Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patie...Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.展开更多
Foreign body(FB) ingestion is very common in Malaysian population.The most commonly ingested FB is fish bone.Common presenting symptoms include FB sensation,odynophagia and or sharp pricking pain during swallowing.A c...Foreign body(FB) ingestion is very common in Malaysian population.The most commonly ingested FB is fish bone.Common presenting symptoms include FB sensation,odynophagia and or sharp pricking pain during swallowing.A careful history and physical examination is very important.Despite negative laryngoscopy and rigid esophagoscopy,persistent symptoms warrants further radiographic imaging studies.The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract.We report 3 cases of extraluminal migration of fish bone and their complications,which were successfully managed.One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland,retropharyngeal and parapharyngeal abscess.展开更多
Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcom...Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.展开更多
Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall condition...Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall conditions are often overlooked,leading to diagnostic delays.Among them,umbilical abscesses are rare but require distinction from urachal abscesses due to differences in management.Patient’s concern:A 46-year-old woman presented with a one-week history of periumbilical pain unresponsive to analgesics.Diagnosis:Physical examination revealed localized tenderness and a positive Carnett’s sign.Computed tomographic images identified an umbilical abscess without evidence of urachal remnants,ruling out a urachal abscess.Interventions:The patient underwent abscess drainage and received cefalexin(1500 mg/day)for 28 days.Outcomes:The abscess resolved completely without recurrence.Lessons:Umbilical abscesses are rare and may be mistaken for urachal abscesses.A thorough clinical evaluation,including Carnett’s sign and imaging studies,is crucial for accurate diagnosis.Prompt differentiation facilitates appropriate management and prevents unnecessary interventions.展开更多
This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incid...This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incidence rate in Europe is lower than in developing countries,but it is a major complication with high morbidity,particularly in immunocompromised patients.They are most frequently caused by Enterobacterales infections,but hypervirulent Klebsiella strains are an emerging problem in Western countries.Amoebiasis has been a public health problem in Europe,primarily imported from other endemic foci.At the same time,this infection is becoming an emerging disease,as the number of infected patients who have not traveled to endemic areas is rising.Treatment options for hydatid liver cyst include chemotherapy,open or laparoscopic surgery,percutaneous treatment(percutaneous aspiration,re-aspiration and injection and its modification)and“wait and watch”strategy.Most hydatid liver cyst patients in Pillay et al’s study received surgical treatment,but several studies have confirmed the safety and efficacy of percutaneous aspiration,re-aspiration and injection.展开更多
In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous conditi...In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.展开更多
Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free...Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free(SPF)grade famale Sprague-Dawley(SD)rats(10-12 weeks,250-280 g)were randomly assigned to either a sham group(n=12)or a spinal cord injury model group(n=40).In the model group,DBND was induced through Hassan Shaker spinal cord transection at T10 level,with 24 rats meeting inclusion criteria and subse-quently randomized into DBND group(n=12)and EA intervention group(DBND+EA group,n=12).After spinal shock recovery(day 19 after modeling),DBND+EA group received EA treatment at Ciliao(BL32),Zhongji(RN3),and Sanyinjiao(SP6)acupoints for 20 min per ses-sion at 10/50 Hz frequencies,once daily for 10 d.Sham and DBND groups received anesthe-sia only without EA intervention.On day 29 post-modeling,all rats underwent urodynamic assessments,followed by hematoxylin and eosin(HE)staining,tandem mass tag(TMT)pro-teomics,and Western blot(WB)analysis of detrusor and bladder neck tissues.Differentially expressed proteins(DEPs)were defined as proteins with P<0.05,unique peptides≥2,and fold change>1.2 or<0.83.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway anal-ysis was performed using KOBAS 3.0(P<0.01),and protein-protein interaction(PPI)net-works were analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins(STRING)11.5 and Cytoscape 3.9.1.Results Compared with sham group,DBND group showed significantly elevated leak point pressure(LPP)and maximum cystometric capacity(MCC)(both P<0.01).EA treatment sig-nificantly reduced both LPP and MCC compared with DBND group(P<0.01 and P<0.05,re-spectively).HE staining revealed that EA reduced detrusor fibrosis and improved bladder neck inflammation.TMT proteomics identified 30 overlapping DEPs in detrusor and 59 over-lapping DEPs in bladder neck when comparing DBND+EA/DBND groups with sham group.In detrusor tissue,KEGG analysis revealed 10 significantly enriched pathways(P<0.01),in-cluding mitogen-activated protein kinase(MAPK)signaling pathway.PPI analysis showed 22 of 30 DEPs were interconnected.In bladder neck tissue,14 pathways were significantly en-riched(P<0.01),including relaxin signaling pathway,with 51 of 59 DEPs showing intercon-nections.Both TMT and WB validations demonstrated that compared with sham controls,DBND rats exhibited upregulated collagen type IV alpha 2 chain(Col4a2)and downregulated guanine nucleotide-binding protein G(z)subunit alpha(Gnaz)in detrusor tissue,while EA treatment normalized both proteins(both P<0.05).In bladder neck tissue,DBND rats showed decreased expression of smoothelin(Smtn)and calcium-activated potassium chan-nel subunit beta-1(Kcnmb1)compared with sham controls(both P<0.01),which were both upregulated following EA treatment(P<0.01 and P<0.05,respectively).Conclusion EA restores detrusor-bladder neck coordination in DBND through dual-target mechanisms.In detrusor tissue,EA modulates contraction via extracellular matrix remodel-ing,cyclic adenosine monophosphate(cAMP)signaling pathway regulation,and enhanced adenosine triphosphate(ATP)biosynthesis mediated by neurotransmitters.In bladder neck tissue,EA promotes relaxation by maintaining contractile phenotypes,reducing fibrosis,sup-pressing smooth muscle excitation,and regulating presynaptic neurotransmitter release.These findings provide mechanistic insights into EA's therapeutic role in managing DBND.展开更多
Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,a...Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].展开更多
Introduction: Arteriovenous malformation is a rare pathology, often discovered accidentally in children. Generally, it presents as an intra-parenchymal hematoma following rupture of the affected vessels. The risk of r...Introduction: Arteriovenous malformation is a rare pathology, often discovered accidentally in children. Generally, it presents as an intra-parenchymal hematoma following rupture of the affected vessels. The risk of rupture is linked to the volume of the malformation, its cortical location and venous drainage. In literature, few cases of rupture have been reported in cases of meningitis, but none are associated with a brain abscess. Objective: To report a case of an intraparenchymal hemorrhage due to rupture of an arteriovenous malformation with an associated brain abscess. Observation: The authors report the case of a 2-year-old child, admitted for impaired state of consciousness associated with a right hemiparesis and seizures in a febrile context. Clinical evaluation revealed a Blantyre score of 3, fever at 40˚C, divergent strabismus of the right eye, a right pyramidal syndrome and meningeal irritative syndrome. Cerebral CT scan revealed a left fronto-parietal intra-parenchymal hematoma and a right occipital ring-enhanced lesion, suggesting a brain abscess. An MRI suggested a probable rupture of an arteriovenous malformation resulting in the intra-parenchymal hematoma. Management consisted of craniotomy to evacuate the intra-parenchymal hematoma, antibiotic therapy with vancomycin and ceftriaxone at meningeal doses. Histopathological analysis of the intraoperative sample revealed an arteriovenous malformation. The postoperative course was marked by regression of hyperthermia, persistence of spasticity, irritability and clonic movement of the right lower limb. These were managed with baclofen, phenobarbital, and ergotherapy. We observed a regression of spasticity and improved motor skills in the right limbs. At 6 months follow-up, child could interact with his social environment despite aphasia, regression of spasticity and right hemiparesis. Conclusion: Rupture of arteriovenous malformations can be enhanced by neuro-meningeal infections and particularly brain abscesses. Cerebrovascular complications of these conditions mostly have unfavorable outcomes and neurological sequelae.展开更多
Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can ...Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.展开更多
Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing d...Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing dysphagia diet awareness among prosthodontists working with head and neck cancer patients. Methods: The study had a post-intervention design and included 10 maxillofacial prosthetic educators from eight countries who participated in a 120-minute workshop focused on theoretical and practical training in nutrition support for patients with dysphagia. Sessions were held in a specialized restaurant in Tokyo and included lectures, observation of Japanese cooking techniques, hands-on preparation of dysphagia-friendly foods, and cross-cultural comparisons. Knowledge, confidence, and practical application were assessed using a post-workshop questionnaire. Descriptive statistics and thematic analysis were used to evaluate outcomes. Results: Seven of the 10 prosthodontists completed the post-intervention questionnaire. All respondents reported overall satisfaction with the workshop. Session content was regarded as easy to understand by 57.14%, appropriate by 28.57%, and easy by 14.29%. Most respondents (85.71%) were “very satisfied” with the instructors’ explanations, and 100% were “very satisfied” with the workshop’s length and structure;71.42% felt they could apply the knowledge in clinical practice, while 28.58% anticipated challenges. The respondents appreciated the workshop’s focus on dysphagia, particularly in elderly patients, and valued the insights into Japanese dysphagia diets and culture. Conclusions: Workshops on nutrition provide an interactive platform for prosthodontists to enhance their knowledge and improve comprehensive patient care, highlighting the importance for prosthodontists to stay updated on developments in nutrition, particularly in dysphagia.展开更多
Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier tren...Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.展开更多
BACKGROUND Renal cysts,especially the cortical type,are a prevalent renal pathology.Most cases are asymptomatic and detected incidentally during abdominal imaging examination for unrelated complaints.They are often be...BACKGROUND Renal cysts,especially the cortical type,are a prevalent renal pathology.Most cases are asymptomatic and detected incidentally during abdominal imaging examination for unrelated complaints.They are often benign,but they can rarely transform into cystic renal malignancies.When huge or complicated,especially with an abscess,it may become symptomatic from the renal capsular stretch or inflammation.The open surgical,endoscopic,laparoscopic,and robotic appro-aches are available for symptomatic renal cyst treatment.This paper aims to report our experience in the management of a case of a giant renal cyst abscess.CASE SUMMARY This is a 26-year-old housewife who was referred to the urology outpatient clinic with a history of left flank pain and swelling for 5 months,with the transabdo-minal ultrasound scan and computerized tomography scan findings of a huge left renal cortical cyst(Bosniak I).She had associated anorexia,weight loss,nausea,and