Causes and global, regional, and national burdens of traumatic brain injury from 1990 to 2019.

PURPOSE: Traumatic brain injury (TBI), currently a major global public health problem, imposes a significant economic burden on society and families. We aimed to quantify and predict the incidence and severity of TBI by analyzing its incidence, prevalence, and years lived with disability (YLDs). The epidemiological changes in TBI from 1990 to 2019 were described and updated to provide a reference for developing prevention, treatment, and incidence-reducing measures for TBI. METHODS: A secondary analysis was performed on the incidence, prevalence, and YLDs of TBI by sex, age group, and region (n = 21,204 countries and territories) between 1990 and 2019 using the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Proportions in the age-standardized incidence rate due to underlying causes of TBI and proportions of minor and moderate or severe TBI were also reported. RESULTS: In 2019, there were 27.16 million (95% uncertainty intervals (UI): 23.36 - 31.42) new cases of TBI worldwide, with age-standardized incidence and prevalence rates of 346 per 100,000 population (95% UI: 298-401) and 599 per 100,000 population (95% UI: 573-627), respectively. From 1990 to 2019, there were no significant trends in global age-standardized incidence (estimated annual percentage changes: -0.11%, 95% UI: -0.18% - -0.04%) or prevalence (estimated annual percentage changes: 0.01%, 95% UI: -0.04% - 0.06%). TBI caused 7.08 million (95% UI: 5.00 - 9.59) YLDs in 2019, with age-standardized rates of 86.5 per 100,000 population (95% UI: 61.1 - 117.2). In 2019, the countries with higher incidence rates were mainly distributed in Central Europe, Eastern Europe, and Australia. The 2019 global age-standardized incidence rate was higher in males than in females. The 2019 global incidence of moderate and severe TBI was 182.7 per 100,000 population, accounting for 52.8% of all TBI, with falls and road traffic injuries being the main causes in most regions. CONCLUSIONS: The incidence of moderate and severe TBI was slightly higher in 2019, and TBI still accounts for a significant portion of the global injury burden. The likelihood of moderate to severe TBI and the trend of major injury under each injury cause from 1990 to 2019 and the characteristics of injury mechanisms in each age group are presented, providing a basis for further research on injury causes in each age group and the future establishment of corresponding policies and protective measures.

Road traffic mortality in Zunyi city, China: A 10 - year data analysis (2013-2022).

PURPOSE: The study aimed to examine the pattern of motorization and the mortality rate related to road traffic crashes in Zunyi (a city in northern Guizhou province of China) from 2013 to 2022, and to identify the epidemiological characteristics of these crashes with to provide insights that could help improve road safety. METHODS: Data were obtained from the Zunyi traffic management data platform, and the mortality rates were calculated. We deployed various analytical methods, including descriptive analysis, Chi-square test or Fisher's exact test of categorical variable, circular distribution map analysis, and Rayleigh test to characterize the traits of road traffic crashes in the region. RESULTS: During the 10-year study period, 7488 people died due to road traffic accidents, with males accounting for 70.4% and females 29.6% (χ2 = 101.97, p < 0.001). The mortality rate increased from 7.80 deaths per 100,000 people in 2013 to 10.70 deaths per 100,000 people in 2016, but then decreased to 9.54 deaths per 100,000 people in 2019. A notable finding was that the death rate per 10,000 vehicles declined from 16.09 deaths per 10,000 vehicles in 2013 to 5.48 deaths per 10,000 vehicles in 2022. The study also found that vulnerable road users represented nearly half (48.76%) of all accident fatalities, and unlicensed or inexperienced driving contributed significantly to the occurrence of road traffic accidents. CONCLUSION: Although the number of road traffic accidents in Zunyi has decreased, there are still some critical issues that need to be addressed, particularly for vulnerable road users and unlicensed drivers. Our results highlight the need of targeted interventions to address the specific risk factors of road traffic crashes, particularly those affecting vulnerable road users and drivers without sufficient experience or license.

