• Coffey Blanton opublikował 5 miesięcy, 1 tydzień temu

    BACKGROUND Chronic osteomyelitis is a serious complication of orthopedic trauma. Residual bacteria after incomplete debridement and/or bacterial colonization, bacterial biofilm formation, and generation of antibiotic-resistant bacterial strains in the microtubule system of compact bones due to irrational use of antibiotics often make the condition more prolonged, recurrent, and refractory. The passive immunotherapy targeting the protein components of bacteria has become an area of intense research interest, for which identifying the bacterial isolates in different areas at different time points remains a key step. Few multicenter randomized controlled trials have investigated the epidemiological data of pathogens in different areas, and there is a lack of timely and dynamic data that can inform clinical treatment. METHODS A total of 5,268 patients with limb fractures were treated in our center from January 1, 2012, to December 31, 2015, among whom 108 were diagnosed with post-traumatic osteomyelitis (PTO) basycin; 48 strains of gram-negative bacteria (46.1%), among which Escherichia coli (n=16, 15.4%) and Enterobacter cloacae (n=11, 10.6%) were the most common bacteria, with both being sensitive to thiomycin; mixed infections were detected in 18 cases (21.4%). CONCLUSIONS The incidence of PTO in the Zunyi area is similar to the national level. The most common site of infection is the lower extremity. Bacterial infections (mainly infection caused by a single bacterial type) were observed in 77.8% of the cases. Staphylococcus aureus is the most common pathogenic bacteria, followed by Escherichia coli and Enterobacter cloacae. The antibiotic-resistant bacteria have characteristic distributions in different regions.BACKGROUND The emerging infection of the 2019 novel coronavirus (2019-nCoV) in late December, 2019 in Wuhan, China, has caused an extreme health concern, with many patients having progressed to acute respiratory disease or other complications in a short period. Meanwhile, the risk factors associated with the disease progression still remain elusive. METHODS A cohort of 17 patients with laboratory-confirmed 2019-nCoV infections who were admitted to the Ninth Hospital of Nanchang between January 28 and February 6, 2020, were enrolled in this study. All the patients received standardized treatment. The disease progression was evaluated every 7 days after admission. The clinical, radiologic, and laboratory characteristics were retrospectively analyzed, and the factors associated with the disease progression were screened by binary logistic regression analysis. RESULTS The cohort comprised 11 women (64.7%) and 6 men (35.3%) between the ages of 18 to 70 years old. All patients had a reported history of contact withrogenase (LDH), and D-dimer. Finally, a binary logistic regression model was used to identify the factors associated with the disease progression. It was found that total lymphocyte count was a risk factor associated with disease progression in patients infected with 2019-nCoV. CONCLUSIONS A higher cell count of total lymphocytes may indicate a better outcome of the disease, and immune response may be a vital factor for directing disease progression in the early stage of 2019-nCoV infection.BACKGROUND The novel coronavirus named COVID-19, which originated in Wuhan, China, has spread to many countries around the world. Currently, no effective medical treatment exists to combat this disease. Traditional Chinese herbal medicines (CHM) have unique roles in the treatment of viral infections. In this article we analyzed the effectiveness and possible molecular mechanisms of CHM formulas for the prevention of COVID-19. METHODS The active ingredients and action targets of CHM formulas were obtained from the TCMSP database. Genes related to severe acute respiratory syndromes (SARS) and Middle East respiratory syndrome (MERS) were queried on the GeneCards database. The action mechanisms of these genes were predicted using a Gene Ontology (GO)-based functional enrichment and annotation tool and the Kyoto Encyclopedia of Genes and Genomes (KEGG). RESULTS CHM formulas played a positive role in preventing COVID-19 and warrant further application. CONCLUSIONS Our research provides new evidence to support the possible value of CHM formulas for the prevention of COVID-19. However, further clinical studies with large sample sizes are required to verify their effectiveness.BACKGROUND To analyze whether face-to-face education before colonoscopy improves the quality of bowel preparation and increases the detection of adenomas. METHODS A retrospective cross-sectional study of adult patients with colorectal polyps identified by colonoscopy as outpatients was performed. The patients underwent an added colonoscopy inpatient for resection of colorectal polyps. As outpatients, we gave the patients written bowel preparation instructions; however, when they were inpatients, we supplied face-to-face education. We analyzed the data from the two colonoscopies of the same group of patients out- and in-patients, including the quality of the intestinal preparation, the time to reach the ileocecal region, and the detection of adenomas. RESULTS A total of 260 patients age 63 [56, 68] years old, male/female (169/91) were retrospectively included in our study. Two hundred fifty-two patients with a total of 685 adenomas were detected, 94 patients with 179 adenomas overlooked in the first colonoscopy. The BBPS Score during inpatient was higher than that during outpatient, 9 [8, 9] vs. 7 [6, 9], P less then 0.05, the Bubble Score during inpatient was lower than that during outpatient [0 (0.00, 0.00) vs. 0 (0.00, 1.00)], P less then 0.05. The time to reach the ileocecal region during inpatient is shorter than that during outpatient 6 [5, 9] vs. 7.5 [5, 11] min, P