intermittent fever,which on one occasion was severe and high-grade with chills and rigors.This warranted hospital admission,analgesic and antibiotic therapy.The physical examination was unremarkable at presentation except for a ballotable and mildly tender left lumbar cystic mass.Her vital signs were stable.There was leukocytosis with relative neutrophilia.Further review of the imaging films confirmed the diagnosis of a left giant renal cortical cyst abscess.She was counselled and had open surgical exploration,drainage of 300 mL of pus,cyst unroofing with marsupialization,and was discharged home on the 10th postoperative day.CONCLUSION Treatment of giant simple renal cortical cyst abscesses should be individualized depending on the pathology in question,the surgeon’s experience,patient preference and availability of facilities for endoscopic,laparoscopic or robotic modalities.Notwithstanding open surgical exploration,cyst unroofing and marsupialization are useful modalities in giant renal cortical cyst abscesses and are associated with patient satisfaction.展开更多
BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alc...BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alcoholic fatty liver disease reaching 29.2%in Chinese adults,the number of patients with liver abscess combined with fatty liver has shown a significant increasing trend clinically.AIM To analyze risk factors affecting prognosis after percutaneous drainage in liver abscess patients with fatty liver.METHODS A retrospective analysis of 165 liver abscess patients with fatty liver who underwent percutaneous drainage from January 2020 to April 2024.Patients were divided into good prognosis(n=121,73.3%)and poor prognosis groups(n=44,26.7%)based on 30-day outcomes.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.RESULTS The poor prognosis group had older age(65.2±11.8 years vs 56.1±11.9 years,P<0.001),higher diabetes prevalence(70.5%vs 47.2%,P=0.008),elevated inflammatory markers,and lower serum albumin(26.8±4.2 g/L vs 32.1±5.6 g/L,P<0.001).Moderate-to-severe fatty liver was more prevalent in the poor prognosis group(68.2%vs 38.0%,P=0.001).Multivariate analysis identified five independent risk factors:Age≥65 years(OR=2.847,P=0.007),diabetes history(OR=3.124,P=0.003),abscess diameter≥8 cm(OR=2.591,P=0.015),serum albumin<30 g/L(OR=3.456,P=0.001),and moderate-to-severe fatty liver(OR=2.213,P=CONCLUSION)Advanced age,diabetes history,large abscess,hypoalbuminemia,and moderate-to-severe fatty liver are independent risk factors for poor prognosis after percutaneous drainage in liver abscess patients with fatty liver.展开更多
AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vi...AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.展开更多
BACKGROUND An epidural abscess is a rare but serious medical condition where a pocket of pus forms in the epidural space—the area between the outer covering of the spinal cord(the dura mater)and the bones of the spin...BACKGROUND An epidural abscess is a rare but serious medical condition where a pocket of pus forms in the epidural space—the area between the outer covering of the spinal cord(the dura mater)and the bones of the spine.It’s usually caused by a bacterial infection,most commonly Staphylococcus aureus.The infection can spread to this area from other parts of the body,through the bloodstream,or it may be intro-duced directly during spinal procedures like epidural injections or surgery.Symptoms often include severe back pain,fever,and neurological deficits like weakness or numbness,which can progress quickly if untreated.It's considered a medical emergency because if the abscess compresses the spinal cord,it can lead to permanent paralysis or even death.Treatment usually involves antibiotics and,in many cases,surgical drainage.CASE SUMMARY Spinal epidural abscess(SEA)represents a rare yet potentially severe infection affecting the epidural space.We present the following case of a 54-year-old Hispanic white male who initially presented to the emergency department with acute deteriorating symptoms of bilateral lower extremity weakness,which subsequently progressed to involve the upper extremities.However,further evaluation uncovered additional notable symptoms,including urinary inconti-nence and decreased appetite.Further investigation broadened the differential diagnosis,including meningitis,spinal cord compression,acute pyelonephritis,osteomyelitis,bacteremia,torticollis,and acutely progressive ascending bilateral lower extremity weakness,raising the concern for possible Guillain-Barre syndrome.Diagnostic imaging,including magnetic resonance imaging of the spine,confirmed the presence of C5-C6 osteomyelitis and a C6-C7 spinal epidural abscess with severe canal narrowing.The patient underwent an emergency evacuation of epidural abscess with a C6 corpectomy and C5-C7 cervical fusion,followed by an 8-week course of intravenous antibiotics.Cultures from the abscess and bone revealed Staphylococcal aureus.The patient was discharged after 54 days with significant improvement in power and function.CONCLUSION This case highlights the importance of maintaining a high index of suspicion for SEA in patients presenting with atypical symptoms,even in the setting of seemingly unrelated conditions.Early recognition and prompt intervention are crucial to prevent permanent neurological deficits and improve outcomes in patients with SEA.展开更多
Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical ap...Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical applications,the deployment of flexible pressure sensors characterized by high sensitivity and fast response time is imperative for the rapid and accurate detection and monitoring of tiny signals.Such capabilities are essential for facilitating immediate feedback and informed decision-making across a spectrum of contexts.Drawing lessons from the hypersensitive and fast-responding pressure sensing structures in the dragonfly’s neck(for stable imaging during its highly maneuverable flight),a Biomimetic Piezoresistive Pressure Sensor(BPPS)with exquisite mechanically interlocking sensing microstructures is developed.Each interlocking perceptual structure pair consists of an ox-horn-shaped and a mushroom-shaped structural unit.Through the characteristic configuration of the perceptual structure pair,the BPPS realizes a fast gradient accumulation of the contact area,thus synergistically enhancing the sensitivity and fast response capability.Remarkably,the sensitivity of the BPPS reaches 0.35 kPa^(−1),which increased by 75%compared to the 0.2 kPa^(−1) of the pressure sensors without biomimetic structures.Moreover,the BPPS also achieves rapid response/recovery times(<90/15 ms).Our BPPS finds utility in tasks such as identifying objects of different weights,monitoring human respiratory status,and tracking motion,demonstrating its potential in wearable healthcare devices,assistive technology,and intelligent soft robotics.Moreover,it possesses the advantages of high sensitivity and fast response time in practical applications.展开更多
