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The clinical characteristics and risk factors for necrotizing soft tissue infection in children

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Pediatric Investigation 2024年第1期8卷 21-26页

作者： Jing Liu Jigang Chen Yanni Wang Hongyan Qi Jing Yu Department of burn and Plastic Surgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Importance:Necrotizing soft tissue infection(NSTI)is a serious infectious ***,the early clinical manifestations and indicators of NSTI in children are still ***:The purpose of this study was to analyze the clinical characteristics and risk factors of NSTI in pediatric ***:A total of 127 children with skin and soft tissue infection(SSTI)were treated at our hospital and divided into two groups:the NSTI group and the non-NSTI group,based on their discharge diagnosis from January 2011 to December ***,we collected and analyzed the clinical characteristics and risk factors of all patients,including sex and age,disease inducement,admission temperature,local skin manifestations,infection site,the presence of sepsis,bacterial culture,and laboratory ***:In our study,there was a statistical difference in the age distribution and disease inducement between NSTI and non-NSTI *** occurrence of local skin manifestations(blisters/bullae and ecchymosis)and the presence of sepsis significantly increased in the NSTI group compared to the non-NSTI ***,only the platelet count on laboratory tests was statistically different between the NSTI and non-NSTI ***,the logistic regression analysis suggested that local skin manifestations such as blisters/bullae,and ecchymosis,as well as the presence of sepsis,were identified as risk factors for ***:Children with SSTI and skin manifestations such as blisters/bullae,ecchymosis,and the presence of sepsis are at a higher risk of developing *** symptoms serve as useful indicators for early detection of NSTI.

关键词： Clinical characteristics Risk factors Necrotizing soft tissue infection Skin andsofttissueinfection

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Study on the Mechanism of Glutamine Promoting the Synthesis of Colonic Mucin and Maintaining the Stability of Intestinal Microbiota in Septic Mice

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Food Science and Human Wellness 2024年

作者： Yanyan Pan Gang Yang Dan Wu Yan Wei Shijun Fan Lin Xia Qian Chen Qianying Huang Yongling Lu Xi Peng Clinical Medical Research Center Southwest hospital Third Military Medical University (Army Medical University) burn Department Ningbo No.2 hospital nstitute of burn Research State Key Laboratory of Trauma and Chemical Poisoning Southwest hospital Third Military Medical University (Army Medical University)

Colonic mucus and gut microbiota closely linked through mutual regulatory effect. While their alterations during sepsis and whether glutamine can maintain the colonic mucus barrier and gut microbiota stability are unclear. Cecal ligation and puncture-induced sepsis in mice was utilized to observe changes in colonic mucus， gut microbiota， and their interaction with glutamine intervention. Our findings indicated that glutamine mitigated sepsis-induced intestinal damage and restores colonic mucus barrier function by augmenting mucin synthesis. Further analysis revealed that goblet cells were under oxidative stress after sepsis， resulting in anterior gradient-2 (AGR2)， the key mucin-modifying enzyme， being dissynthesized， and inhibiting mucin2 (MUC2) maturation. glutamine could ameliorates this situation by promoting the key enzyme glucose-6-phosphate dehydrogenase (G6PD) glycosylation in the pentose phosphate pathway， increasing the reduced nicotinamide adenine dinucleotide phosphate (NADPH) synthesis， reducing endoplasmic reticulum stress， and accelerating AGR2 synthesis and MUC2 maturation. Additionally， glutamine aided in maintaining gut microbiota stability during sepsis， up-regulating mucin-associated bacteria such as Akkermansia and Alistipes. These bacteria， intimately linked to mucin synthesis and degradation， may impact intestinal mucus stability. In conclusion， glutamine can maintain goblet cell redox balance， promotes AGR2 synthesis and MUC2 maturation， shields the mucus barrier， and potentially maintains gut microbiota stability by regulating the interaction between bacteria and mucus， thus alleviating sepsis-induced intestinal damage.