A safety assessment of a 300-meter saturation dive at sea by mental ability and performance efficacy.

High pressure is an environmental characteristic of the deep sea that may exert critical effects on the physiology and mental abilities of divers. In this study we evaluated the performance efficacy and mental ability of four divers during a 300-meter helium-oxygen saturation dive at sea. Spatial memory, 2D/3D mental rotation functioning, grip strength, and hand-eye coordination ability were examined for four divers during the pre-dive, compression, decompression, and post-dive phases. The results showed that both the reaction time and the correct responses for the mental rotation and hand-eye coordination were slightly fluctuated. In addition, there was a significant decline in the grip strength of the left hand. It is concluded that the performance efficacy and mental ability of divers were virtually unaffected during 300-meter helium-oxygen saturation diving at sea.

Influence of road types on road traffic accidents in northern Guizhou Province, China.

PURPOSE: The increasing number of deaths due to road traffic accidents (RTAs) has attracted global attention. However, the influence of road types is rarely considered in the study of RTAs. This study evaluates the influence of different road types in RTAs in northern Guizhou to provide a basis for the formulation of evidence-based policies and measures. METHODS: We obtained the data from the Zunyi Traffic Management Data Platform for the years 2009-2018. The mortality rates of RTAs were calculated. Descriptive methods and Chi-square tests were used to analyze the characteristics of road traffic collisions on different road types. We also examined the associations between the mortality rate per 10,000 vehicles and the growth of per capital gross domestic product (GDP) with Spearman's rank correlation analysis. According to the passing volume and the infrastructure, we defined different types of roads, like administrative road, functional road, general urban road and urban expressway. RESULTS: In 2012, the traffic mortality rate of administrative roads was 8.9 per 100,000 people, and the mortality rate of functional roads was 7.4 per 100,000 people, which decreased in 2018 to 6.1 deaths per 100,000 people and 5.2 deaths per 100,000 people, respectively. The mortality rate per 10,000 vehicles reached the highest level in 2011 (28.8 per 10,000 vehicles and 22.5 per 10,000 vehicles on administrative and functional roads, respectively). The death rate of county roads was the highest among administrative roads (χ2 = 17.389, p < 0.05) and that of fourth-class roads was the highest among functional roads (χ2 = 21.785, p < 0.05). The mortality rate per 10,000 vehicles was negatively correlated with per capital GDP. CONCLUSION: Although our research shows that RTAs in northern Guizhou have steadily declined in recent years, the range of decline is relatively small. Many measures and sustainable efforts are needed to control road traffic death and accelerate the progress in road traffic safety in northern Guizhou.

Insights into optimizing exosome therapies for acute skin wound healing and other tissue repair.

Exosome therapy holds great promise as a novel approach to improve acute skin wound healing. This review provides a comprehensive overview of the current understanding of exosome biology and its potential applications in acute skin wound healing and beyond. Exosomes, small extracellular vesicles secreted by various stem cells, have emerged as potent mediators of intercellular communication and tissue repair. One advantage of exosome therapy is its ability to avoid potential risks associated with stem cell therapy, such as immune rejection or stem cells differentiating into unwanted cell types. However, further research is necessary to optimize exosome therapy, not only in the areas of exosome isolation, characterization, and engineering, but also in determining the optimal dose, timing, administration, and frequency of exosome therapy. Thus, optimization of exosome therapy is critical for the development of more effective and safer exosome-based therapies for acute skin wound healing and other diseases induced by cancer, ischemia, or inflammation. This review provides valuable insights into the potential of exosome therapy and highlights the need for further research to optimize exosome therapy for clinical use.

Protective effect of acute splenic irradiation in rats with traumatic brain injury.