[Objectives]To investigate the use of the classical Chinese medicine formula Sihu Powder modified decoction for postoperative fumigation and sitz bath in patients with perianal abscess,aiming to promote wound healing ...[Objectives]To investigate the use of the classical Chinese medicine formula Sihu Powder modified decoction for postoperative fumigation and sitz bath in patients with perianal abscess,aiming to promote wound healing and reduce medical burden.[Methods]An observational cohort study was conducted,selecting 200 patients with perianal abscess who underwent surgery in Shenzhen Guangming District People's Hospital.They were randomly divided into a treatment group and an observation group,with 100 cases in each group.Both groups followed the same surgical and antibiotic treatment principles.Starting from the first postoperative day,the treatment group received fumigation and sitz bath with modified Sihu Powder for decoction twice daily;the observation group used Compound Huangbai Liquid for fumigation and sitz bath twice daily.Indicators including pain score,wound secretion score,wound granulation tissue growth score,multidrug-resistant bacterial infection clearance rate,antibiotic usage days,and wound healing rate were observed in both groups 7,14 and 21 d after operation.[Results]On postoperative day 7,the differences in postoperative pain score,wound secretions,and multidrug-resistant bacterial clearance rate between the treatment group and the observation group were statistically significant.On postoperative day 14,the differences between the two groups were significant in indicators including pain score,wound secretions,wound granulation tissue growth,multidrug-resistant bacterial clearance rate,and wound healing rate.On postoperative day 21,the difference in wound healing rate between the two groups was significant;furthermore,the antibiotic usage days in the treatment group were significantly fewer than those in the observation group.[Conclusions]Modified Sihu Powder for fumigation and washing can effectively alleviate postoperative pain in perianal abscess patients,inhibit the colonization and infection of multidrug-resistant bacteria at the wound site,accelerate wound healing,reduce antibiotic usage intensity and medical burden.It possesses advantages such as being economical,effective,safe,and easy to operate,making it worthy of clinical promotion.展开更多
BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur....BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur.AIM To investigate the clinical value of early ultrasound-guided percutaneous drainage(PCD)in PLA patients,specifically those with non-liquefied abscesses,and evaluate the feasibility of early intervention.METHODS This retrospective analysis included 143 patients with PLA who were admitted to the Department of General Surgery between January 2018 and March 2023.All patients underwent ultrasound-guided PCD.Based on the liquefaction status of the abscess,patients were divided into two groups:Liquefied group and nonliquefied group.Clinical outcomes,including puncture success rate,puncture duration,length of hospital stay,time to fever resolution,abscess shrinkage rate,and complication rates,were compared between the two groups.RESULTS The puncture success rate for all patients was 99.3%,with a postoperative complication rate of 5.59%,and no intraoperative deaths occurred.Compared to the liquefied group,the non-liquefied group had significantly shorter hospital stays(3.9±1.8 days vs 5.1±2.7 days),faster fever resolution(2.4±1.1 days vs 4.9±2.2 days),and quicker abscess shrinkage(>50%)(4.7±1.5 days vs 8.6±3.3 days)(P<0.05).There were no significant differences in puncture success rates or complication rates between the two groups.CONCLUSION Early ultrasound-guided PCD can be safely and effectively performed in PLA,even when the abscess is not fully liquefied or is non-liquefied,supporting the clinical feasibility of early intervention.展开更多
BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in d...BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment.There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.CASE SUMMARY Here,we report a 16-year-old female patient with intestinal obstruction due to AC.She was treated with abdominal surgery three times.First,she underwent a laparotomy for peritonitis after trauma from a traffic accident.During the pro-cedure,pelvic empyema,severe intestinal adhesions,and damage to the serous layer of the rectum were found,but no significant intestinal rupture and perfo-ration were found.As a precaution,she underwent a prophylactic ileostomy after a flush in her abdomen.The second and third surgeries were for treatment of recurrent stoma obstruction.The patient’s condition was complicated for a long period,but after comprehensive treatment by our department,the patient was successfully discharged from the hospital and is currently recovering well.CONCLUSION Currently,abdominal contrast-enhanced computed tomography is the best imaging modality for pre-operative evaluation of AC,but most patients are diagnosed only after intrao-perative exploration.For the treatment of typical or severe ACs,the primary me-thod of removal and healing of ACs is complete removal of the abdominal fibrous membrane.Finding a breakthrough in the anatomy is the key to the success of the surgery.展开更多
文摘Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.