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Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports

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World Journal of Clinical Cases 2024年第4期12卷 865-871页

作者： Yi-Meng Sun Wang Xin Yu-Fang Liu Zhe-Ming Guan Hao-Wen Du Ning-Ning Sun Yong-Dong Liu School of Clinical Medicine Weifang Medical UniversityWeifang 261000Shandong ProvinceChina Department of Pediatric Surgery Weifang People’s HospitalWeifang 261000Shandong ProvinceChina Department of burn Surgery Weifang People’s HospitalWeifang 261000Shandong ProvinceChina

BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and *** date,only a few cases have been reported *** children,the clinical symptoms are similar to *** most of the imaging features are nonspecific,the preoperative diagnosis is not *** addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric *** with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal *** SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular *** three patients,aged 11-12 years,had acute appendicitis as their initial clinical *** were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also *** Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in *** combined with laparotomy is useful for diagnosis and treatment.

关键词： Meckel’s diverticulum Complications Intestinal obstruction Perforation Appendicitis in children Mesodiverticular band Ligament Diverticular disease Case report

Click-hydrogel delivered aggregation-induced emissive nanovesicles for simultaneous remodeling and antibiosis of deep burn wounds

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Aggregate 2024年第1期5卷 244-256页

作者： Xu Chen Meijiao Zhao Qihu Xie Sitong Zhou Xiaoping Zhong Judun Zheng Ronghua Yang Xianjin Du Jinyu Xia Yuhui Liao Department of Infectious Diseases The Fifth Affiliated HospitalSun Yat-sen UniversityZhuhaiChina Molecular Diagnosis and Treatment Center for Infectious Diseases Dermatology HospitalSouthern Medical UniversityGuangzhouChina Department of burns and Plastic Surgery The Second Affiliated Hospital of Shantou University Medical CollegeShantouChina Department of Dermatology TheFirst People’s Hospital of FoshanFoshanChina Department of burn and Plastic Surgery Guangzhou First People’s HospitalSouth China University of TechnologyGuangzhouChina Department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhanChina

As a high-risk trauma,deep burns are always hindered in their repair process by decreased tissue regeneration capacity and persistent *** this study,we developed a simultaneous strategy for deep burn wounds treatment using functional nanovesicles with antibacterial and tissue remodeling properties,delivered via a click-chemistry *** aggregation-induced emission photosensitizer of 4-(2-(5-(4-(diphenylamino)phenyl)thiophen-2-yl)vinyl)-1-(2-hydroxyethyl)pyridin-1-ium bromide(THB)with excellent photodynamic properties was first prepared,and then combined with readily accessible adipose stem cells-derived nanovesicles to generate the THB functionalized nanovesicles(THB@ANVs).The THB@ANVs showed strong antibacterial activity against Gram-positive bacteria(up to 100%killing rate),and also beneficial effects on tissue remodeling,including promoting cell migration,cell proliferation,and regulating *** addition,we prepared a click-hydrogel of carboxymethyl chitosan for effective delivery of THB@ANVs on *** hydrogel could be injected to conform to the wound morphology while responding to the acidic *** vivo evaluations of wound healing revealed that the THB@ANVs hydrogel dressing efficiently accelerated the healing of second-degree burn wounds by reducing bacterial growth,regulating inflammation,promoting early angiogenesis,and collagen *** study provides a promising candidate of wound dressing with diverse functions for deep burn wound repair.

