BACKGROUND & AIMS: :A 29-year-old man was admitted to our institution 10 days after he had undergone an urgent exploratory laparotomy at a local army hospital after a terrorist bombing attack. On admission, deep second-degree and third-degree burns involving 25% of the upper and lower extremities were present, together with a 25 x 10-cm abdominal full-thickness blast injury defect on the left side, an infected eviscerated midline incision, and a colostomy on the right side of the abdomen. The patient underwent a second laparotomy, at which time the intraabdominal abscess was drained, and the abdominal cavity was irrigated with saline. A jejunal perforation was found and sutured. The abdominal cavity was left open and covered with a Bogota bag for temporary closure. On postburn day 18, the patient underwent débridment and grafting of the third-degree burns to the left and right arm and right lower extremities. After several débridment sessions (postburn days 16, 18, 20, 22, and 24), an abdominal skin release and reapproximation were performed (postburn day 26). On postburn day 36, split-thickness skin grafts were placed directly on the granulated tissue of the intestines and on a defect in the left flank and iliac regions. Postoperatively, the patient did well. He was discharged on postburn day 78 with all wounds well healed. In our opinion, temporary closure followed by direct application of meshed split-thickness skin grafts to exposed abdominal viscera represents a simple method of reconstruction that can be safely performed, with minimal risk, on critically ill patients.

背景与目标： ：一名29岁的男子在恐怖炸弹袭击后在当地一家军队医院接受紧急探查剖腹手术10天后被送进我们的机构。入院时出现上，下肢深部烧伤，累及上肢和下肢的25％，左侧有25 x 10-cm腹部全层爆炸伤缺损，被感染的内脏中线切口，在腹部右侧进行结肠造口术。患者进行了第二次剖腹手术，此时排空了腹腔内脓肿，并用生理盐水冲洗了腹腔。发现并缝合了空肠穿孔。腹腔保持开放并用Bogota袋覆盖以暂时关闭。烧伤后第18天，患者进行了清创术，并在左右臂和右下肢进行了三度烧伤。经过几次清创术后（烧伤后第16、18、20、22和24天），进行了腹部皮肤的释放和重新逼近（烧伤后第26天）。在烧伤后第36天，将切开厚度的皮肤移植物直接放在肠的肉芽组织上以及左侧腹和骨区域的缺损处。术后病人表现良好。烧伤后第78天他已出院，所有伤口均得到了良好治愈。在我们看来，暂时闭合然后直接将网状劈开厚度的皮肤移植物应用于暴露的腹腔内脏代表了一种简单的重建方法，可以对重症患者进行安全且风险最小的重建。

BACKGROUND & AIMS: BACKGROUND:Pulmonary surfactant dysfunction may contribute to the development of ventilator induced lung injury (VILI). Tracheal gas insufflation (TGI) is a technique in which fresh gas is introduced into the trachea and augment ventilation by reducing the dead space of ventilatory system, reducing ventilatory pressures and tidal volume (V(T)) while maintaining constant partial arterial CO2 pressure (PaCO(2)). We hypothesised that TGI limited peak inspiratory pressure (PIP) and V(T) and would minimize conventional mechanical ventilation (CMV) induced pulmonary surfactant dysfunction and thereby attenuate VILI in rabbits with acute lung injury (ALI). METHODS:ALI was induced by intratracheal administration of lipopolysaccharide in anaesthetized, ventilated healthy adult rabbits randomly assigned to continuous TGI at 0.5 L/min (TGI group) or CMV group (n = 8 for each group), and subsequently ventilated with limited PIP and V(T) to maintain PaCO(2) within 35 to 45 mmHg for 4 hours. Physiological dead space to V(T) ratio (V(D)/V(T)), dynamic respiratory compliance (Cdyn) and partial arterial O(2) pressure (PaO(2)) were monitored. After ventilation, lungs were analysed for total phospholipids (TPL), total proteins (TP), pulmonary surfactant small to large aggregates ratio (SA/LA) in bronchoalveolar lavage fluid (BALF) and for determination of alveolar volume density (V(V)), myeloperoxidase and interleukin (IL)-8. RESULTS:TGI resulted in significant (P < 0.05 or P < 0.01) decrease in PIP [(22.4 +/- 1.8) cmH2O vs (29.5 +/- 1.1) cmH2O], V(T) [(6.9 +/- 1.3) ml/kg vs (9.8 +/- 1.11) ml/kg], V(D)/V(T) [(32 +/- 5)% vs (46 +/- 2)%], TP [(109 +/- 22) mg/kg vs (187 +/- 25) mg/kg], SA/LA (2.5 +/- 0.4 vs 5.4 +/- 0.7), myeloperoxidase [(6.2 +/- 0.5) U/g tissue vs (12.3 +/- 0.8) U/g tissue] and IL-8 [(987 +/- 106) ng/g tissue vs (24 +/- 3) mN/m] of BALF, and significant (P < 0.05) increase in Cdyn [(0.47 +/- 0.02) ml.cmH2O(-1).kg(-1) vs (0.31 +/- 0.02) ml.cmH2O(-1).kg(-1)], PaO(2) [(175 +/- 24) mmHg vs (135 +/- 26) mmHg], TPL/TP (52 +/- 8 vs 33 +/- 11) and Vv (0.65 +/- 0.05 vs 0.44 +/- 0.07) as compared with CMV. CONCLUSIONS:In this animal model of ALI, TGI decreased ventilatory requirements (PIP, V(T) and V(D)/V(T)), resulted in more favourable alveolar pulmonary surfactant composition and function and less severity of lung injury than CMV. TGI in combination with pressure limited ventilation may be a lung protective strategy for ALI.