文摘Foreign body(FB) ingestion is very common in Malaysian population.The most commonly ingested FB is fish bone.Common presenting symptoms include FB sensation,odynophagia and or sharp pricking pain during swallowing.A careful history and physical examination is very important.Despite negative laryngoscopy and rigid esophagoscopy,persistent symptoms warrants further radiographic imaging studies.The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract.We report 3 cases of extraluminal migration of fish bone and their complications,which were successfully managed.One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland,retropharyngeal and parapharyngeal abscess.
文摘Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.
文摘Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall conditions are often overlooked,leading to diagnostic delays.Among them,umbilical abscesses are rare but require distinction from urachal abscesses due to differences in management.Patient’s concern:A 46-year-old woman presented with a one-week history of periumbilical pain unresponsive to analgesics.Diagnosis:Physical examination revealed localized tenderness and a positive Carnett’s sign.Computed tomographic images identified an umbilical abscess without evidence of urachal remnants,ruling out a urachal abscess.Interventions:The patient underwent abscess drainage and received cefalexin(1500 mg/day)for 28 days.Outcomes:The abscess resolved completely without recurrence.Lessons:Umbilical abscesses are rare and may be mistaken for urachal abscesses.A thorough clinical evaluation,including Carnett’s sign and imaging studies,is crucial for accurate diagnosis.Prompt differentiation facilitates appropriate management and prevents unnecessary interventions.
文摘This manuscript is based on a recent study by Pillay et al that was published in recently.Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin.The incidence rate in Europe is lower than in developing countries,but it is a major complication with high morbidity,particularly in immunocompromised patients.They are most frequently caused by Enterobacterales infections,but hypervirulent Klebsiella strains are an emerging problem in Western countries.Amoebiasis has been a public health problem in Europe,primarily imported from other endemic foci.At the same time,this infection is becoming an emerging disease,as the number of infected patients who have not traveled to endemic areas is rising.Treatment options for hydatid liver cyst include chemotherapy,open or laparoscopic surgery,percutaneous treatment(percutaneous aspiration,re-aspiration and injection and its modification)and“wait and watch”strategy.Most hydatid liver cyst patients in Pillay et al’s study received surgical treatment,but several studies have confirmed the safety and efficacy of percutaneous aspiration,re-aspiration and injection.
文摘In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.
基金National Natural Science Foundation of China (General Program, 81874510)Natural Science Foundation of Hunan Province (2022JJ40301)Scientific Research Project of the Hunan Provincial Department of Education (21B0369)。
文摘Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free(SPF)grade famale Sprague-Dawley(SD)rats(10-12 weeks,250-280 g)were randomly assigned to either a sham group(n=12)or a spinal cord injury model group(n=40).In the model group,DBND was induced through Hassan Shaker spinal cord transection at T10 level,with 24 rats meeting inclusion criteria and subse-quently randomized into DBND group(n=12)and EA intervention group(DBND+EA group,n=12).After spinal shock recovery(day 19 after modeling),DBND+EA group received EA treatment at Ciliao(BL32),Zhongji(RN3),and Sanyinjiao(SP6)acupoints for 20 min per ses-sion at 10/50 Hz frequencies,once daily for 10 d.Sham and DBND groups received anesthe-sia only without EA intervention.On day 29 post-modeling,all rats underwent urodynamic assessments,followed by hematoxylin and eosin(HE)staining,tandem mass tag(TMT)pro-teomics,and Western blot(WB)analysis of detrusor and bladder neck tissues.Differentially expressed proteins(DEPs)were defined as proteins with P<0.05,unique peptides≥2,and fold change>1.2 or<0.83.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway anal-ysis was performed using KOBAS 3.0(P<0.01),and protein-protein interaction(PPI)net-works were analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins(STRING)11.5 and Cytoscape 3.9.1.Results Compared with sham group,DBND group showed significantly elevated leak point pressure(LPP)and maximum cystometric capacity(MCC)(both P<0.01).EA treatment sig-nificantly reduced both LPP and MCC compared with DBND group(P<0.01 and P<0.05,re-spectively).HE staining revealed that EA reduced detrusor fibrosis and improved bladder neck inflammation.TMT proteomics identified 30 overlapping DEPs in detrusor and 59 over-lapping DEPs in bladder neck when comparing DBND+EA/DBND groups with sham group.In detrusor tissue,KEGG analysis revealed 10 significantly enriched pathways(P<0.01),in-cluding mitogen-activated protein kinase(MAPK)signaling pathway.PPI analysis showed 22 of 30 DEPs were interconnected.In bladder neck tissue,14 pathways were significantly en-riched(P<0.01),including relaxin signaling pathway,with 51 of 59 DEPs showing intercon-nections.Both TMT and WB validations demonstrated that compared with sham controls,DBND rats exhibited upregulated collagen type IV alpha 2 chain(Col4a2)and downregulated guanine nucleotide-binding protein G(z)subunit alpha(Gnaz)in detrusor tissue,while EA treatment normalized both proteins(both P<0.05).In bladder neck tissue,DBND rats showed decreased expression of smoothelin(Smtn)and calcium-activated potassium chan-nel subunit beta-1(Kcnmb1)compared with sham controls(both P<0.01),which were both upregulated following EA treatment(P<0.01 and P<0.05,respectively).Conclusion EA restores detrusor-bladder neck coordination in DBND through dual-target mechanisms.In detrusor tissue,EA modulates contraction via extracellular matrix remodel-ing,cyclic adenosine monophosphate(cAMP)signaling pathway regulation,and enhanced adenosine triphosphate(ATP)biosynthesis mediated by neurotransmitters.In bladder neck tissue,EA promotes relaxation by maintaining contractile phenotypes,reducing fibrosis,sup-pressing smooth muscle excitation,and regulating presynaptic neurotransmitter release.These findings provide mechanistic insights into EA's therapeutic role in managing DBND.
