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Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

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World Journal of Pediatric Surgery 2024年第1期7卷 42-46页

作者： Xiaofeng Xiong Wei Lu Fuzhong Xing Yuan Cai Jixin Yang Yuhang Yuan Jiexiong Feng Xuyong Chen department of Pediatric Surgery Tongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanHubeiChina department of Neonate Surgery Wuhan Children's HospitalHuazhong University of Science and TechnologyWuhanHubeiChina department of Pediatric Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina

Objective To review postoperative necrotizing enterocolitis(NEC)in patients with jejunoileal atresia(JIA)and to explore the potential risk factors related to the concurrence ofNEC.Methods Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled.Demographics,viral infection of the fetus,transfusion within 48 hours before NEC,sepsis before JIA repair,pathological and anatomical classification of JIA,combined malformation,occurrence time of NEC after the operation,treatment,and prognosis of patients were analyzed.Patients were divided into NEC group and non-NEC group,and all patients were followed up for 3-6 months to observe for complications.Results A total of 180 patients with JIA were included,of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up.The average age,birth weight,gestational age,proportion of premature infants,proportion of preoperative infections,and pathological classification of JIA did not significantly differ between the two groups.The probability of patients with proximal jejunal atresia(PJA)in the NEC group(58.3%)was higher than that in the non-NEC group(22.6%)(p=0.011),and patients with PJA had longer parenteral nutrition time than patients without PJA(26.64±9.21 days vs 15.11±6.58 days,p<0.001).Conclusion PJA was more likely to be associated with concurrent NEC after surgery,which is a highly NEC-related risk factor inherent in JIA.

关键词： patients postoperative transfusion

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Effect of weight-adjusted antimicrobial antibiotic prophylaxis on postoperative dosage and surgical site infection incidence in total joint arthroplasty

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World Journal of Orthopedics 2024年第4期15卷 318-320页

作者： Ashim Gupta Vijay Kumar Jain department of Orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States department of Orthopaedics South Texas Orthopaedic Research Institute(STORI Inc.)LaredoTX 78045United States department of Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States department of Orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301India department of Orthopaedics Atal Bihari Vajpayee Institute of Medical SciencesDr Ram Manohar Lohia HospitalNew Delhi 110001India

Surgical site infections(SSI)following total joint arthroplasty pose a significant concern for both providers and patients across the globe.Currently,administration of antimicrobial antibiotic prophylaxis is used throughout the world to reduce the incidence of SSI.However,the correct dosage and frequency of administration remains debatable.In this editorial,we emphasized the determination of the effect of administration of weight-adjusted antimicrobial antibiotic prophylaxis regime on the incidence of SSI and postoperative dosage reduction compared to the conventionally used regime during total joint arthroplasty.The results demonstrated similar efficacy between both regimes with respect to the incidence of SSI.In addition,weight-adjustment led to reduced postoperative dosage and has the potential to reduce chances of achieving lower therapeutic concentration,drug resistance,drug toxicity,and costs.

关键词： Antibiotics Antimicrobial prophylaxis Weight-adjusted Surgical site infections Total joint arthroplasty Knee arthroplasty Hip arthroplasty

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Multidisciplinary comprehensive treatment of massive hepatocellular carcinoma with hemorrhage:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2225-2232页

作者： Xian-Shuai Kou Fan-Fan Li Yun Meng Jian-Ming Zhao Sheng-Fen Liu Lan Zhang The First Clinical Medical College Gansu University of Chinese MedicineLanzhou 730000Gansu ProvinceChina department of Thoracic Surgery The First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina department of Surgery Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina department of Orthopedics Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC),a major contributor to cancer-related deaths,is particularly prevalent in Asia,largely due to hepatitis B virus infection.Its prognosis is generally poor.This case report contributes to the medical literature by detailing a unique approach in treating a large HCC through multidisciplinary collaboration,particularly in patients with massive HCC complicated by ruptured bleeding,a scenario not extensively documented previously.CASE SUMMARY The patient presented with large HCC complicated by intratumoral bleeding.Treatment involved a multidisciplinary approach,providing individualized care.The strategy included drug-eluting bead transarterial chemoembolization,sorafenib-targeted therapy,laparoscopic partial hepatectomy,and standardized sintilimab monoclonal antibody therapy.Six months after treatment,the patient achieved complete radiological remission,with significant symptom relief.Imaging studies showed no lesions or recurrence,and clinical assessments confirmed complete remission.This report is notable as possibly the first docu-mented case of successfully treating such complex HCC conditions through integrated multidisciplinary efforts,offering new insights and a reference for future similar cases.CONCLUSION This study demonstrated effective multidisciplinary treatment for massive HCC with intratumoral bleeding,providing insights for future similar cases.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Sintilimab Sorafenib Translational therapy Multidisciplinary team Case report

