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Microcluster colloidosomes for hemostat delivery into complex wounds:A platform inspired by the attack action of torpedoes

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Bioactive Materials 2022年第10期7卷 372-387页

作者： Bitao Lu Enling Hu Ruiqi Xie Kun Yu Fei Lu Rong Bao Chenhui Wang Guangqian Lan Fangyin Dai State Key Laboratory of Silkworm Genome Biology College of SericultureTextile and Biomass SciencesSouthwest UniversityChongqing400715China Chongqing Engineering Research center of Biomaterial Fiber and Modern Textile Chongqing400715China The Ninth People’s Hospital of Chongqing No.69 Jialing Village BeiBei DistrictChongqing400715China Chongqing Key Laboratory of Natural Product Synthesis and Drug Research School of Pharmaceutical SciencesChongqing University55 South Daxuecheng RoadChongqing401331China

Complex yet lethal wounds with uncontrollable bleeding hinder conventional hemostats from clotting blood at the source or deep sites of injury vasculature,thereby causing massive blood loss and significantly increased *** by the attack action of torpedoes,we synthesized microcluster(MC)colloidosomes equipped with magnetic-mediated navigation and“blast”systems to deliver hemostats into the cavity of vase-type ***_(3)/Fe_(2)O_(3)(CF)microparticles functionalized with Arg-Gly-Asp(RGD)modified polyelectrolyte multilayers were co-assembled with oppositely charged zwitterionic carbon dots(CDs)to form MC colloidosomes,which were loaded with thrombin and protonated tranexamic acid(TXA-NH_(3)^(+)).The composite microparticles moved against blood flow under magnetic mediation and simultaneously disassembled for the burst release of thrombin stimulated by TXA-NH_(3)^(+).The CO_(2) bubbles generated during disassembly produced a“blast”that propelled thrombin into the wound *** bleeding in a vase-type hemorrhage model in the rabbit liver was rapidly controlled within~60 ***,in vivo subcutaneous muscle and liver implantation models demonstrated excellent biodegradability of MC *** study is the first to propose a novel strategy based on the principle of torpedoes for transporting hemostats into vase-type wounds to achieve rapid hemostasis,creating a new paradigm for combating trauma treatment.

关键词： Torpedoes-inspired Microcluster colloidosomes Magnetic guidance Disintegration Hemostasis

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Epithelial-mesenchymal transition in organ fibrosis development:current understanding and treatment strategies

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Burns & trauma 2022年第1期10卷 598-617页

作者： Lexin Liu Qizhe Sun Frank Davis Jianhua Mao Hailin Zhao Daqing Ma Division of Anaesthetics Pain Medicine and Intensive CareDepartment of Surgery and CancerFaculty of MedicineImperial College LondonChelsea andWestminster HospitalLondonSW109NHUK Department of Nephrology and Urology Pediatric Urolith CenterThe Children’s Hospital of Zhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhouZhejiang Province310003China Department of Nephrology The Children Hospital of Zhejiang UniversitySchool of MedicineHangzhouZhejiang Province310003China

Organ fibrosis is a process in which cellular homeostasis is disrupted and extracellular matrix is excessively *** can lead to vital organ failure and there are no effective treatments *** epithelial-mesenchymal transition(EMT)may be one of the key cellular mechanisms,the underlying mechanisms of fibrosis remain largely *** is a cell phenotypic process in which epithelial cells lose their cell-to-cell adhesion and polarization,after which they acquire mesenchymal features such as infiltration and migration *** injurious stimulation in different organs,EMT can be triggered by multiple signaling pathways and is also regulated by epigenetic *** narrative review summarizes the current understanding of the underlying mechanisms of EMT in fibrogenesis and discusses potential strategies for attenuating EMT to prevent and/or inhibit *** better understanding the role of EMT in fibrosis development,targeting EMT and beyond in developing therapeutics to tackle fibrosis is challenging but likely feasible.

关键词： EMT Fibrosis TGF-β Smad HDAC inhibitors TGF-βantibody Organ fibrosis Senescence Extracellular matrix

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Assessing keloid recurrence following surgical excision and radiation

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Burns & trauma 2020年第1期8卷 34-40页

作者： Michael H.Gold Mark S.Nestor Brian Berman David Goldberg Gold Skin Care center 2000 Richard Jones RoadSuite 220NashvilleTN 37215 center for Clinical and Cosmetic Research 2925 NE 199th StSuite 205AventuraFL 33180 Department of Dermatology and Cutaneous Surgery University of Miami Miller School of MedicineMiamiFL Skin Laser&Surgery Specialists of NY/NJ 110 E.55th Street13th floorNew YorkNY 10022