背景与目标： 背景：肺表面活性物质功能障碍可能导致呼吸机诱发的肺损伤（VILI）的发展。气管注气（TGI）是一种将新鲜气体引入气管并通过减少通气系统的死腔，降低通气压力和潮气量（V（T））并同时保持恒定的部分动脉CO2压力来增强通气的技术（ PaCO（2））。我们假设，TGI限制了峰值吸气压力（PIP）和V（T），并且将传统机械通气（CMV）引起的肺表面活性剂功能障碍降至最低，从而减轻了急性肺损伤（ALI）兔的VILI。
方法：通过气管内脂多糖经气管内给药的麻醉，通风的健康成年兔随机分为0.5 L / min（TGI组）或CMV组（每组n = 8），然后在有限的PIP和通气条件下通气，以诱导ALI。 V（T）将PaCO（2）维持在35至45 mmHg的范围内4个小时。监测生理死区与V（T）的比率（V（D）/ V（T）），动态呼吸顺应性（Cdyn）和部分动脉O（2）压力（PaO（2））。通气后，对肺中的总磷脂（TPL），总蛋白（TP），支气管肺泡灌洗液（BALF）中的肺表面活性剂小到大聚集比（SA / LA）进行分析，并测定肺泡体积密度（V（V）） ），髓过氧化物酶和白介素（IL）-8。
结果：TGI导致PIP显着降低（P <0.05或P <0.01）[（22.4 /-1.8）cmH2O与（29.5 /-1.1）cmH2O]，V（T）[（6.9 /-1.3）ml / kg vs（9.8 /-1.11）ml / kg]，V（D）/ V（T）[（32 /-5）％vs（46 /-2）％]，TP [（109 /-22）mg / kg vs（187 /-25）mg / kg]，SA / LA（2.5 /-0.4 vs 5.4 /-0.7），髓过氧化物酶[（6.2 /-0.5）U / g组织vs（12.3 /-0.8）U / g组织]和IL-8 [（987 /-106）ng / g组织vs（24 /-3）mN / m] BALF，Cdyn [（0.47 /-0.02）ml.cmH2O显着（P <0.05）增加（-1）.kg（-1）vs（0.31 /-0.02）ml.cmH2O（-1）.kg（-1）]，PaO（2）[（175 /-24）mmHg vs（135 /-26 ）mmHg]，TPL / TP（52 /-8 vs 33 /-11）和Vv（0.65 /-0.05 vs 0.44 /-0.07）。
结论：在这种ALI动物模型中，TGI降低了通气需求（PIP，V（T）和V（D）/ V（T）），与CMV相比，肺泡表面活性剂的肺泡表面活性剂组成和功能更佳，肺部损伤的严重程度更低。 TGI结合限压通气可能是ALI的肺保护策略。

BACKGROUND & AIMS: :Both animal models of experimental myocardial infarction and clinical studies on reperfusion therapy for acute myocardial infarction have provided evidence of impaired tissue perfusion at the microvascular level after initiation of reperfusion despite adequate restoration of epicardial vessel patency. Characteristics of this "no-reflow" phenomenon found in basic science investigations, such as distinct perfusion defects, progressive decrease of resting myocardial flow with ongoing reperfusion and functional vascular alterations are paralleled by clinical observations demonstrating similar features during the course of reperfusion. In experimental animal investigations of coronary occlusion and reperfusion, this no-reflow phenomenon could be characterized as a fundamental mechanism of myocardial ischemia and reperfusion. Major determinants of the amount of no-reflow are the duration of occlusion, infarct size, but also the length of reperfusion, as rapid expansion of perfusion defects occurs during reperfusion. Moreover, no-reflow appears to persist over a period of at least four weeks, a period when major steps of infarct healing take place. The significant association of the degree of compromised tissue perfusion at four weeks and indices of infarct expansion, found in chronic animal models of reperfused myocardial infarction, might be the pathoanatomic correlate for the prognostic significance observed in the clinical setting.