关键词： aggregation-induced emission burn wounds nanovesicles

Efficacy and safety of clarithromycin for patients with sepsis or septic shock:a systematic review and meta-analysis

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Emergency and Critical Care Medicine 2024年第2期4卷 90-96页

作者： Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du Department of General Surgery First Medical Center of the Chinese PLA General HospitalBeijingChina Translational Medicine Research Center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General HospitalBeijingChina Department of burn Surgery the First Affiliated Hospital of Naval Medical UniversityShanghaiChina Department of General Surgery Hainan Hospital of Chinese PLA General HospitalSanyaHainanChina

Background:Clarithromycin exerts an immunomodulatory role in several human ***,whether this effect improves the prognosis in patients with sepsis remains controversial,and higher levels of clinical evidence are urgently *** the best of our knowledge,no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in ***:A comprehensive literature search of PubMed,EMBASE,and the Cochrane Library was conducted up to December 31,*** randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were *** were pooled by applying a fixed-effects model and a relative risk(RR)estimate with 95%confidence intervals(CIs)using Review Manager(version 5.3;Cochrane Collaboration,Copenhagen,Denmark).Results:Three randomized controlled trials involving a total of 910 patients were *** pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome(RR:1.51;95%CI:1.02-2.25;P=0.04;I^(2)=0%),28-day mortality(RR:1.09;95%CI:0.87-1.36;P=0.46;I^(2)=0%),and 90-day mortality(RR:0.86;95%CI:0.71-1.03;P=0.10;I^(2)=81%)in patients with sepsis or septic ***,there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group(RR:1.02;95%CI:0.87-1.19;P=0.83;I^(2)=18%).Conclusion:Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with ***,administration of clarithromycin did not increase the risk of adverse events.

关键词： Clarithromycin Meta-analysis Outcomes Sepsis Septic shock

Risk Factors of Enternal Nutrition Intolerance in Septic Patients:A Case-control Study

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Current Medical Science 2024年第2期44卷 328-332页

作者： Li-zhu WANG Yan XIANG Qian LI Yi-rong ZHU Jue FANG Xiao-dan LU Zhao-cai ZHANG Department of Nursing The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China Department of Critical Care Medicine The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China Key Laboratory of the Diagnosis and Treatment for Severe Trauma and burn of Zhejiang Province Hangzhou 310009China Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine Hangzhou 310009China

Objective:This study aimed to investigate the incidence of enteral nutrition intolerance(ENI)in patients with sepsis and explore potential risk ***:A case-control study was conducted in patients with sepsis who were receiving enteral nutrition(EN)at a tertiary hospital in *** included patients were divided into the ENI group and the non-ENI *** and multivariate analyses were performed to identify the risk factors for ***:A total of 859 patients were included in the *** them,288(33.53%)patients experienced symptoms of ENI,including diarrhea,vomiting,bloating,and gastric *** regression analysis revealed that the Acute Physiology and Chronic Health Evaluation H(APACHE H)score,thoracocentesis,and usage of cardiotonic drugs(namely,inotropes)were independent predictors of the ***:The incidence of ENI is relatively high in patients with sepsis,especially in those who have higher APACHE H scores,have undergone thoracocentesis,and have received inotropes.

关键词： sepsis enteral nutrition intolerance influencing factor

Advances in the Treatment of Bromhidrosis

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Journal of Biosciences and Medicines 2024年第7期12卷 281-288页

作者： Jiangpeng Huang Yongfang Wu Graduate School Youjiang Medical University for Nationalities Baise China Department of burn and Plastic Surgery Affiliated Southwest Hospital of Youjiang Medical University for Nationalities Baise China

Armpit odor is a common disease with genetic tendency in cosmetic surgery. The odor emitted by it often affects the quality of life and social communication of patients, leading to psychological disorders in patients and seriously jeopardizing their mental health. With the continuous development and progress of medicine, there are many ways to treat armpit odor at present, but there is still no perfect way to treat armpit odor. This article reviews the progress of treatment methods in recent years.