文摘Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].
文摘Introduction: Arteriovenous malformation is a rare pathology, often discovered accidentally in children. Generally, it presents as an intra-parenchymal hematoma following rupture of the affected vessels. The risk of rupture is linked to the volume of the malformation, its cortical location and venous drainage. In literature, few cases of rupture have been reported in cases of meningitis, but none are associated with a brain abscess. Objective: To report a case of an intraparenchymal hemorrhage due to rupture of an arteriovenous malformation with an associated brain abscess. Observation: The authors report the case of a 2-year-old child, admitted for impaired state of consciousness associated with a right hemiparesis and seizures in a febrile context. Clinical evaluation revealed a Blantyre score of 3, fever at 40˚C, divergent strabismus of the right eye, a right pyramidal syndrome and meningeal irritative syndrome. Cerebral CT scan revealed a left fronto-parietal intra-parenchymal hematoma and a right occipital ring-enhanced lesion, suggesting a brain abscess. An MRI suggested a probable rupture of an arteriovenous malformation resulting in the intra-parenchymal hematoma. Management consisted of craniotomy to evacuate the intra-parenchymal hematoma, antibiotic therapy with vancomycin and ceftriaxone at meningeal doses. Histopathological analysis of the intraoperative sample revealed an arteriovenous malformation. The postoperative course was marked by regression of hyperthermia, persistence of spasticity, irritability and clonic movement of the right lower limb. These were managed with baclofen, phenobarbital, and ergotherapy. We observed a regression of spasticity and improved motor skills in the right limbs. At 6 months follow-up, child could interact with his social environment despite aphasia, regression of spasticity and right hemiparesis. Conclusion: Rupture of arteriovenous malformations can be enhanced by neuro-meningeal infections and particularly brain abscesses. Cerebrovascular complications of these conditions mostly have unfavorable outcomes and neurological sequelae.
基金supported by the Scientific Research Fund of the National Health Commission-Zhejiang Provincial Health Major Science and Technology Plan Project(No.WKJ-ZJ-2415)the Key Research and Development Program of Zhejiang Province(No.2024C03166)+1 种基金the Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(No.2022ZB020)the Zhejiang Provincial Natural Science Foundation of China(No.LY21H160049).
文摘Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.
文摘Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing dysphagia diet awareness among prosthodontists working with head and neck cancer patients. Methods: The study had a post-intervention design and included 10 maxillofacial prosthetic educators from eight countries who participated in a 120-minute workshop focused on theoretical and practical training in nutrition support for patients with dysphagia. Sessions were held in a specialized restaurant in Tokyo and included lectures, observation of Japanese cooking techniques, hands-on preparation of dysphagia-friendly foods, and cross-cultural comparisons. Knowledge, confidence, and practical application were assessed using a post-workshop questionnaire. Descriptive statistics and thematic analysis were used to evaluate outcomes. Results: Seven of the 10 prosthodontists completed the post-intervention questionnaire. All respondents reported overall satisfaction with the workshop. Session content was regarded as easy to understand by 57.14%, appropriate by 28.57%, and easy by 14.29%. Most respondents (85.71%) were “very satisfied” with the instructors’ explanations, and 100% were “very satisfied” with the workshop’s length and structure;71.42% felt they could apply the knowledge in clinical practice, while 28.58% anticipated challenges. The respondents appreciated the workshop’s focus on dysphagia, particularly in elderly patients, and valued the insights into Japanese dysphagia diets and culture. Conclusions: Workshops on nutrition provide an interactive platform for prosthodontists to enhance their knowledge and improve comprehensive patient care, highlighting the importance for prosthodontists to stay updated on developments in nutrition, particularly in dysphagia.
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(Project No.:2025AFD278)Three Gorges University Scientific Fund Project(Project No.:2022kj008)Three Gorges University Special Scientific Fund Project(Project No.:2023kjzx001)。
文摘Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.