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Cellular angiofibroma arising from the rectocutaneous fistula in an adult: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1778-1784页

作者： Hao-En Chen Yu-Yang Lu Ruei-Yu Su Hong-Hau Wang Chao-Yang Chen Je-Ming Hu Jung-Cheng Kang Kuan-Hsun Lin Ta-Wei Pu department of Surgery Taichung Armed Forces General HospitalTaichung 411Taiwan department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan department of Pediatrics Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan department of Pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 32551Taiwan department of Radiology Tri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Rectocutaneous fistulae are common.The infection originates within the anal glands and subsequently extends into adjacent regions,ultimately resulting in fistula development.Cellular angiofibroma(CAF),also known as an angiomy ofibroblastoma-like tumor,is a rare benign soft tissue neoplasm predominantly observed in the scrotum,perineum,and inguinal area in males and in the vulva in females.We describe the first documented case CAF that developed within a rectocutaneous fistula and manifested as a perineal mass.CASE SUMMARY In the outpatient setting,a 52-year-old male patient presented with a 2-year history of a growing perineal mass,accompanied by throbbing pain and minor scrotal abrasion.Physical examination revealed a soft,well-defined,non-tender mass at the left buttock that extended towards the perineum,without a visible opening.The initial assessment identified a soft tissue tumor,and the laboratory data were within normal ranges.Abdominal and pelvic computed tomography(CT)revealed swelling of the abscess cavity that was linked to a rectal cutaneous fistula,with a track-like lesion measuring 6 cm×0.7 cm in the left perineal region and attached to the left rectum.Rectoscope examination found no significant inner orifices.A left medial gluteal incision revealed a thick-walled mass,which was excised along with the extending tract,and curettage was performed.Histopathological examination confirmed CAF diagnosis.The patient achieved total resolution during follow-up assessments and did not require additional hospitalization.CONCLUSION CT imaging supports perineal lesion diagnosis and management.Perineal angiofibromas,even with a cutaneous fistula,can be excised transperineally.

关键词： Angiofibroma Perineal mass Rectocutaneous fistula Anorectal fistula Anal fistula Case report

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Outcomes of early versus late irrigation and debridement of pediatric open long bone fractures

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World Journal of Orthopedics 2024年第6期15卷 539-546页

作者： Riya Savla Yen-Hong Kuo Nasim Ahmed department of Surgery and Trauma Hackensack Meridian School of MedicineNutleyNJ 07110United States department of Medical Sciences Hackensack Meridian School of medicineNutleyNJ 08753United States Office of Research Administration Hackensack Meridian Health Research InstituteNutleyNJ 077110United States department of Surgery Department of Trauma and Surgical Critical CareJersey Shore University Medical CenterNeptuneNJ 07754United States department of Surgery Department of Trauma and Surgical Critical CareHackensack Meridian School of MedicineNutleyNJ 07110United States

BACKGROUND Open long bone fractures are a major concern for pediatric patients due to the risk of surgical site infection(SSI).Early studies have recommended irrigation and debridement of open fractures within 6 hours-8 hours for the prevention of SSI.According to the American College of Surgeons(ACS)Best Practice Guidelines,in 2015,irrigation and debridement should be done within 24 hours.AIM To identify whether early irrigation and debridement,within 8 hours,vs late,between 8 hours and 24 hours,for pediatric open long bone fractures impacts rate of SSI.METHODS Using retrospective data review from the National Trauma Data Bank,Trauma Quality Improvement Project(TQIP)of 2019.TQIP database is own by the ACS and it is the largest database for trauma quality program in the world.Propensity matching analysis was performed for the study.RESULTS There were 390 pediatric patients with open long bone fractures who were incl-uded in the study.After completing propensity score matching,we had 176 patients in each category,irrigation and debridement within 8 hours and irrigation and debridement between 8 hours and 24 hours.We found no significant differences between each group for the rate of deep SSI which was 0.6%for patients who received surgical irrigation and debridement within 8 hours and 1.1%for those who received it after 8 hours[adjusted odd ratio(AOR):0.5,95%CI:0.268-30.909,P>0.99].For the secondary outcomes studied,in terms of length of hospital stay,patients who received irrigation and debridement within 8 hours stayed for an average of 3.5 days,and those who received it after 8 hours stayed for an average of 3 days,with no significant difference found,and there were also no sig-nificant differences found between the discharge dispositions of the patients.CONCLUSION Our findings support the recommendation for managing open long bone fractures from the ACS:Complete surgical irrigation and debridement within 24 hours.