背景与目标： ：实验性心肌梗死的动物模型和急性心肌梗死的再灌注治疗的临床研究均提供了证据，表明尽管充分恢复了心外膜血管通畅性，再灌注开始后微血管水平的组织灌注受损。在基础科学研究中发现的这种“无回流”现象的特征，例如明显的灌注缺陷，随着进行中的再灌注而逐渐减少的静息心肌血流量和功能性血管改变，与在再灌注过程中表现出相似特征的临床观察结果相吻合。在对冠状动脉闭塞和再灌注的动物实验研究中，这种无再流现象可被表征为心肌缺血和再灌注的基本机制。决定是否再流的主要因素是闭塞的持续时间，梗塞面积以及再灌注的时间，因为在再灌注过程中会出现灌注缺陷的快速扩展。此外，在至少四周的时间内，即梗塞愈合的主要步骤发生时，无复流似乎会持续。在再灌注心肌梗死的慢性动物模型中发现，在四周时受损的组织灌注程度与梗塞扩展指数之间存在显着相关性，这可能与在临床环境中观察到的预后意义相关。

BACKGROUND & AIMS: :This pilot study investigated adolescents with well-documented childhood lead burdens to determine the relationship between lead and unintentional injury. Adolescents completed a self-administered injury questionnaire. Results demonstrated that elevated childhood blood lead concentrations were significantly related to injury variables. Further study is necessary to understand adolescent health and safety implications.

背景与目标： ：这项先导研究调查了有充分文献证明的儿童期铅负担的青少年，以确定铅与意外伤害之间的关系。青少年填写了一份自我管理的伤害调查表。结果表明，儿童血铅浓度升高与伤害变量显着相关。有必要进一步研究以了解青少年健康和安全隐患。

BACKGROUND & AIMS: Neurologic injury in infection with Borrelia burgdorferi can be due to the direct action of the spirochetes and spirochetal products on neural cells. There is in vitro evidence for the adherence of this organism to neurons, to glia, and to Schwann cells. Adhesion was found to be associated with galactocerebroside, a glycolipid component of myelin, and could act as a receptor for B. burgdorferi in oligodendroglia and in Schwann cells. Another pathway for neurologic injury could be through amplification of the inflammatory response by newly invading organisms (acute) and persisting (chronic) organisms. There is experimental evidence for production of IL-6, TNF-alpha, and nitric oxide by neural cells exposed to B. burgdorferi. Similar findings have been obtained from neuroborreliosis patients. Although less likely, there is the possibility that autoreactive mechanisms could have a role in the development of some manifestations of neuroborreliosis.

背景与目标： 伯氏疏螺旋体感染中的神经系统损伤可能是由于螺旋体和螺旋体产物对神经细胞的直接作用。有体外证据表明该生物粘附于神经元，神经胶质和雪旺氏细胞。发现粘附与半乳糖脑苷，髓磷脂的糖脂成分有关，并且可以在少突胶质细胞和施万细胞中充当伯氏疏螺旋体的受体。神经损伤的另一种途径可能是通过新侵入的生物（急性）和持续存在的（慢性）生物的炎症反应增强。有实验证据表明暴露于伯氏疏螺旋体的神经细胞可产生IL-6，TNF-α和一氧化氮。从神经性贝托病患者中也获得了类似的发现。尽管可能性较小，但自反应机制可能会在某些神经性硼疽病的发展中起作用。

BACKGROUND & AIMS: :Many field sports involve equipment that restricts one or both arms from moving while running. Arm swing during running has been examined from a biomechanical and physiologic perspective but not from an injury perspective. Moreover, only bilateral arm swing suppression has been studied with respect to running. The purpose of this study was to determine the influence of running with one arm restrained on lower extremity mechanics associated with running or sport-related injury. Fifteen healthy participants ran at a self-selected speed with typical arm swing, with one arm restrained and with both arms restrained. Lower extremity kinematics and spatiotemporal measures were analysed for all arm swing conditions. Running with one arm restrained resulted in increased frontal plane knee and hip angles, decreased foot strike angle, and decreased centre of mass vertical displacement compared to typical arm swing or bilateral arm swing restriction. Stride length was decreased and step frequency increased when running with one or both arms restrained. Unilateral arm swing restriction induces changes in lower extremity kinematics that are not similar to running with bilateral arm swing restriction or typical arm swing motion. Running with one arm restrained increases frontal plane mechanics associated with risk of knee injury.