文摘BACKGROUND Renal cysts,especially the cortical type,are a prevalent renal pathology.Most cases are asymptomatic and detected incidentally during abdominal imaging examination for unrelated complaints.They are often benign,but they can rarely transform into cystic renal malignancies.When huge or complicated,especially with an abscess,it may become symptomatic from the renal capsular stretch or inflammation.The open surgical,endoscopic,laparoscopic,and robotic appro-aches are available for symptomatic renal cyst treatment.This paper aims to report our experience in the management of a case of a giant renal cyst abscess.CASE SUMMARY This is a 26-year-old housewife who was referred to the urology outpatient clinic with a history of left flank pain and swelling for 5 months,with the transabdo-minal ultrasound scan and computerized tomography scan findings of a huge left renal cortical cyst(Bosniak I).She had associated anorexia,weight loss,nausea,and intermittent fever,which on one occasion was severe and high-grade with chills and rigors.This warranted hospital admission,analgesic and antibiotic therapy.The physical examination was unremarkable at presentation except for a ballotable and mildly tender left lumbar cystic mass.Her vital signs were stable.There was leukocytosis with relative neutrophilia.Further review of the imaging films confirmed the diagnosis of a left giant renal cortical cyst abscess.She was counselled and had open surgical exploration,drainage of 300 mL of pus,cyst unroofing with marsupialization,and was discharged home on the 10th postoperative day.CONCLUSION Treatment of giant simple renal cortical cyst abscesses should be individualized depending on the pathology in question,the surgeon’s experience,patient preference and availability of facilities for endoscopic,laparoscopic or robotic modalities.Notwithstanding open surgical exploration,cyst unroofing and marsupialization are useful modalities in giant renal cortical cyst abscesses and are associated with patient satisfaction.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2024ZL039.
文摘BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alcoholic fatty liver disease reaching 29.2%in Chinese adults,the number of patients with liver abscess combined with fatty liver has shown a significant increasing trend clinically.AIM To analyze risk factors affecting prognosis after percutaneous drainage in liver abscess patients with fatty liver.METHODS A retrospective analysis of 165 liver abscess patients with fatty liver who underwent percutaneous drainage from January 2020 to April 2024.Patients were divided into good prognosis(n=121,73.3%)and poor prognosis groups(n=44,26.7%)based on 30-day outcomes.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.RESULTS The poor prognosis group had older age(65.2±11.8 years vs 56.1±11.9 years,P<0.001),higher diabetes prevalence(70.5%vs 47.2%,P=0.008),elevated inflammatory markers,and lower serum albumin(26.8±4.2 g/L vs 32.1±5.6 g/L,P<0.001).Moderate-to-severe fatty liver was more prevalent in the poor prognosis group(68.2%vs 38.0%,P=0.001).Multivariate analysis identified five independent risk factors:Age≥65 years(OR=2.847,P=0.007),diabetes history(OR=3.124,P=0.003),abscess diameter≥8 cm(OR=2.591,P=0.015),serum albumin<30 g/L(OR=3.456,P=0.001),and moderate-to-severe fatty liver(OR=2.213,P=CONCLUSION)Advanced age,diabetes history,large abscess,hypoalbuminemia,and moderate-to-severe fatty liver are independent risk factors for poor prognosis after percutaneous drainage in liver abscess patients with fatty liver.
文摘AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.
文摘BACKGROUND An epidural abscess is a rare but serious medical condition where a pocket of pus forms in the epidural space—the area between the outer covering of the spinal cord(the dura mater)and the bones of the spine.It’s usually caused by a bacterial infection,most commonly Staphylococcus aureus.The infection can spread to this area from other parts of the body,through the bloodstream,or it may be intro-duced directly during spinal procedures like epidural injections or surgery.Symptoms often include severe back pain,fever,and neurological deficits like weakness or numbness,which can progress quickly if untreated.It's considered a medical emergency because if the abscess compresses the spinal cord,it can lead to permanent paralysis or even death.Treatment usually involves antibiotics and,in many cases,surgical drainage.CASE SUMMARY Spinal epidural abscess(SEA)represents a rare yet potentially severe infection affecting the epidural space.We present the following case of a 54-year-old Hispanic white male who initially presented to the emergency department with acute deteriorating symptoms of bilateral lower extremity weakness,which subsequently progressed to involve the upper extremities.However,further evaluation uncovered additional notable symptoms,including urinary inconti-nence and decreased appetite.Further investigation broadened the differential diagnosis,including meningitis,spinal cord compression,acute pyelonephritis,osteomyelitis,bacteremia,torticollis,and acutely progressive ascending bilateral lower extremity weakness,raising the concern for possible Guillain-Barre syndrome.Diagnostic imaging,including magnetic resonance imaging of the spine,confirmed the presence of C5-C6 osteomyelitis and a C6-C7 spinal epidural abscess with severe canal narrowing.The patient underwent an emergency evacuation of epidural abscess with a C6 corpectomy and C5-C7 cervical fusion,followed by an 8-week course of intravenous antibiotics.Cultures from the abscess and bone revealed Staphylococcal aureus.The patient was discharged after 54 days with significant improvement in power and function.CONCLUSION This case highlights the importance of maintaining a high index of suspicion for SEA in patients presenting with atypical symptoms,even in the setting of seemingly unrelated conditions.Early recognition and prompt intervention are crucial to prevent permanent neurological deficits and improve outcomes in patients with SEA.
基金supported by the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(No.52021003)National Natural Science Foundation of China(Nos.52222509,52105301)+1 种基金the Natural Science Foundation of Jilin Province(Grant No.20220101220JC)supported by“Fundamental Research Funds for the Central Universities”.