Keloids are a fibroproliferative disorder that can result from a cutaneous injury to the reticular *** rates as high as 100%have been reported following surgical excision ***,a variety of post-surgical techniques have been employed to prevent keloid recurrence,including the use of *** numerous studies have shown post-excisional X-rays,electron beam,lasers and brachytherapy can reduce the rate of keloid recurrence,numerous inconsistencies,including a wide range of definitions for keloid recurrence,make it difficult to compare study *** review aims to examine the various means for defining keloid recurrence in clinical trials involving the use of radiation *** of the Cochrane Library and PubMed were performed to identify the available information for post-surgical keloid recurrence following radiation *** identified study was reviewed for patient followup and criteria used to define keloid *** search results included clinical studies with external beam radiation,brachytherapy and superficial radiation *** studies did not include a definition of keloid recurrence,or defined recurrence only as the return of scar *** studies defined keloid recurrence based on patient self-assessment questionnaires,symptoms and scar elevation and changes in Kyoto Scar Scale,Japan Scar Workshop Scale and Vancouver Scar Scale *** results of this review indicate keloidectomy followed by radiation therapy provide satisfactory recurrence rates;however,clinical studies evaluating these treatments do not describe treatment outcomes or use different definitions of keloid ***,recurrence rates vary widely,making comparisons across studies *** recurrence should be clearly defined using both objective and subjective measures.

关键词： Keloid Keloid scar Recurrence External beam radiation Brachytherapy Superficial radiation therapy

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Road traffic injury mortality and morbidity by country development status, 2011- 2017

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Chinese Journal of traumatology 2021年第2期24卷 88-93页

作者： Jie-Yi He Wang-Xin Xiao David CSchwebel Mo-Tao Zhu Pei-Shan Ning Li Li Xun-Jie Cheng Jun-Jie Hua Guo-Qing Hu Department of Epidemiology and Health Statistics Xiangya School of Public HealthCentral South UniversityChangsha410078China Department of Psychology University of Alabama at BirminghamBirminghamAL35294USA center for Injury Research and Policy Abigail Wexner Research Institute at Nationwide Children’s HospitalDepartment of PediatricsThe Ohio State UniversityColumbusOH43205USA Division of Epidemiology College of Public HealthThe Ohio State UniversityColumbusOH43210USA

Purpose:This research examined road traffic injury mortality and morbidity disparities across of country development status,and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 e to halve the number of global deaths and injuries from road traffic accidents by ***:Data for road traffic mortality,morbidity,and socio-demographic index(SDI)were extracted by country from the estimates of the Global Burden of Disease study,and the implementation of the three types of national actions(legislation,prioritized vehicle safety standards,and trauma-related post-crash care service)were extracted from the Global Status Report on Road Safety byWorld Health *** fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to ***:Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017(by 7.52%e16.08%).Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period,while age-adjusted morbidity generally increased as SDI *** analysis by road user yielded similar results,but with two major differences during the study period of 2011 to 2017:(1)pedestrians in the high SDI countries experienced the lowest mortality(1.68e1.90 per 100,000 population)and morbidity(110.45e112.72 per 100,000 population for incidence and 487.48e491.24 per 100,000 population for prevalence),and(2)motor vehicle occupants in the high SDI countries had the lowest mortality(4.07e4.50 per 100,000 population)but the highest morbidity(428.74e467.78 per 100,000 population for incidence and 1025.70e1116.60 per 100,000 population for prevalence).Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SD

关键词： Road traffic injury Mortality Morbidity Socioeconomic disparity Sustainable development goals

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儿童暴露于创伤所致的精神病理学改变:需要检测和干预以减少下游负担

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英国医学杂志中文版 2021年第7期24卷 365-369页

作者： Andrea Danese Katie A McLaughlin Muthanna Samara Carla S Stover 韩彤妍(译) King′s College London Department of Child and Adolescent PsychiatryInstitute of PsychiatryPsychology&NeuroscienceLondonUK King′s College London SocialGenetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology&NeuroscienceLondonUK South London and Maudsley NHS Foundation Trust National and Specialist CAMHS Clinic for TraumaAnxietyand DepressionLondonUK Department of Psychology Harvard UniversityCambridge MAUSA Department of Psychology Kingston UniversityLondonUK Yale Early Stress and Adversity Consortium Yale University Child Study CenterNew Haven CTUSA 北京大学第三医院儿科

Andrea Danese及其同事认为,临床评估和循证干预滞后于研究,给个人和社会带来了巨大的花费。为了向一些最脆弱的儿童提供尽可能好的照护,必须加强专家培训、提高临床能力和增加儿童获得照护的机会。

关键词：临床能力临床评估循证干预病理学改变照护儿童

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The complexity of providing humanitarian surgical care in armed conflict: a framework to help categorize needs

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Emergency and Critical Care Medicine 2022年第2期2卷 41-44页

作者： Kevin Gianaris Barclay T.Stewart Sherry M.Wren Adam L.Kushner Indiana University School of Medicine IndianapolisINUSA Department of Surgery University of WashingtonSeattleWAUSA Harborview Injury Prevention and Research center University of WashingtonSeattleWAUSA Department of Surgery Stanford UniversityPalo AltoCAUSA Surgeons OverSeas New York CityNYUSA Department of International Health Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA

Armed conflicts are increasing globally due to political unrest and the broader effects of climate *** resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income *** understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was *** published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this *** novel matrix incorporates 108 *** variables are grossly divided into local and international agency components to address the issue of who is providing *** a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their *** addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient *** testing of this matrix to obtain feedback from end users is the next step in ***,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.