背景与目标： ：许多野外运动都涉及限制一只或两只手臂在跑步时移动的设备。已从生物力学和生理学的角度检查了跑步过程中的手臂摆动，但从伤害的角度未进行检查。此外，关于跑步，仅研究了双侧手臂摆动抑制。这项研究的目的是确定一只手臂被约束跑步对与跑步或运动相关的伤害相关的下肢力学的影响。 15名健康参与者以典型的手臂挥杆，一只手臂被约束和两只手臂被约束的速度以自行选择的速度跑步。分析了所有手臂摆动情况的下肢运动学和时空测量。与典型的手臂摆动或双侧手臂摆动限制相比，用一只手臂约束跑步会导致额平面膝盖和臀部角度增加，脚打击角减小以及质心垂直位移减小。当一只手或两只手都受约束时，步幅减小，步频增加。单侧手臂摆动限制引起下肢运动学的改变，这与双侧手臂摆动限制或典型手臂摆动运动的跑步不同。用一只手臂约束跑步会增加与膝盖受伤风险相关的额叶平面力学。

BACKGROUND & AIMS: :Isolated rat adipose tissue-derived stromal cells (rATSCs) contain pluripotent cells that can be differentiated into a variety of cell lineages, including neural cells. Recent work has shown that ATSCs can make neurosphere-like clumps and differentiate into neuron-like cells expressing neuronal markers, but their therapeutic effect is unclear. Here we report that intravenous infusion of oligodendrocyte precursor cells (OPCs) derived from rATSC autograft cells sources improve motor function in rat models of spinal cord injury (SCI). After 4-5 weeks, transplanted rATSC-OPC cells survived and migrated into the injured region of SCI very efficiently (30-35%) and migrated cells were partially differentiated into neurons and oligodendrocyte. Also, we found some of the engrafted OPCs migrated and integrated in the kidney, brain, lung, and liver through the intravenous system. Behavioral analysis revealed the locomotor functions of OPC-autografted SCI rats were significantly restored. Efficient migration of intravenously engrafted rATSC-OPCs cells into SCI lesion suggests that SCI-induced chemotaxic factors facilitate migration of rATSC-OPCs. Here, we verified that engrafted rATSCs and SCI-induced chemotaxic factors indeed play an important role in proliferation, migration, and differentiation of endogeneous spinal cord-derived neural progenitor cells in the injured region. In transplantation paradigms, the interaction between engrafted rATSC-OPCs and endogeneous spinal cord-derived neuronal progenitor cells will be important in promoting healing through fate decisions, resulting in coordinated induction of cell migration and differentiation.

背景与目标： ：分离的大鼠脂肪组织来源的基质细胞（rATSC）包含多能细胞，可以分化为多种细胞谱系，包括神经细胞。最近的工作表明，ATSCs可以使神经球样团块并分化为表达神经元标记物的神经元样细胞，但其治疗效果尚不清楚。在这里，我们报道静脉输注源自rATSC自体移植细胞来源的少突胶质前体细胞（OPC）可改善大鼠脊髓损伤（SCI）模型的运动功能。 4-5周后，移植的rATSC-OPC细胞存活并非常有效地（30-35％）迁移至SCI的受损区域，并且迁移的细胞部分分化为神经元和少突胶质细胞。此外，我们发现一些植入的OPC通过静脉系统迁移并整合在肾脏，脑，肺和肝脏中。行为分析表明，OPC自体移植SCI大鼠的运动功能得到了显着恢复。静脉移植的rATSC-OPCs细胞向SCI病变的有效迁移表明，SCI诱导的化学趋化因子促进了rATSC-OPCs的迁移。在这里，我们验证了移植的rATSCs和SCI诱导的趋化因子确实在受损区域内源性脊髓来源的神经祖细胞的增殖，迁移和分化中起着重要作用。在移植范例中，移植的rATSC-OPC与内源性脊髓源性神经元祖细胞之间的相互作用对于通过命运决定促进愈合，导致细胞迁移和分化的协同诱导非常重要。

BACKGROUND & AIMS: OBJECTIVES:To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. DESIGN:A prospective cross-sectional cohort study. SETTING:Level I trauma center. PARTICIPANTS:Adults (N=242) with TBI of various severity. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. RESULTS:In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P<.05) and depressed (46% vs 23%; P<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. CONCLUSIONS:Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences.