文摘Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical applications,the deployment of flexible pressure sensors characterized by high sensitivity and fast response time is imperative for the rapid and accurate detection and monitoring of tiny signals.Such capabilities are essential for facilitating immediate feedback and informed decision-making across a spectrum of contexts.Drawing lessons from the hypersensitive and fast-responding pressure sensing structures in the dragonfly’s neck(for stable imaging during its highly maneuverable flight),a Biomimetic Piezoresistive Pressure Sensor(BPPS)with exquisite mechanically interlocking sensing microstructures is developed.Each interlocking perceptual structure pair consists of an ox-horn-shaped and a mushroom-shaped structural unit.Through the characteristic configuration of the perceptual structure pair,the BPPS realizes a fast gradient accumulation of the contact area,thus synergistically enhancing the sensitivity and fast response capability.Remarkably,the sensitivity of the BPPS reaches 0.35 kPa^(−1),which increased by 75%compared to the 0.2 kPa^(−1) of the pressure sensors without biomimetic structures.Moreover,the BPPS also achieves rapid response/recovery times(<90/15 ms).Our BPPS finds utility in tasks such as identifying objects of different weights,monitoring human respiratory status,and tracking motion,demonstrating its potential in wearable healthcare devices,assistive technology,and intelligent soft robotics.Moreover,it possesses the advantages of high sensitivity and fast response time in practical applications.
基金Supported by Shenzhen Guangming District Health System Scientific Research Project(2020R01120).
文摘[Objectives]To investigate the use of the classical Chinese medicine formula Sihu Powder modified decoction for postoperative fumigation and sitz bath in patients with perianal abscess,aiming to promote wound healing and reduce medical burden.[Methods]An observational cohort study was conducted,selecting 200 patients with perianal abscess who underwent surgery in Shenzhen Guangming District People's Hospital.They were randomly divided into a treatment group and an observation group,with 100 cases in each group.Both groups followed the same surgical and antibiotic treatment principles.Starting from the first postoperative day,the treatment group received fumigation and sitz bath with modified Sihu Powder for decoction twice daily;the observation group used Compound Huangbai Liquid for fumigation and sitz bath twice daily.Indicators including pain score,wound secretion score,wound granulation tissue growth score,multidrug-resistant bacterial infection clearance rate,antibiotic usage days,and wound healing rate were observed in both groups 7,14 and 21 d after operation.[Results]On postoperative day 7,the differences in postoperative pain score,wound secretions,and multidrug-resistant bacterial clearance rate between the treatment group and the observation group were statistically significant.On postoperative day 14,the differences between the two groups were significant in indicators including pain score,wound secretions,wound granulation tissue growth,multidrug-resistant bacterial clearance rate,and wound healing rate.On postoperative day 21,the difference in wound healing rate between the two groups was significant;furthermore,the antibiotic usage days in the treatment group were significantly fewer than those in the observation group.[Conclusions]Modified Sihu Powder for fumigation and washing can effectively alleviate postoperative pain in perianal abscess patients,inhibit the colonization and infection of multidrug-resistant bacteria at the wound site,accelerate wound healing,reduce antibiotic usage intensity and medical burden.It possesses advantages such as being economical,effective,safe,and easy to operate,making it worthy of clinical promotion.
文摘BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur.AIM To investigate the clinical value of early ultrasound-guided percutaneous drainage(PCD)in PLA patients,specifically those with non-liquefied abscesses,and evaluate the feasibility of early intervention.METHODS This retrospective analysis included 143 patients with PLA who were admitted to the Department of General Surgery between January 2018 and March 2023.All patients underwent ultrasound-guided PCD.Based on the liquefaction status of the abscess,patients were divided into two groups:Liquefied group and nonliquefied group.Clinical outcomes,including puncture success rate,puncture duration,length of hospital stay,time to fever resolution,abscess shrinkage rate,and complication rates,were compared between the two groups.RESULTS The puncture success rate for all patients was 99.3%,with a postoperative complication rate of 5.59%,and no intraoperative deaths occurred.Compared to the liquefied group,the non-liquefied group had significantly shorter hospital stays(3.9±1.8 days vs 5.1±2.7 days),faster fever resolution(2.4±1.1 days vs 4.9±2.2 days),and quicker abscess shrinkage(>50%)(4.7±1.5 days vs 8.6±3.3 days)(P<0.05).There were no significant differences in puncture success rates or complication rates between the two groups.CONCLUSION Early ultrasound-guided PCD can be safely and effectively performed in PLA,even when the abscess is not fully liquefied or is non-liquefied,supporting the clinical feasibility of early intervention.
基金Supported by Suqian Science and Technology Project Contract,No.S201910。
文摘BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment.There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.CASE SUMMARY Here,we report a 16-year-old female patient with intestinal obstruction due to AC.She was treated with abdominal surgery three times.First,she underwent a laparotomy for peritonitis after trauma from a traffic accident.During the pro-cedure,pelvic empyema,severe intestinal adhesions,and damage to the serous layer of the rectum were found,but no significant intestinal rupture and perfo-ration were found.As a precaution,she underwent a prophylactic ileostomy after a flush in her abdomen.The second and third surgeries were for treatment of recurrent stoma obstruction.The patient’s condition was complicated for a long period,but after comprehensive treatment by our department,the patient was successfully discharged from the hospital and is currently recovering well.CONCLUSION Currently,abdominal contrast-enhanced computed tomography is the best imaging modality for pre-operative evaluation of AC,but most patients are diagnosed only after intrao-perative exploration.For the treatment of typical or severe ACs,the primary me-thod of removal and healing of ACs is complete removal of the abdominal fibrous membrane.Finding a breakthrough in the anatomy is the key to the success of the surgery.
