This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection b...This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection began to appear on day 16 of admission,and both sputum and catheter tip cultures revealed R.mannitolilytica.The infection control department of the hospital later sampled and identified R.mannitolilytica in the ventilator tube that was used by the patient with the exact gene sequence as the infecting strain.These findings indicate that ventilator tubing is a significant contamination source of this pathogen,and hospitals need to enhance their disinfection methods of ventilator-related devices.展开更多
Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatri...As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.展开更多
To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor ...To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor expression in ocular tissues,and associated clinical manifestations.This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular,histological,or clinical evidence.The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2(ACE2),including transmembrane serine protease 2(TMPRSS2),CD147,alanyl aminopeptidase N(ANPEP),dipeptidyl peptidase 4(DPP4),angiotensin II receptor type 2(AGTR2),and polymeric immunoglobulin receptor(PIGR),which are expressed in retinal,conjunctival,corneal,limbal,and photoreceptor cells.The virus may also reach ocular structures via neurovascular invasion.Clinically,patients with coronavirus disease 2019(COVID-19)may present with a broad spectrum of ophthalmic manifestations,including conjunctivitis,hyperreflective lesions in the inner retinal layers,flame-shaped hemorrhages,cottonwool spots,retinal pallor,hard exudates,and various forms of maculopathy,such as paracentral acute middle maculopathy and acute macular neuroretinopathy(AMN).These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury.Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis,appropriate ophthalmologic care,and the prevention of long-term visual sequelae in patients affected by COVID-19.展开更多
Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have signi...Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.展开更多
Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SD...Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SDAT)has emerged as a promising area of research.This perspective summarizes the recent NPT-based sonosensitizers in SDAT.Currently,common NPT-based sonosensitizers include curcumin,chlorophyll derivatives,hypericin,and berberine.Compared with other sonosensitizers,natural sources of NPT-based sonosensitizers with reactive oxide species production performance under ultrasound conditions,low biotoxicity,and other additional biological activity make them have application prospects in bacterial removal.Finally,the potential benefits and challenges of NPT-based nanosonosensitizers were also discussed.展开更多
Human fungal infections represent a rapidly emerging global health threat,especially threatening immunocompromised populations,highlighting the urgent need for accurate and timely diagnostic approaches to reduce morbi...Human fungal infections represent a rapidly emerging global health threat,especially threatening immunocompromised populations,highlighting the urgent need for accurate and timely diagnostic approaches to reduce morbidity and mortality.This review synthesizes recent advances in diagnostic methodologies,including serological assays,point-of-care diagnostics,polymerase chain reaction(PCR)-based and sequencing technologies,as well as artificial intelligence(AI)-and machine learning(ML)-powered tools.Emerging diagnostic approaches have demonstrated notable improvements in detection accuracy,turnaround time,and antifungal resistance profiling capabilities,especially for drug-resistant strains.Nevertheless,substantial challenges persist in terms of standardization,scalability,cost-effectiveness,and implementation,particularly in resource-constrained settings.Future efforts should be directed toward the continuous innovation of rapid,sensitive,and multiplex diagnostic platforms for the simultaneous detection of fungi,bacteria,and viruses.Such advances may accelerate result acquisition,enhance diagnostic accuracy,support the development of more targeted therapeutic strategies,and ultimately improve clinical outcomes for patients.展开更多
Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following bu...Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following burns make patients highly susceptible to wound infections,which can progress to systemic sepsis.Although burn wounds are initially sterile,they are rapidly colonized by Gram-positive bacteria(e.g.,Staphylococcus aureus)within a short period,followed by colonization with Gram-negative bacteria(e.g.,Pseudomonas aeruginosa),thereby increasing therapeutic challenges.Current clinical management relies on a multidisciplinary collaborative approach,combining conventional antibiotics,emerging therapies,and comprehensive care strategies.Among these methods,early intervention,precise treatment administration,and prevention and control are critical to improving patient survival and prognosis.In recent years,drug-loaded hydrogels,as a class of wound repair materials characterized by biocompatibility,controlled drug release,and multifunctional integration,have demonstrated significant advantages in the treatment of burn infections.They can effectively inhibit pathogenic microorganisms,alleviate inflammation,and promote tissue regeneration.This review systematically summarizes recent research advances in the application of drug-loaded hydrogels for the treatment of infected burn wounds,aiming to provide a reference for their further development and clinical translation.展开更多
Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
White-nose syndrome(WNS)has caused recent catastrophic declines among multiple species of bats in eastern North America.The disease's name derives from a visually apparent white growth of the newly discovered fung...White-nose syndrome(WNS)has caused recent catastrophic declines among multiple species of bats in eastern North America.The disease's name derives from a visually apparent white growth of the newly discovered fungus Geomyces destructans on the skin(including the muzzle)of hibernating bats.Colonization of skin by this fungus is associated with characteristic cutaneous lesions that are the only consistent pathological finding related to WNS.However,the role of G.destructans in WNS remains controversial because evidence to implicate the fungus as the primary cause of this disease is lacking.The debate is fuelled,in part,by the assumption that fungal infections in mammals are most commonly associated with immune system dysfunction.Additionally,the recent discovery that G.destructans commonly colonizes the skin of bats of Europe,where no unusual bat mortality events have been reported,has generated further speculation that the fungus is an opportunistic pathogen and that other unidentified factors are the primary cause of WNS.展开更多
BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidec...BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.展开更多
BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is ...BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.展开更多
Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Henek...Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Heneka,2024).This perspective article,which draws on insights from diverse fields including neuroscience,immunology,and pathology,p rovides a critical analysis of ongoing research efforts in inflammasome biology,with specific emphasis on Nod-like receptor(NLR)and pyrin domain-containing protein 3(NLRP3).展开更多
Postoperative infection is a major global health concern,affecting 5%-10%of surgical patients and nearly doubling mortality in severe cases[1].Transplant recipients are particularly vulnerable,with 30%-80%developing i...Postoperative infection is a major global health concern,affecting 5%-10%of surgical patients and nearly doubling mortality in severe cases[1].Transplant recipients are particularly vulnerable,with 30%-80%developing infections within 30 days,often from opportunistic pathogens[2,3].Key risk factors include epidemiological exposure,net immunosuppression,age,transplant type,and surgical history[4].Despite known infection risks,current evidence remains transplantation type-specific and neglects behavioral modulators[5].Different types of transplantation may share similar risk factors[6].To identify common factors affecting postoperative infection,this study collected standardized clinical data-including diet,psychological response,medication use,and biochemical indicators-from liver and kidney transplant patients across six hospitals using a unified standard operating procedure(SOP).展开更多
As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding N...As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding NK cell regulation is of considerable clinical importance.This article reviews the role of circadian processes(melatonin and the cortisol system),aryl hydrocarbon receptor,and vagal nerve in the modulation of NK cell function,highlighting the importance of the endogenous mitochondrial melatonergic pathway in NK cells.As circadian and exogenous melatonin increase NK cell cytotoxicity,the presence of the endogenous melatonergic pathway may be of some importance not only to NK function and immune checkpoint regulation but also from the efflux of melatonin,which decreases tumor cell survival,proliferation,and metastasis,as well as decreasing immune checkpoint ligands,such as programmed cell ligand 1(PD-L1).NK cell melatonergic pathway regulation may therefore have significant impacts not only on NK cell cytotoxicity but also on the intercellular interactions within tumors and other pathological microenvironments.As melatonin has anti-viral effects,the regulation of the NK cell melatonergic pathway can have wider impacts on how NK cells regulate viral infections,including in the course of viral-induced susceptibility to neurodegenerative conditions.Recent data indicate that the endogenous melatonergic pathway is regulated by interactions of signal transducer and activator of transcription(STAT)3 and nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB)dimer composition.As both STAT3 and NF-κB dimer composition modulate NK cells,their interaction in the modulation of the NK cell melatonergic pathway will be important to determine.This has significant future research and treatment implications,including improving the clinical efficacy of current treatment approaches such as immune checkpoint inhibition and chimeric antigen receptor(CAR)NK cell therapy,and may accelerate a means of preventing cancer.展开更多
Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central ne...Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcu...Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria...Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.展开更多
文摘This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection began to appear on day 16 of admission,and both sputum and catheter tip cultures revealed R.mannitolilytica.The infection control department of the hospital later sampled and identified R.mannitolilytica in the ventilator tube that was used by the patient with the exact gene sequence as the infecting strain.These findings indicate that ventilator tubing is a significant contamination source of this pathogen,and hospitals need to enhance their disinfection methods of ventilator-related devices.