背景与目标： 目的：探讨各种严重程度的脑外伤（TBI）患者脑震荡后主诉，焦虑和抑郁与职业结局的关系，并评估性别差异。
设计：一项前瞻性横断面队列研究。
地点：一级创伤中心。
参与者：成人（N = 242），患有各种严重程度的TBI。
干预措施：不适用。
主要观察指标：扩大格拉斯哥结果量表，重返工作时间（RTW），头部受伤症状清单以及医院焦虑症和抑郁量表。
结果：在67％的患者中，有主诉。 22％的人感到焦虑，而18％的人感到沮丧。与焦虑和抑郁相比，随着严重程度的增加，投诉的频率显着增加。完全RTW的焦虑和抑郁患者的频率（9％和5％）低于不完全RTW的频率（42％和37％； P <.001）。与其他严重程度类别和RTW不完全的患者（67％）相比，患有轻微TBI症状的患者更焦虑（50％vs 27％; P <.05）和抑郁（46％vs 23％; P <.05）。分别为36％和60％与30％）。与男性相比，患有轻度TBI的女性患抑郁症的比例更高（45％比13％； P = .01），RTW不完全（50％比18％； P <.05）。多元回归分析表明，损伤的严重程度，主诉，焦虑和抑郁都是RTW的预测因素（解释方差为45％）。在所有严重程度类别中，焦虑和抑郁仅可预测较小的TBI患者的RTW，主诉和性别。
结论：焦虑和抑郁与TBI后的职业结局有关，在次要TBI类别中的情况有所不同，部分原因是性别差异。

BACKGROUND & AIMS: BACKGROUND:Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n=38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.

背景与目标： 背景：现有的预测严重颅脑外伤后恢复的方法缺乏准确性。这项研究的目的是确定定量扩散张量成像（DTI）的预后价值。
方法：在一项多中心研究中，作者前瞻性地招募了105名在颅脑外伤后至少7天仍保持昏迷状态的患者。患者接受了脑磁共振成像，包括在20个预选的白质区中的DTI。使用改良的格拉斯哥成果量表对患者进行1年评估。在该训练数据库上构建了综合的DTI评分以进行预后，然后在独立的数据库上进行了验证（n = 38）。将DTI得分与国际预后和临床试验分析得分进行比较。
结果：使用DTI评分预测训练数据库上的不良结果，接收器工作特征曲线下方的面积为0.84（95％CI：0.75-0.91）。 DTI评分对不良结局的预测具有64％的敏感性和95％的特异性。在独立于验证的数据库上，接收器工作特性曲线下的面积为0.80（95％CI：0.54-0.94）。在培训数据库上，与国际临床试验预后和评估得分相比，重新分类方法显示出分类准确度的显着提高（P <0.05）。在验证数据库上观察到了相似的结果。
结论：与可用的临床/影像学预后评分相比，定量DTI的白质评估可提高长期结果预测的准确性。

BACKGROUND & AIMS: :The cardioprotective drugs used for treatment against ischemia/reperfusion (MI/R) injury have been well evaluated and are considered inadequate. The Chinese herbal medicine formula, Xinji pill (XJP) has been used traditionally for the prevention and treatment of ischemic heart diseases for decades. In the present study, the cardioprotective effects of XJP against MI/R injury were assessed in vivo and its possible mechanism was examined. Male Sprague‑Dawley rats were selected for establishing an MI/R model, which was induced by ischemia for 30 min followed by 24 h reperfusion. Drugs and saline were administered intragastrically from day 14 prior to MI/R. Blood samples were collected for biochemical detection. The rats were then sacrificed and cardiac muscle tissues were harvested. The mRNA expression levels of antioxidant genes were measured by reverse transcription‑quantitative polymerase chain reaction and the protein levels were measured by western blotting. Pretreatment with XJP for 14 days protected the heart against I/R‑induced myocardial function disorder, protected against heart injury, as demonstrated by normalized serum levels of lactate dehydrogenase and creatine kinase, and suppressed oxidative stress. XJP markedly upregulated the expression of antioxidant genes, including superoxide dismutase, catalase, glutathione reductase and glutathione peroxidase, and promoted the protein expression of heme oxygenase‑1 and NFE2‑related factor 2 (Nrf2) in the heart tissues. Furthermore, Akt kinase was confirmed to be upstream of Nrf2 in the XJP treatment. LY294002, a specific inhibitor of Akt, significantly eliminated the cardioprotective effects of XJP. In conclusion, these results demonstrated that XJP exhibited notable cardioprotective properties, in which the Akt/Nrf2 signaling pathway may be involved.