关键词： Armed conflict Emergency care Global surgery Humanitarian assistance trauma care

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Scapula Fracture in a Child: Report of a Rare Injury

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Open Journal of Pediatrics 2023年第2期13卷 158-163页

作者： Florent Tshibwid A. Zeng Mbaye Fall Nankouman Konaté Faty Balla Lô Eben-Ezer Samé Souleymane Camara Aimé Lakh Faye Fall Oumar Ndour Gabriel Ngom Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Cheikh Anta Diop University Dakar Senegal Department of Pediatric Surgery Albert Royer National Children’s Hospital Center Cheikh Anta Diop University Dakar Sene-gal

Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.

关键词： Fracture Scapula Child Non-Operative Management Case Report

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Longitudinal monitoring and prediction of long-term outcome of scar stiffness on pediatric patients

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Burns & trauma 2021年第1期9卷 196-206页

作者： Bettina Müller Edoardo Mazza Clemens Schiestl Julia Elrod Institute for Mechanical Systems Department of Mechanical and Process EngineeringETH ZurichLeonhardstrasse 218092 ZurichSwitzerland Empa Swiss Federal Laboratories for Materials Science and TechnologyUeberlandstrasse 1298600 DübendorfSwitzerland Burn center Division of Plastic and Reconstructive SurgeryUniversity Children’s Hospital ZurichSteinwiesstrasse 758032 ZürichSwitzerland Children’s Research center(CRC) University Children’s Hospital ZurichSteinwiesstrasse 758032 ZürichSwitzerland

Background:Hypertrophic scarring after burn injury is one of the greatest unmet challenges in patients with burn injuries.A better understanding of the characteristics of scar maturation and early prediction of the long-term outcome of scarring are prerequisites for improving targeted therapies and pivotal for patient ***:Repeated measurements of scar stiffness in 11 pediatric patients were performed over the course of 1 year using 2 suction devices,the Cutometer and the *** addition,the observer pliability score of the Patient and Observer Scar Assessment Scale was *** longitudinal study allowed quantification of the ability of each of the measured parameters to reflect scar maturation,as indicated by change in skin pliability/stiffness,over time(using linear regression);the ability to distinguish individual patients(intraclass correlation coefficient(ICC));the correlation of the devices(Spearman correlation coefficient);and the ability to predict longterm scar maturation based on early scar assessment(using receiver operating characteristic).Results:All the tools used showed significant longitudinal decrease of scar stiffness from 3 months until 12 months after the *** Nimble(ICC_(patient)^(Nimble)=0.99)and the Cutometer(ICC_(patient)^(Cuto)=0.97)demonstrated an excellent ability to distinguish between individual *** Nimble seemed to be able to predict the 12-month pliability of scars based on early(3-month)measurements(area under the curve(AUC)_(12m)^(POSAS)=0.67;AUC_(12m)^(C)=0.46;AUC_(12m)^(N)=0.79).Conclusions:The results of this preliminary study suggest that all 3 tools provide suitable means to quantify alterations in scar stiffness over *** evidence suggests the Nimble is most favorable for predicting changes in stiffness associated with long-term scar *** studies with a larger sample size are required to validate tissue suction as a clinical tool for analysis of changes of scar stiffne

关键词： Pediatric burns Scar maturation POSAS Cutometer Nimble

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Adhesive cryogel particles for bridging confined and irregular tissue defects

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Military medical Research 2023年第6期10卷 763-777页

作者： Yao-Ting Xue Ming-Yu Chen Jia-Sheng Cao Lei Wang Jia-Hao Hu Si-Yang Li Ji-Liang Shen Xin-Ge Li Kai-Hang Zhang Shu-Qiang Hao Sarun Juengpanich Si-Bo Cheng Tuck-Whye Wong Xu-Xu Yang Tie-Feng Li Xiu-Jun Cai Wei Yang Department of Engineering Mechanics Zhejiang UniversityHang‑zhou 310027China Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province Zhejiang UniversityHangzhou 310027China center for X‑Mechanics Department of Engineering MechanicsZhejiang Univer‑sityHangzhou 310027China Department of General Surgery Sir Run-Run Shaw HospitalZhejiang UniversityHangzhou 310016China Soft Intelligent Materials Co. LtdSuzhou 215123China School of Biomedical Engineering and Health Sciences and Advanced Membrane Technology Research Centre Universiti Teknologi Malaysia81310 SkudaiMalaysia