less then 0.05. Poor bowel preparation, flat adenoma morphology, and adenoma diameter lower than 5mm were related adenoma misdiagnoses, P less then 0.05. CONCLUSIONS Face-to-face patient education can improve the quality of bowel preparation, then shorten the time to reach the ileocecal region, and increase detection of colorectal adenomas.BACKGROUND To evaluate and analyze the therapeutic effect of stereotactic soft channel puncture and drainage on hypertensive cerebral hemorrhage. METHODS Sixty patients with hypertensive cerebral hemorrhage admitted to our hospital from September 2014 to September 2019 were selected for study and randomly divided into study group (n=30) and routine group (n=30) according to admission number. Two groups of patients were given basic treatment after admission, while routine group patients were given small bone window hematoma removal, study group patients were given stereotactic soft channel puncture and drainage, and the clinical effects of the two groups were analyzed. RESULTS The total effective rate of the study group was 96.67%, which was significantly higher than that of the routine group (80.00%), and the difference was statistically significant (P0.05). After treatment, the CD8+ positive cell rate in the study group was lower than that in the conventional group, and the CD3+ positive cell rate was higher than that in the conventional group, with statistically significant difference (P less then 0.05). The incidence of postoperative complications such as pulmonary infection, urinary tract infection, liver and kidney dysfunction in the study group was lower than that in the conventional group, and the difference was statistically significant (P less then 0.05). CONCLUSIONS Stereotactic soft-channel puncture and drainage has the advantages of less trauma, less bleeding, fewer complications and rapid postoperative recovery. It can be used for the treatment of hypertensive cerebral hemorrhage, promote the recovery of neurological function of patients, improve independent living standard and effectively improve prognosis.BACKGROUND To investigate the imaging findings of bladder paraganglioma (BPG) and improve the imaging recognition and diagnostic accuracy of the disease. METHODS The clinical and imaging data of 10 cases of BPG confirmed by operation and pathology were retrospectively analyzed from the aspects of tumor location, size and morphology, presence or absence of necrosis, cystic change and calcification, and enhancement methods. RESULTS Of the 10 cases, 7 cases underwent basal and contrast enhanced computed tomography (CT) scan examination, 1 case underwent basal and contrast enhanced MRI scan examination, and 9 cases underwent ultrasonography examination; 5 cases were located in the right wall of bladder, 3 cases were located in the left wall, and 2 cases were located in the bottom wall; 2 cases showed necrosis, 1 case had cystic degeneration, and 2 cases had arcuate and semicircular calcification; both contrast enhanced CT and MRI examinations showed significant post-contrast enhancement; in 9 cases of ultrasonography examination, 5 cases had hypoechoic mass, 3 cases had moderate echoic mass, and 1 case had hyperechoic mass. CONCLUSIONS The imaging findings of BPG have certain characteristics, and combining with clinical history is helpful for accurate preoperative diagnosis.Advanced intrahepatic cholangiocarcinoma (ICC) is a highly challenging malignancy characterized by rapid progression and poor prognosis. Although programmed cell death-1/programmed cell death1 ligand-1 (PD-1/PD-L1) inhibitors licensed abroad have achieved certain effectiveness in treating various tumors, few studies have investigated the efficacies of these drugs on advanced ICC. Here, we describe a 63-year-old female patient with stage IV ICC involving the porta hepatis, retroperitoneal lymph nodes, and left adrenal gland, along with right femur metastasis. She suffered from lower back pain that had affected her sleep. A pathological fracture of her right femur was detected. Multiple lymph node metastases were found in the left adrenal glands, porta hepatis, and retroperitoneum. She failed the first- and secondline chemotherapies. After 6 cycles of combined therapy with sintilimab injection (PD-1) and tegafurgimeracil-oteracil potassium capsules (S-1), the patient’s condition gradually improved and finally achieved partial remission (PR). The patient’s pain score decreased, and her quality of life was significantly improved. The third-line treatment was efficacious and significantly improved survival. We can therefore speculate that PD-1 plays an important role in the treatment of advanced ICC and can benefit patients with similar conditions.Recently high-frequency electric knife and abdominal binder are widely used in the abdominal operation in China. Nevertheless, with the high occurrence of the abdominal wound, we think that whether both these operations could be used or not. Here, we report the case of a 40-year-old female patient where negative pressure wound therapy (NPWT) was applied to her dehisced abdominal wound as well as fat liquefaction and large skin necrosis with pleasing results. The patient with high fever was referred to our department from her earlier hospital for 6 days after cesarean delivery. During the surgery, her earlier doctor used a high-frequency electric knife for convenient-using, and after the operation, the patient immediately used an abdominal binder for good shape. However, the abdominal surgical incision was opened at postoperative day 3, with fat liquefaction releasing large fatty acids along both abdominal sides with penetration under the abdominal binder. After admitted at postoperative day 6 with aggravating wound, surgery was considered because of no reduction in the size of the wound.

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