OBJECTIVE: To explore the protective effect of acute splenic irradiation against traumatic brain injury (TBI) in rats. METHODS: A rat model of TBI was established according to Feeney's method. Splenic irradiation was performed by the reverse intensity-modulated radiation therapy (IMRT) source-axis distance (SAD) irradiation technique. Rat brain tissue samples were collected, the water content of the rat brain tissue was determined and the abundance of microglia was detected by immunofluorescence. Spleens were collected to measure the spleen index. Lung, liver, small intestine and kidney tissues were taken for hematoxylin and eosin staining to observe whether there was radiation-induced pathological damage. Peripheral blood was collected to detect tuftsin and the inflammatory factors IL-6 and IL-10. RESULTS: Compared with the nonirradiated TBI rat group, the 4-h spleen irradiation TBI rat group showed (1) increased behavioral scores at 3 days after TBI (P < 0.05), (2) reduced water content of the ipsilateral hemisphere at 3 days after TBI, (3) reduced spleen index at 3 and 7 days after TBI, (4) reduced number of microglia cells infiltrating around the lesion at 7 days after TBI, (5) reduced IL-6 levels at 3 days after TBI, (6) increased IL-10 levels at 3 and 5days after TBI and (7) Compared with the nonirradiated TBI rat group, the 8-h spleen irradiation TBI rat group showed reduced tuftsin levels at 3 and 7days after TBI. CONCLUSIONS: Acute splenic irradiation had a protective effect in rats with TBI.

Quantitative analysis for the differences in vasculogenic activity and sensitivity to angiogenic stimulants between human glioma cells and normal endothelial cells.

Neovascularization is a histological feature of glioma, especially of glioblastoma (GBM), being associated with tumor invasiveness and poor prognosis. However, current anti-angiogenic therapies targeting vascular endothelial cells (ECs), has exhibited poor efficacy in some GBM cases. This may be at least partially attributed to the potential of glioblastoma cells to construct blood supply chain via vasculogenic mimicry or endothelial differentiation. This study aims to explore differences in vasculogenic activity and sensitivity to angiogenic stimulants between normal human ECs and glioma cells of different grades. We found that grade IV U87 GBM cells showed highly inducible vasculogenic activity either in the orthotopic xenograft model or under in vitro angiogenic stimulants as compared with grade II CHG5 glioma cells. The hypoxia mimetic more strongly induced in vitro vasculogenic capacity and endothelial marker expression of U87 GBM cells than the stimulation with multiple proangiogenic growth factors (vascular endothelial growth factor, basic fibroblast growth factor and epidermal growth factor). In contrast, proangiogenic effect of hypoxia on human umbilical vein endothelial cells (HUVECs) was weaker than on U87 GBM cells. In addition, it was also observed that the in vitro vasculogenic process of U87 cells started later but lasted longer than that of HUVECs. These results demonstrate that when compared with normal ECs, high-grade glioma cells basically possess weaker vasculogenic activity, but exhibit higher sensitivity and longer-lasting response to angiogenic stimulants, especially to hypoxia. This may be helpful to develop novel anti-angiogenic strategies targeting both vascular ECs and vasculogenic glioma cells.

[Current status of spleen-mediated inflammatory response in traumatic acute respiratory distress syndrome].

OBJECTIVE: Acute respiratory distress syndrome (ARDS) is considered to be a pulmonary manifestation of systemic inflammatory response syndrome (SIRS), often occurring as a complication of disease, and worsening the prognosis of patients. In recent years, the incidence of trauma has increased year by year. Severe trauma can lead to SIRS, which is one of the common risk factors of ARDS. The spleen is the largest peripheral immune organ of the body, containing a large number of immune cells and secreting inflammatory factors. The inflammatory factors play an important role in the formation of traumatic ARDS. In recent years, the benefits of treating ARDS by inhibiting spleen-induced inflammatory response have gradually been discovered, providing new ideas for the treatment of ARDS. Therefore, the research status of spleen-mediated inflammatory response in traumatic ARDS is of great significance for the prevention and treatment of traumatic ARDS. This article reports the spleen-mediated systemic inflammatory response, the role of inflammatory mediators in the development of ARDS, and the current state of research on ARDS treatment to explore new approaches to the prevention and treatment of traumatic ARDS.