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A"messenger zone hypothesis"based on the visual three-dimensional spatial distribution of motoneurons innervating deep limb muscles

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Neural Regeneration Research 2024年第7期19卷 1559-1567页

作者： Chen Huang Shen Wang Jin Deng Xinyi Gu Shuhang Guo Xiaofeng Yin MoE Key Laboratory for trauma Treatment and Nerve Regeneration Peking UniversityBeijingChina department of Orthopedics and trauma Peking University People’s HospitalBeijingChina

Coordinated contraction of skeletal muscles relies on selective connections between the muscles and multiple classes of the spinal motoneuro *** r,current research on the spatial location of the spinal motoneurons innervating differe nt muscles is *** this study,we investigated the spatial distribution and relative position of different motoneurons that control the deep muscles of the mouse hindlimbs,which were innervated by the obturator nerve,femoral nerve,inferior gluteal nerve,deep pe roneal nerve,and tibial *** were visualized by combining a multiplex retrograde tracking technique compatible with three-dimensional imaging of solvent-cleared o rgans(3DISCO)and 3-D imaging technology based on lightsheet fluorescence microscopy(LSFM).Additionally,we propose the hypothesis that"messenger zones"exist as interlaced areas between the motoneuron pools that dominate the synergistic or antagonist muscle *** hypothesize that these interlaced neurons may participate in muscle coordination as messenger *** revealed the precise mutual positional relationships among the many motoneurons that innervate different deep muscles of the *** only do these findings update and supplement our knowledge regarding the overall spatial layout of spinal motoneurons that control mouse limb muscles,but they also provide insights into the mechanisms through which muscle activity is coordinated and the architecture of motor circuits.

关键词： 3-D imaging motoneurons multiple retrograde tracing muscle coordination skeletal muscle spatial distribution optical tissue clearing

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The emerging role of tranexamic acid and its principal target,plasminogen,in skeletal health

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Acta Pharmaceutica Sinica B 2024年第7期14卷 2869-2884页

作者： Weixin Xie Antonia Donat Shan Jiang Anke Baranowsky Johannes Keller department of trauma and Orthopedic Surgery University Medical Center Hamburg-EppendorfHamburg 20246Germany

The worldwide burden of skeletal diseases such as osteoporosis,degenerative joint disease and impaired fracture healing is steadily *** acid(TXA),a plasminogen inhibitor and anti-fibrinolytic agent,is used to reduce bleeding with high effectiveness and safety in major surgical *** its widespread clinical application,the effects of TXA beyond anti-fibrinolysis have been noticed and prompted renewed interest in its *** clinical trials have characterized the effects of TXA on reducing postoperative infection rates and regulating immune responses in patients undergoing ***,several animal studies suggest potential therapeutic effects of TXA on skeletal diseases such as osteoporosis and fracture *** a direct effect of TXA on the differentiation and function of bone cells in vitro was shown,few mechanisms of action have been ***,we summarize recent findings of the effects of TXA on skeletal diseases and discuss the underlying plasminogen-dependent and-independent mechanisms related to bone metabolism and the immune *** furthermore discuss potential novel indications for TXA application as a treatment strategy for skeletal diseases.

关键词： Tranexamic acid Osteoporosis Osteoarthritis Fracture healing Bone metabolism Inflammation Plasminogen Fibrinolysis

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Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

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World Journal of Orthopedics 2024年第2期15卷 110-117页

作者： Valerio Pace Francesco Bronzini Giovanni Novello Giuseppe Mosillo Luca Braghiroli department of trauma and Orthopaedics AOSP TerniTerni 05100Italy department of trauma and Orthopaedics University of PerugiaPerugia 06100Italy department of trauma and Orthopaedics Hand UnitAOSP TerniTerni 05100Italy

Triangular fibrocartilage complex injuries are common in amateur and professional *** injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar *** order to treat professional athletes,a detailed specific knowledge of the pathology is ***,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position *** early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be *** procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same *** measures are often used as first line treatment when *** lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic *** procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