背景与目标： ：用于抵抗缺血/再灌注（MI / R）损伤的心脏保护药物已得到很好的评估，被认为是不足的。几十年来，传统的中草药配方辛集丸（XJP）被用于预防和治疗缺血性心脏病。在本研究中，体内评估了XJP对MI / R损伤的心脏保护作用，并研究了其可能的机制。选择雄性Sprague-Dawley大鼠建立MI / R模型，该模型由局部缺血30分钟然后再灌注24 h诱导。从MI / R之前第14天开始，在胃内施用药物和盐水。收集血样用于生化检测。然后处死大鼠并收获心肌组织。通过逆转录定量聚合酶链反应测量抗氧化剂基因的mRNA表达水平，并通过蛋白质印迹法测量蛋白质水平。 XJP预处理14天可以保护心脏免受I / R诱导的心肌功能障碍的侵害，防止心脏受伤，如血清乳酸脱氢酶和肌酸激酶水平的正常化以及抑制氧化应激所证明的。 XJP明显上调了抗氧化基因的表达，包括超氧化物歧化酶，过氧化氢酶，谷胱甘肽还原酶和谷胱甘肽过氧化物酶，并促进了心脏组织中血红素加氧酶-1和NFE2相关因子2（Nrf2）的蛋白表达。此外，在XJP处理中，证实Akt激酶位于Nrf2的上游。 LY294002是Akt的特异性抑制剂，可显着消除XJP的心脏保护作用。总之，这些结果表明，XJP具有明显的心脏保护特性，其中可能涉及Akt / Nrf2信号传导途径。

BACKGROUND & AIMS: :Mitochondrial dysfunction is the most prominent source of oxidative stress in acute and chronic kidney disease. NLRX1 is a receptor of the innate immune system that is ubiquitously expressed and localized in mitochondria. We investigated whether NLRX1 may act at the interface of metabolism and innate immunity in a model of oxidative stress. Using a chimeric mouse model for renal ischemia-reperfusion injury, we found that NLRX1 protects against mortality, mitochondrial damage, and epithelial cell apoptosis in an oxidative stress-dependent fashion. We found that NLRX1 regulates oxidative phosphorylation and cell integrity, whereas loss of NLRX1 results in increased oxygen consumption, oxidative stress, and subsequently apoptosis in epithelial cells during ischemia-reperfusion injury. In line, we found that NLRX1 expression in human kidneys decreased during acute renal ischemic injury and acute cellular rejection. Although first implicated in immune regulation, we propose that NLRX1 function extends to the control of mitochondrial activity and prevention of oxidative stress and apoptosis in tissue injury.

背景与目标： 线粒体功能障碍是急性和慢性肾脏疾病中最主要的氧化应激源。 NLRX1是先天免疫系统的受体，在线粒体中普遍表达和定位。我们调查了NLRX1是否可能在氧化应激模型中的新陈代谢和先天免疫的界面上起作用。使用针对肾缺血-再灌注损伤的嵌合小鼠模型，我们发现NLRX1以氧化应激依赖性的方式防止死亡，线粒体损伤和上皮细胞凋亡。我们发现NLRX1调节氧化磷酸化和细胞完整性，而NLRX1的缺失导致缺血再灌注损伤期间上皮细胞的耗氧量增加，氧化应激和随后的细胞凋亡。一致地，我们发现在急性肾缺血性损伤和急性细胞排斥期间，人肾脏中的NLRX1表达降低。尽管首先涉及免疫调节，但我们认为NLRX1功能扩展到线粒体活性的控制以及组织损伤中氧化应激和细胞凋亡的预防。

BACKGROUND & AIMS: :Repetitive transcranial magnetic stimulation (rTMS), a non-invasive form of brain stimulation, has shown experimental and clinical efficacy in a range of neuromodulatory models, even when delivered at low intensity (i.e. subthreshold for action potential generation). After central nervous system (CNS) injury, studies suggest that reactive astrocytes and microglia can have detrimental but also beneficial effects; thus modulating glial activity, for example through application of rTMS, could potentially be a useful therapeutic tool following neurotrauma. Immunohistochemistry was used to measure the effect of low intensity rTMS (LI-rTMS) on GFAP (astrocyte), IBA1 (microglial), and CS56 (proteoglycan) expression in a unilateral penetrating cortical stab injury model of glial scarring in young adult and aged male and female C57BL6/J mice. Mice received contralateral low frequency, ipsilateral low frequency, ipsilateral high frequency or sham LI-rTMS (4-5mT intensity), for two weeks following injury. There was no significant difference in the overall volume of tissue containing GFAP positive (+) astrocytes, IBA1+ microglia, or proteoglycan expression, between sham and LI-rTMS-treated mice of all ages and sex. Importantly however, the density of GFAP+ astrocytes and IBA1+ microglia immediately adjacent to the injury was significantly reduced following ipsilateral low and high frequency stimulation in adult and aged females (p≤0.05), but was significantly increased in adult and aged males (p≤0.05). LI-rTMS effects were generally of greater magnitude in aged mice compared to young adult mice. These results suggest that sex differences need to be factored into therapeutic rTMS protocols. In particular, more work analyzing frequency and intensity specific effects, especially in relation to age and sex, is required to determine how rTMS can best be used to modify glial reactivity and phenotype following neurotrauma.