关键词： Pediatric trauma Open tibia fracture Irrigation and debridement Timing of intervention Surgical site infection

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Tenosynovitis of hand: Causes and complications

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World Journal of Clinical Cases 2024年第4期12卷 671-676页

作者： Sathish Muthu Saravanan Annamalai Velmurugan Kandasamy department of Orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia Orthopaedic Research Group Coimbatore 641045Tamil NaduIndia department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia department of Orthopaedics Government Thiruvallur Medical CollegeThiruvallur 631203Tamil NaduIndia department of Orthopaedics Government Kilpauk Medical CollegeChennai 600010Tamil NaduIndia

Tenosynovitis represents a common clinical condition characterized by inflam-mation of the synovium that encases the tendon sheath.Although tenosynovities may be noted in any tendon in the body,extremities such as hand,and foot remain the sites of high predilection to acquire this condition.The predominant cause of this predilection rests in the intricate tendon arrangements in these extremities that permit fine motor actions.This editorial explores the common causes and the complications associated with this condition to improve the understanding of the readers of this common condition encountered in our everyday clinical practice.

关键词： Tenosynovitis Gout Hand Complications infection

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HIV-1 DNA levels in peripheral blood mononuclear cells of patients with HIV-related non-Hodgkin’s lymphoma

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Chinese Medical Journal 2023年第22期136卷 2741-2743页

作者： Zhenyan Wang Jingna Xun Zichen Song Yinzhong Shen Li Liu Jun Chen Tangkai Qi Jianjun Sun Wei Song Yang Tang Shuibao Xu Junyang Yang Bihe Zhao Renfang Zhang department of infection and Immunity Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China

To the Editor:Human immunodeficiency virus(HIV)patients have an increased risk of non-Hodgkin’s lymphoma(NHL),even in the era of antiretroviral therapy(ART).[1]The specific mechanisms of HIVrelated NHL(HIV-NHL)remain unclear.It is currently thought that HIV causes lymphoma primarily through chronic immune activation and an increased risk of infection with oncoviruses.In addition,HIV may have some other mechanisms that directly contribute to the occurrence of lymphoma.[2]Even with sustained ART,HIV-DNA remains in infected cells,creating a persistent reservoir of HIV infection.It is not known whether HIV reservoirs are involved in the development of HIV-NHL.In the present study,we detected HIV-1 DNA levels in peripheral blood mononuclear cells(PBMCs)and plasma inflammatory cytokines levels in HIV-NHL,and then evaluated their effects on HIV-NHL development and prognosis.

关键词： lymphoma patients sustained

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Predictive model using four ferroptosis-related genes accurately predicts gastric cancer prognosis

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2018-2037页

作者： Li Wang Wei-Hua Gong department of Emergency The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina department of Surgery The Second Affiliated Hospital Zhejiang University School of MedicineHangzhou 310052Zhejiang ProvinceChina

BACKGROUND Gastric cancer(GC)is a common malignancy of the digestive system.According to global 2018 cancer data,GC has the fifth-highest incidence and the thirdhighest fatality rate among malignant tumors.More than 60%of GC are linked to infection with Helicobacter pylori(H.pylori),a gram-negative,active,microaerophilic,and helical bacterium.This parasite induces GC by producing toxic factors,such as cytotoxin-related gene A,vacuolar cytotoxin A,and outer membrane proteins.Ferroptosis,or iron-dependent programmed cell death,has been linked to GC,although there has been little research on the link between H.pylori infection-related GC and ferroptosis.AIM To identify coregulated differentially expressed genes among ferroptosis-related genes(FRGs)in GC patients and develop a ferroptosis-related prognostic model with discrimination ability.METHODS Gene expression profiles of GC patients and those with H.pylori-associated GC were obtained from The Cancer Genome Atlas and Gene Expression Omnibus(GEO)databases.The FRGs were acquired from the FerrDb database.A ferroptosis-related gene prognostic index(FRGPI)was created using least absolute shrinkage and selection operator–Cox regression.The predictive ability of the FRGPI was validated in the GEO cohort.Finally,we verified the expression of the hub genes and the activity of the ferroptosis inducer FIN56 in GC cell lines and tissues.RESULTS Four hub genes were identified(NOX4,MTCH1,GABARAPL2,and SLC2A3)and shown to accurately predict GC and H.pylori-associated GC.The FRGPI based on the hub genes could independently predict GC patient survival;GC patients in the high-risk group had considerably worse overall survival than did those in the low-risk group.The FRGPI was a significant predictor of GC prognosis and was strongly correlated with disease progression.Moreover,the gene expression levels of common immune checkpoint proteins dramatically increased in the highrisk subgroup of the FRGPI cohort.The hub genes were also confirmed to be highly overexpressed in GC cell line