关键词： Triangular fibrocartilage complex injuries Professional athletes Ulnar sided wrist pain Wrist arthroscopy Wrist debridement

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Neutrophil peptide 1 accelerates the clearance of degenerative axons during Wallerian degeneration by activating macrophages after peripheral nerve crush injury

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Neural Regeneration Research 2024年第8期19卷 1822-1827页

作者： Yuhui Kou Yusong Yuan Qicheng Li Wenyong Xie Hailin Xu Na Han department of trauma and Orthopedics Peking University People’s HospitalBeijingChina National Center for trauma Medicine BeijingChina Key Laboratory of trauma and Neural Regeneration(Peking University) Ministry of EducationBeijingChina department of Orthopedics China-Japan Friendship HospitalBeijingChina department of Central Laboratory and Institute of Clinical Molecular Biology Peking University People’s HospitalBeijingChina

Macrophages play an important role in peripheral nerve regeneration,but the specific mechanism of regeneration is still *** preliminary findings indicated that neutrophil peptide 1 is an innate immune peptide closely involved in peripheral nerve ***,the mechanism by which neutrophil peptide 1 enhances nerve regeneration remains *** study was designed to investigate the relationship between neutrophil peptide 1 and macrophages in vivo and in vitro in peripheral nerve crush *** functions of RAW 264.7 cells we re elucidated by Cell Counting Kit-8 assay,flow cytometry,migration assays,phagocytosis assays,immunohistochemistry and enzyme-linked immunosorbent *** debris phagocytosis was observed using the CUBIC(Clear,Unobstructed Brain/Body Imaging Cocktails and Computational analysis)optical clearing technique during Wallerian *** inflammatory factor expression in different polarization states was detected using a protein *** results showed that neutrophil peptide 1 promoted the prolife ration,migration and phagocytosis of macrophages,and CD206 expression on the surfa ce of macrophages,indicating M2 *** axonal debris clearance rate during Wallerian degeneration was enhanced after neutrophil peptide 1 *** peptide 1 also downregulated inflammatory factors interleukin-1α,-6,-12,and tumor necrosis factor-αin invo and in ***,the results suggest that neutrophil peptide 1 activates macrophages and accelerates Wallerian degeneration,which may be one mechanism by which neutrophil peptide 1 enhances peripheral nerve regeneration.

关键词： axonal debris inflammatory factors macrophages neutrophil peptide 1 peripheral nerve injury peripheral nerve regeneration RAW 264.7 cells sciatic nerve Wallerian degeneration

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Effect of tubastatin A on NLRP3 inflammasome activation in macrophages under hypoxia/ reoxygenation conditions

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World Journal of Emergency Medicine 2024年第4期15卷 289-296页

作者： Hao Li Chang Liu Ying Cui Panpan Chang Wei Chong department of Emergency Medicine the First Hospital of China Medical UniversityShenyang 110001China trauma Medicine Center Peking University People's HospitalBeijing 100871China Key Laboratory of trauma and Neural Regeneration Peking UniversityBeijing 100871China National Center for trauma Medicine of China Beijing 100871China