背景与目标： ：反复经颅磁刺激（rTMS）是一种非侵入性的脑刺激形式，即使在低强度下（即产生动作电位的阈值下），也已在一系列神经调节模型中显示出实验和临床功效。中枢神经系统（CNS）损伤后，研究表明反应性星形胶质细胞和小胶质细胞可能具有有害作用，但也有有益作用。因此，例如通过应用rTMS调节神经胶质活动可能是神经创伤后的一种有用的治疗工具。免疫组织化学方法用于测定低强度rTMS（LI-rTMS）对单侧穿透性胶质瘢痕形成的成年男性和老年男性的单侧穿透性皮层刺伤模型中GFAP（星形胶质细胞），IBA1（微胶质细胞）和CS56（蛋白聚糖）表达的影响。和雌性C57BL6 / J小鼠。小鼠在受伤后两周接受对侧低频，同侧低频，同侧高频或假LI-rTMS（4-5mT强度）。在假手术和LI-rTMS处理的所有年龄和性别的小鼠之间，含有GFAP阳性（）星形胶质细胞，IBA1小胶质细胞或蛋白聚糖表达的组织总体积均无显着差异。然而重要的是，成年和老年女性在同侧低频和高频刺激后，紧邻损伤的GFAP星形胶质细胞和IBA1小胶质细胞的密度显着降低（p≤0.05），而成年和老年男性显着增加（p≤0.05） ）。与成年小鼠相比，老年小鼠的LI-rTMS效应通常更大。这些结果表明，性别差异需要纳入治疗性rTMS方案中。特别是，需要做更多的工作来分析频率和强度的具体影响，尤其是与年龄和性别相关的影响，以确定rTMS如何最好地用于改变神经外伤后的神经胶质反应性和表型。

BACKGROUND & AIMS: OBJECTIVE:To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period. DESIGN:Prospective cohort study. PARTICIPANTS/METHODS:Individuals with SCI (N=130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined. RESULTS:After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m(-2). A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m(-2) higher BMI. CONCLUSION:Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified.

背景与目标： 目的：调查：（1）住院脊髓损伤（SCI）康复出院后的最初五年中，冠心病危险因素（血脂和体重指数（BMI））的病程，以及（2）在此期间的生活方式（体育锻炼，与健身，吸烟，饮酒，体重和低脂饮食有关的自我保健）和冠心病的危险因素。
设计：前瞻性队列研究。
参与者/方法：具有SCI的个人（N = 130）。在住院康复出院时以及出院后1和5年测定总胆固醇（TC），高密度脂蛋白（HDL），低密度脂蛋白（LDL），甘油三酸酯（TG）和BMI。使用多级回归模型，确定了生活方式（饮酒，吸烟，积极的生活方式和自我保健）对血脂和BMI的影响。
结果：校正病灶和个人特征后，出院后五年内血脂没有变化，而BMI显着增加，为1.8 kg m（-2）。高百分比的BMI（63-75％）或HDL（66-95％）导致罹患心血管疾病的风险较高。表示要尽可能保持健康水平的个体和BMI较低的个体表现出更好的血脂状况。生活方式更加活跃的人表现出较高的HDL水平。避免吸烟的人的BMI升高1.5 kg m（-2）。
结论：住院SCI康复出院后的几年中，脂质分布似乎稳定，而BMI升高。可以确定与良好的脂质状况和BMI相关的生活方式因素。

BACKGROUND & AIMS: :Peripheral artery disease (PAD) is a result of the atherosclerotic narrowing of blood vessels to the extremities, and the subsequent tissue ischemia can lead to the up-regulation of angiogenic growth factors and formation of new vessels as a recovery mechanism. Such formation of new vessels can be evaluated with various non-invasive molecular imaging techniques, where serial images from the same subjects can be obtained to allow the documentation of disease progression and therapeutic response. The most commonly used animal model for preclinical studies of PAD is the murine hindlimb ischemia model, and a number of radiotracers have been investigated for positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging of PAD. In this review article, we summarize the PET/SPECT tracers that have been tested in the murine hindlimb ischemia model as well as those used clinically to assess the extremity blood flow.