关键词： Bromhidrosis Treatment Research Progress

Glibenclamide pretreatment attenuates early hematoma expansion of warfarin-associated intracerebral hemorrhage in rats by alleviating perihematomal blood-brain barrier dysfunction

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Chinese Neurosurgical Journal 2024年第1期10卷 8-19页

作者： Zongwei Zeng Liang Liang Zhou Feng Peiwen Guo Xiaoke Hao Jishu Xian Hua Feng Yujie Chen Zhi Chen Department of Neurosurgery and State Key Laboratory of Trauma Burn and Combined InjurySouthwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Department of Neurosurgery The 945Th Hospital of PLAYaanSichuan Province 625099China Department of Rehabilitation Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Key Laboratory of Precision Neuromedicine and Neuroregeneration Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Clinical Research Center for Neurosurgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China

Background Hematoma expansion is a determinant of poor outcome of intracerebral hemorrhage but occurs frequently,especially in warfarin-associated intracerebral hemorrhage(W-ICH).In the present study,we employ the warfarin-associated intracerebral hemorrhage(W-ICH)rat model,to explore the efficacy and potential mechanism of glibenclamide pretreatment on hematoma expansion after intracerebral hemorrhage,hoping to provide proof of concept that glibenclamide in stroke primary and secondary prevention is also potentially beneficial for intracerebral hemorrhage patients at early *** In the present study,we tested whether glibenclamide,a common hypoglycemic drug,could attenuate hematoma expansion in a rat model of *** expansion was evaluated using magnetic resonance imaging;brain injury was evaluated by brain edema and neuronal death;and functional outcome was evaluated by neurological *** blood-brain barrier integrity was assessed using Evans blue extravasation and tight junction-related *** The data indicated that glibenclamide pretreatment significantly attenuated hematoma expansion at 24 h after W-ICH,thus mitigating brain edema and neuronal death and promoting neurological function recovery,which may benefit from alleviating blood-brain barrier disruption by suppressing matrix *** The results indicate that glibenclamide pretreatment in stroke primary and secondary prevention might be a promising therapy for hematoma expansion at the early stage of W-ICH.

关键词： Intracerebral hemorrhage Warfarin Glibenclamide Hematoma expansion Blood-brain barrier Matrix metallopeptidase-9

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The expression mechanism of programmed cell death 1 ligand 1 and its role in immunomodulatory ability of mesenchymal stem cells

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Chinese Journal of Traumatology 2024年第1期27卷 1-10页

作者： Zhuo Chen Meng-Wei Yao Xiang Ao Qing-Jia Gong Yi Yang Jin-Xia Liu Qi-Zhou Lian Xiang Xu Ling-Jing Zuo Department of Stem Cell&Regenerative Medicine State Key Laboratory of TraumaBurn and Combined InjuryDaping HospitalArmy Medical UniversityChongqing400042China College of Basic Medical Sciences Army Medical UniversityChongqing400038China Department of Orthopedics 953 Hospital of PLAShigatse Branch of Xinqiao HospitalArmy Medical UniversityShigatse857000Tibet Autonomous RegionChina Department of Rheumatology and Immunology Daping HospitalArmy Medical UniversityChongqing400042China Department of Obstetrics and Gynecology Chongqing People's HospitalChongqing401121China Department of Medicine Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina Department of Nuclear Medicine The First People's Hospital of Yunnan provinceAffiliated Hospital of Kunming University of Science and TechnologyKunming650034China

Programmed cell death 1 ligand 1(PD-L1)is an important immunosuppressive molecule,which inhibits the function of T cells and other immune cells by binding to the receptor programmed cell *** PD-L1 expression disorder plays an important role in the occurrence,development,and treatment of sepsis or other inflammatory diseases,and has become an important target for the treatment of these *** stem cells(MSCs)are a kind of pluripotent stem cells with multiple differentiation *** recent years,MSCs have been found to have a strong immunosuppressive ability and are used to treat various inflammatory insults caused by hyperimmune ***,PD-L1 is deeply involved in the immunosuppressive events of MSCs and plays an important role in the treatment of various *** this review,we will summarize the main regulatory mechanism of PD-L1 expression,and discuss various biological functions of PD-L1 in the immune regulation of MSCs.

关键词： PD-L1 MSCs Immunomodulation

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