BACKGROUND:There are currently no effective drugs to mitigate the ischemia/reperfusion injury caused by fluid resuscitation after hemorrhagic shock(HS).The aim of this study was to explore the potential of the histone deacetylase 6(HDAC6)-specific inhibitor tubastatin A(TubA)to suppress nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome activation in macrophages under hypoxia/reoxygenation(H/R)***:The viability of RAW264.7 cells subjected to H/R after treatment with different concentrations of TubA was assessed using a cell-counting kit-8(CCK8)***,2.5μmol/L TubA was used with RAW264.7 cells under H/R ***264.7 cells were divided into three groups,namely the control,H/R,and TubA *** levels of reactive oxygen species(ROS)in the cells were detected using fluorescence *** protein expression of HDAC6,heat shock protein 90(Hsp90),inducible nitric oxide synthase(iNOS),NLRP3,gasdermin-D(GSDMD),Caspase-1,GSDMD-N,and Caspase-1 p20 was detected by western *** levels of interleukin-1β(IL-1β)and IL-18 in the supernatants were detected using enzyme-linked immunosorbent assay(ELISA).RESULTS:HDAC6,Hsp90,and iNOS expression levels were significantly higher(P<0.01)in the H/R group than in the control group,but lower in the TubA group than in the H/R group(P<0.05).When comparing the H/R group to the control group,ROS levels were significantly higher(P<0.01),but significantly reduced in the TubA group(P<0.05).The H/R group had higher NLRP3,GSDMD,Caspase-1,GSDMD-N,and Caspase-1 p20 expression levels than the control group(P<0.05),however,the TubA group had significantly lower expression levels than the H/R group(P<0.05).IL-1βand IL-18 levels in the supernatants were significantly higher in the H/R group compared to the control group(P<0.01),but significantly lower in the TubA group compared to the H/R group(P<0.01).CONCLUSION:TubA inhibited the expression of HDAC6,Hsp90,and iNOS in macrophages

关键词： Hemorrhagic shock Hypoxia/reoxygenation Macrophage NLRP3 Tubastatin A

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Clinical Versus Doppler Based Assessment in Determining Amputation Level in Diabetic Foot Gangrene;A Prospective Cross-Sectional Study at Atbuth, Bauchi

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Open Journal of Orthopedics 2024年第8期14卷 366-373页

作者： Shaphat Shuaibu Ibrahim Stephen Yusuf Abubakar Musa Shirama Yakubu Bababa Yusuf Aliyu Salihu Makama Baje Salihu Bukar Shehu department of orthoepaedics and trauma Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria department of Radiology Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria department of Surgery Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria

Background: Amputation is defined as the surgical removal of a limb or part of a limb through the bone. If the amputation is done above or below the knee, they are termed major while minor amputations involve the partial removal of foot including forefoot resections, ray amputation of the digits or parts of the digits. Significant number of patients with diabetic foot ulcers end with amputations. In the past the amputation level was decided by clinical assessment alone, such as physical examination using color, temperature, peripheral pulses and wound bleeding during surgical procedure. The use of Doppler ultrasound to measure arterial blood pressure at the proposed amputation site has been advocated as a predictor of amputation success. An optimal choice of the level of amputation can reduce amputation complications. Methodology: A Prospective comparative randomized cross-sectional study carried out between 1st January 2022 and 1st January 2024 in ATBUTH, Bauchi amongst patients with diabetic foot Wagener stage IV and V scheduled for amputation. Outcome measures of wound break down, flap necrosis and re-amputation were assessed amongst the clinical based level assessment group and the doppler based level assessment group. Results: A total of 171 patients were recruited into the study. Males 103 and 68 are females, giving a male to female ratio of 1.5:1. mean age 47 years. There were 84 patients in the clinical based level assessment group and 87 patients in the doppler based level assessment. Conclusion: Diabetes mellitus foot disease is a significant risk factor for non-traumatic lower limb amputation and doppler level assessment is superior to clinical level in determining amputation level among diabetic patients scheduled for amputation. P-value 0.003.

关键词： Diabetics Amputation Foot Gangrene Doppler Clinical

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Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

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World Journal of Emergency Medicine 2024年第1期15卷 3-9页

作者： Rashed Alremeithi Quincy K.Tran Megan T.Quintana Soroush Shahamatdar Ali Pourmand department of Emergency Medicine George Washington University School of Medicine and Health SciencesWashington DC 20037USA department of Emergency Medicine University of Maryland School of MedicineBaltimore 21201USA Program in trauma the R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimore 21201USA Center for trauma and Critical Care Department of Surgerythe George Washington University School of Medicine&Health SciencesWashington DC 20037USA

