅱ injuries, IOFBs are more harmful than penetrating injuries, and level Ⅳ represents burn-related eye injuries.PVR is more associated with penetrating mechanisms than with OGI. Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.

Non-coding RNAs:an emerging player in osteomyelitis

Osteomyelitis is a debilitating bone infection primarily caused by Staphylococcus aureus.Despite advancements in surgery and chemotherapy,the treatment of osteomyelitis remains unsatisfactory,characterized by antibiotic resistance and recurrent relapses.Numerous studies have confirmed that non-coding RNAs could play an emerging role in regulating gene expression,as well as in the differentiation of osteoblasts and osteoclasts,along with bone formation.In this context,we provide an overview of current knowledge regarding the roles of non-coding RNAs in osteomyelitis and explore the potential therapeutic applications of these molecules in disease management,aiming to uncover novel diagnostic and treatment approaches.