背景与目标： ：周围动脉疾病（PAD）是动脉粥样硬化狭窄至四肢的结果，随后的组织缺血可导致血管生成生长因子的上调并形成新血管作为恢复机制。可以使用各种非侵入性分子成像技术来评估这种新血管的形成，其中可以获得来自相同受试者的系列图像，从而可以记录疾病的进展和治疗反应。用于PAD临床前研究的最常用动物模型是鼠后肢缺血模型，并且已经对PAD的正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）成像研究了许多放射性示踪剂。在这篇综述文章中，我们总结了已经在鼠后肢缺血模型中测试过的PET / SPECT示踪剂，以及在临床上用于评估肢体血流的示踪剂。

BACKGROUND & AIMS: INTRODUCTION:Management of traumatic brain injury (TBI) is focused on minimizing or preventing secondary brain injury. Remote ischemic conditioning (RIC) is an established treatment modality that has been shown to improve patient outcomes in different clinical settings by influencing inflammatory insults. In a clinical trial, RIC showed amelioration of SB100 and neuron-specific enolase. The aim of our study was to further elucidate the mechanisms and outcome when applying RIC in a mouse model of traumatic brain injury. METHODS:We subjected 100 male C57BL mice to a closed-skull cortical-controlled impact injury. Two hours after the TBI, the animals were allocated to either the RIC group (n = 50) or the sham group (n = 50). By clamping the exposed femoral artery, we induced RIC by six 4-minute cycles of ischemia and reperfusion. Circulating levels of S100-B, neuron-specific enolase, and glial fibrillary acidic protein were measured at multiple time points. Animals were additionally observed daily for cognition and motor coordination via novel object recognition and rotarod. Brain sections were stained and evaluated for neuronal injury at post-TBI Day 5. RESULTS:The RIC animals had a significantly higher recognition index than did sham at 24, 48, and 72 hours after intervention. Rotarod latency was higher in the RIC animals compared to the sham animals at all-time points, and statistically significant at 120 hours after intervention. The RIC group demonstrated preserved cognitive function and motor coordination compared to the sham. On hematoxylin and eosin and immunohistochemical staining of brain sections, there was less area of neuronal degeneration and astrocytosis, respectively, in the RIC group compared to the sham group. There was no significant difference in systemic neuronal markers between the RIC and sham animals. CONCLUSION:Remote ischemic conditioning 2 hours after injury preserved cognitive functions and motor coordination in a mouse model of TBI. Remote ischemic conditioning can preserve viability of neurons and astrocytes after TBI and has potential as a clinically noninvasive and relatively easy method to improve outcome after TBI. LEVEL OF EVIDENCE:Therapeutic studies, randomized controlled trial, level I.

背景与目标： 简介：创伤性脑损伤（TBI）的管理重点在于最大程度地减少或预防继发性脑损伤。远程缺血性调节（RIC）是一种既定的治疗方式，已显示可通过影响炎症损伤改善不同临床环境下的患者预后。在一项临床试验中，RIC显示SB100和神经元特异性烯醇化酶得到改善。我们研究的目的是进一步阐明将RIC应用于创伤性脑损伤小鼠模型的机制和结果。
方法：我们对100只雄性C57BL小鼠进行了闭合颅骨皮质控制的撞击伤害。 TBI后两小时，将动物分为RIC组（n = 50）或假组（n = 50）。通过夹紧暴露的股动脉，我们通过六个4分钟的缺血和再灌注周期诱导RIC。在多个时间点测量了S100-B，神经元特异性烯醇化酶和神经胶质原纤维酸性蛋白的循环水平。每天还通过新颖的物体识别和旋转仪观察动物的认知和运动协调。在TBI后第5天对脑切片进行染色并评估其神经元损伤。
结果：在干预后24、48和72小时，RIC动物的识别指数明显高于假手术。在所有时间点，RIC动物的罗塔洛德潜伏期均高于假动物，在干预后120小时具有统计学意义。与假手术相比，RIC组显示出保留的认知功能和运动协调能力。关于苏木精和曙红以及脑切片的免疫组织化学染色，与假手术组相比，RIC组的神经元变性和星形胶质细胞减少的区域分别较少。 RIC动物和假动物之间的系统神经元标记没有显着差异。
结论：TBI小鼠模型在损伤后2小时可进行远程缺血调节，以保持认知功能和运动协调性。远端缺血性调理可以保留TBI后神经元和星形胶质细胞的活力，并具有作为临床无创且相对容易的方法来改善TBI后预后的潜力。
证据级别：治疗研究，随机对照试验，I级。