关键词： Ferroptosis Gastric cancer Helicobacter pylori infection Immune checkpoint protein Prognostic model Ferroptosis-related gene prognostic index

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Effects of different intervention methods on psychological flexibility,negative emotions and sleep quality in chronic hepatitis B

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World Journal of Psychiatry 2023年第10期13卷 753-762页

作者： Ying Zheng Xiao-Wei Wang Chen-Xi Xia department of infection The First People’s Hospital of WenlingWenling 317500Zhejiang ProvinceChina

BACKGROUND Patients with chronic hepatitis B(CHB)experience various problems,including low psychological flexibility,negative emotions,and poor sleep quality.Therefore,effective nursing interventions are required to reduce adverse events.Acceptance and commitment therapy(ACT)combined with enabling cognitivebehavioral education(ECBE)can improve patients'psychological and sleep.Therefore,we speculate that this may also be effective in patients with CHB.AIM To investigate the effects of different intervention methods on psychological flexibility,negative emotions,and sleep quality in patients with CHB.METHODS This retrospective study examined clinical and evaluation data of 129 patients with CHB.Intervention methods were divided into a conventional group(routine nursing,n=69)and a combination group(ACT combined with ECBE,n=60).We observed changes in psychological flexibility,negative emotions,sleep quality,and self-care ability in both groups.Observation items were evaluated using the Acceptance and Action Questionnaire-2nd Edition(AAQ-II),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),and Exercise of Self-Care Agency Scale(ESCA).RESULTS Compared with the conventional group,the AAQ-II score of the combined group was lower(F_(between-group effect)=8.548;F_(time effects)=25.020;F_(interaction effects)=52.930;all P<0.001),the SAS score(t=5.445)and SDS score(t=7.076)were lower(all P<0.001),as were the PSQI dimensions(tsleep quality=4.581,tfall sleep time=2.826,tsleep time=2.436,tsleep efficiency=5.787,tsleep disorder=5.008,thypnotic drugs=3.786,tdaytime dysfunction=4.812);all P<0.05).The ESCA scores for all dimensions were higher(thealth knowledge level=6.994,t self-concept=5.902,tself-responsibility=19.820,tself-care skills=8.470;all P<0.001).CONCLUSION ACT combined with ECBE in patients with CHB can improve psychological flexibility and sleep quality,alleviate negative emotions,and improve self-care.

关键词： Acceptance and commitment therapy Empowerment cognitive-behavioral education Chronic hepatitis B Psychological flexibility Negative emotion Sleep quality

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Efficacy and safety of carrimycin in ten patients with severe pneumonia following solid organ transplantation

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World Journal of Clinical Cases 2024年第15期12卷 2542-2550页

作者： Xian-Quan Cui Lu-Wei Zhang Peng Zhao Jing-Jing Feng department of Organ Transplantation Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina department of Blood Purification Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina

BACKGROUND The number of patients undergoing solid organ transplantation has increased annually.However,infections in solid organ transplant recipients can have a severe effect on patient survival owing to the continued use of immunosuppressants.Carrimycin is a novel macrolide antibiotic produced by genetically engineered streptomyces spiramyceticus harboring a 4’’-O-isovaleryltransferase gene(ist)from streptomyces thermotoleran.Carrimycin has good antibacterial and antiviral effects.However,no relevant studies have been conducted on the efficacy and safety of carrimycin in patients with severe pneumonia(SP)after solid organ transplantation.AIM To explore the efficacy and safety of carrimycin in patients with SP after solid organ transplantation to provide a medication reference for clinical treatment.METHODS In March 2022,ten patients with SP following solid-organ transplantation were treated at our hospital between January 2021 and March 2022.When the condition was critical and difficult to control with other drugs,carrimycin was administered.These ten patients'clinical features and treatment protocols were retrospectively analyzed,and the efficacy and safety of carrimycin for treating SP following solid organ transplantation were evaluated.RESULTS All ten patients were included in the analysis.Regarding etiological agent detection,there were three cases of fungal pneumonia,two cases of bacterial pneumonia,two cases of Pneumocystis pneumonia,and three cases of mixed infections.After treatment with carrimycin,the disease in seven patients significantly improved,the course of the disease was significantly shortened,fever was quickly controlled,chest computed tomography was significantly improved,and oxygenation was significantly improved.Finally,the patients were discharged after curing.One patient died of acute respiratory distress syndrome,and two patients discontinued treatment.CONCLUSION Carrimycin is a safe and effective treatment modality for SP following solid organ transplantation.Carrimycin may have anti

关键词： Carrimycin Organ transplantation Severe pneumonia Immunosuppressant infection Antiviral drugs

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