Background Reconstruction of damaged tissues requires both surface hemostasis and tissue *** with damage resulting from physical trauma or surgical treatments may have arbitrary surface topographies,making tissue bridging *** This study proposes a tissue adhesive in the form of adhesive cryogel particles(ACPs) made from chitosan,acrylic acid,1-ethyl-3-(3-dimethylaminopropyl) carbodiimide(EDC) and N-hydroxysuccinimide(NHS).The adhesion performance was examined by the 180-degree peel test to a collection of tissues including porcine heart,intestine,liver,muscle,and *** of ACPs was evaluated by cell proliferation of human normal liver cells(LO2)and human intestinal epithelial cells(Caco-2).The degree of inflammation and biodegradability were examined in dorsal subcutaneous rat *** ability of ACPs to bridge irregular tissue defects was assessed using porcine heart,liver,and kidney as the ex vivo ***,a model of repairing liver rupture in rats and an intestinal anastomosis in rabbits were established to verify the effectiveness,biocompatibility,and applicability in clinical *** ACPs are applicable to confined and irregular tissue defects,such as deep herringbone grooves in the parenchyma organs and annular sections in the cavernous *** formed tough adhesion between tissues[(670.9±50.1) J/m^(2) for the heart,(607.6±30.0) J/m^(2) for the intestine,(473.7±37.0) J/m^(2) for the liver,(186.1±13.3) J/m^(2) for the muscle,and(579.3±32.3) J/m^(2) for the stomach].ACPs showed considerable cytocompatibility in vitro study,with a high level of cell viability for 3 d[(98.8±1.2)%for LO2 and(98.3±1.6)%for Caco-2].It has comparable inflammation repair in a ruptured rat liver(P=0.58 compared with suture closure),the same with intestinal anastomosis in rabbits(P=0.40 compared with suture anastomosis).Additionally,ACP-based intestinal anastomosis(less than 30 s) was remarkably faster than the convention

关键词： Tissue reconstruction Wet adhesion Adhesive hydrogel Bioadhesive

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幼龄大鼠深低温低流量脑损伤模型的建立和评估

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中华创伤杂志 2010年第4期26卷 344-348页

作者：何晓敏莫绪明顾群陈凤彭卫戚继荣顾海涛 YIN Kejie 南京医科大学附属南京儿童医院心胸外科 210008 Department of Neurology and center for the Study of Nervous System Injury Washington University School of Medicine USA

目的建矿幼龄大鼠深低温低流量（deep hypothennia low flow，DHLF）脑损伤模型，研究DHLF期间大鼠脑血流龟的变化及脑损伤程度。方法3周龄健康sD大鼠12只，雌雄不限，体重45～50g，按随机数字表法分为假手术组和模型组。建立DHLF模型... 详细信息

目的建矿幼龄大鼠深低温低流量（deep hypothennia low flow，DHLF）脑损伤模型，研究DHLF期间大鼠脑血流龟的变化及脑损伤程度。方法3周龄健康sD大鼠12只，雌雄不限，体重45～50g，按随机数字表法分为假手术组和模型组。建立DHLF模型后，利用激光多普勒血流监测仪于DHLF期间连续监测腑血流量变化，并在降温前、降温至（21．0±0．5）℃、DHLF0～5min、DHLF25～30min、DHLF55～60min、DHLF115～120min和DHLF术后0～5min这7个时间段记录局部脑血流量（rI=BF）变化，降温前rCBF作为基线水平。另取3周龄健康SD大鼠60只，按随机数字表法分为假手术组和模型组，每组设5个时相点：DHLF术后1h、6h、24h、72h和7d，每个时相点6只，采用HE染色和TUNEL法分别观察不同时相点脑组织病理改变及细胞凋亡变化，并于术后24h、72h和7d进行神经功能缺陷评分（NDS）。结果假手术组和模型组在降温至（21．0±0．5）oC时rCBF分别降至基线水平的（41．1±4．2）％和（40．7±3．4）％，且模型组rCBF在DHLF0～5min内进一步降低至（15．7±3．5）％（P〈0．01），而在DHLF期间无明显改变。与假手术组比较，模型组在术后24h和72h时NDS评分显著降低（P〈0．05或0．01），且脑组织病理改变明显，TUNEL阳性细胞在术后6h、24h、72h和7d均显著增高（P〈0．01）。结论DHLF模型可以造成脑损伤，与细胞凋亡有关，且操作简单，是一种较为理想、可靠的DHLF脑损伤模型，可近似于临床心脏直视手术DHLF过程。

关键词：脑损伤模型,动物激光多普勒流量测定深低温低流量

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