BACKGROUND:traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare *** there have been advances in treatment modalities,survival rates for TCA patients remain *** narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating ***:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,*** search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English *** the search,943 articles were retrieved,and two independent reviewers conducted a screening ***:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable *** were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital *** thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt *** endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic *** implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality ***-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,*** the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ***:TCA remains a signifi cant challenge for emergency medical services due to its high m

关键词： traumatic cardiac arrest Emergency thoracotomy Resuscitative endovascular balloon occlusion of the aorta

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Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

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World Journal of Orthopedics 2024年第6期15卷 501-511页

作者： Dario Regis Mattia Cason Bruno Magnan department of Orthopedic and trauma Surgery Integrated University HospitalVerona 37126VenetoItaly

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint ***,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic *** is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical *** most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of ***,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the *** spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after *** options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

关键词： Dislocation Total hip arthroplasty Revision surgery Review Risk factors Complication

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Evaluation of erastin synergized cisplatin anti-nasopharyngeal carcinoma effect with a glutathione-activated near-infrared fluorescent probe

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Chinese Chemical Letters 2024年第2期35卷 311-316页

作者： Rong He Dandan Tang Ningge Xu Heng Liu Kun Dou Xuejun Zhou Fabiao Yu department of Otolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Hainan Medical UniversityHaikou 570102China Key Laboratory of Hainan trauma and Disaster Rescue Key Laboratory of Emergency and TraumaMinistry of EducationEngineering Research Center for Hainan Bio-Smart Materials and Bio-Medical DevicesCollege of Emergency and TraumaHainan Medical UniversityHaikou 571199China Sichuan Provincial General Hospital of Judicial Police Chengdu 610225China

Nasopharyngeal carcinoma(NPC),a malignant tumor originating from the nasopharynx,is one of the common malignant tumors of the head and *** are significant geographical differences in the incidence of nasopharyngeal carcinoma,with a high incidence in China and Southeast Asian ***,we designed and synthesized a novel near-infrared fluorescent(NIRF)probe to detect glutathione(GSH)in cellular and tumor environments using semi-naphthofluorescein(SNAFL)as the fluorescent molecular backbone and 2-fluoro-4-nitrobenzenesulfonate as the recognition *** reaction with GSH,SNAFL-GSH emitted a fluorescence signal,and its emission wavelength at 650 nm was remarkably *** results of selectivity experiments indicated that SNAFL-GSH was able to discriminate GSH from Cys,Hcy,and H_(2) ***,SNAFL-GSH could image both endogenous and exogenous GSH and distinguish normal and cancer cells by fluorescence signal *** the cellular level,cisplatin(DDP)-induced ferroptosis and inhibition of proliferation of various NPC cell lines(CNE2,CNE1,5-8F cells)by erastin combined with DDP were visualized with the help of *** a mouse tumor xenograft model,we successfully employed SNAFL-GSH for the evaluation of the efficacy of erastin combined with DDP in the treatment of *** importantly,the probe could image cancerous tissue sections from NPC patients with an imaging depth of approximately 80µ*** was foreseen that SNAFL-GSH offered great potential for application in the diagnosis and evaluation of the therapeutic efficacy of NPC,and these results would also provide new ideas for the clinical treatment of NPC.

关键词： Glutathione NIRF probe Ferroptosis Anti-tumor therapy evaluation Bioimaging

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Surgical management of the diabetic foot:The current evidence

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World Journal of Orthopedics 2024年第5期15卷 404-417页

作者： Richard Henry Randall Roberts Gareth Rhys Davies-Jones James Brock Vaishnav Satheesh Greg AJ Robertson department of trauma and Orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom department of trauma and Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens *** review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,*** escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality *** review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse *** addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot *** integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关键词： Diabetes Diabetic foot Charcot Osteomyelitis Amputation Diabetic foot attack Conservative surgery

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