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
文摘As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.
文摘To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor expression in ocular tissues,and associated clinical manifestations.This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular,histological,or clinical evidence.The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2(ACE2),including transmembrane serine protease 2(TMPRSS2),CD147,alanyl aminopeptidase N(ANPEP),dipeptidyl peptidase 4(DPP4),angiotensin II receptor type 2(AGTR2),and polymeric immunoglobulin receptor(PIGR),which are expressed in retinal,conjunctival,corneal,limbal,and photoreceptor cells.The virus may also reach ocular structures via neurovascular invasion.Clinically,patients with coronavirus disease 2019(COVID-19)may present with a broad spectrum of ophthalmic manifestations,including conjunctivitis,hyperreflective lesions in the inner retinal layers,flame-shaped hemorrhages,cottonwool spots,retinal pallor,hard exudates,and various forms of maculopathy,such as paracentral acute middle maculopathy and acute macular neuroretinopathy(AMN).These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury.Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis,appropriate ophthalmologic care,and the prevention of long-term visual sequelae in patients affected by COVID-19.
文摘Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.
基金supported by the Innovation and Entrepreneurship Training Program for College Students(X2025102911746,X2025102910483).
文摘Natural product(NPT)derived from traditional Chinese medicine has a rich history as an integral part of Chinese healthcare for thousands of years.Recently,the application of NPT in sonodynamic antibacterial therapy(SDAT)has emerged as a promising area of research.This perspective summarizes the recent NPT-based sonosensitizers in SDAT.Currently,common NPT-based sonosensitizers include curcumin,chlorophyll derivatives,hypericin,and berberine.Compared with other sonosensitizers,natural sources of NPT-based sonosensitizers with reactive oxide species production performance under ultrasound conditions,low biotoxicity,and other additional biological activity make them have application prospects in bacterial removal.Finally,the potential benefits and challenges of NPT-based nanosonosensitizers were also discussed.
基金supported by the MOST Key R&D Program of China(grant number 2022YFC2303500 to X.H.)the National Natural Science Foundation of China(grant numbers 32570236,32170195,and 32311530119 to C.C.and 32470200 to X.H.)+1 种基金Shanghai Science and Technology Innovation Action Plan 2023“Basic Research Project”(grant number 23JC1404200 to C.C.)the Foundation of State Key Laboratory of Pathogen and Biosecurity(grant number SKLPBS2236 to C.C.).
文摘Human fungal infections represent a rapidly emerging global health threat,especially threatening immunocompromised populations,highlighting the urgent need for accurate and timely diagnostic approaches to reduce morbidity and mortality.This review synthesizes recent advances in diagnostic methodologies,including serological assays,point-of-care diagnostics,polymerase chain reaction(PCR)-based and sequencing technologies,as well as artificial intelligence(AI)-and machine learning(ML)-powered tools.Emerging diagnostic approaches have demonstrated notable improvements in detection accuracy,turnaround time,and antifungal resistance profiling capabilities,especially for drug-resistant strains.Nevertheless,substantial challenges persist in terms of standardization,scalability,cost-effectiveness,and implementation,particularly in resource-constrained settings.Future efforts should be directed toward the continuous innovation of rapid,sensitive,and multiplex diagnostic platforms for the simultaneous detection of fungi,bacteria,and viruses.Such advances may accelerate result acquisition,enhance diagnostic accuracy,support the development of more targeted therapeutic strategies,and ultimately improve clinical outcomes for patients.
基金Supported by Natural Science Foundation of Guangxi(2025GXNSFHA069111,2020GXNSFAA159033,2019GXNSFAA245078)National Undergraduate Innovation and Entrepreneurship Training Program(202410601054).
文摘Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following burns make patients highly susceptible to wound infections,which can progress to systemic sepsis.Although burn wounds are initially sterile,they are rapidly colonized by Gram-positive bacteria(e.g.,Staphylococcus aureus)within a short period,followed by colonization with Gram-negative bacteria(e.g.,Pseudomonas aeruginosa),thereby increasing therapeutic challenges.Current clinical management relies on a multidisciplinary collaborative approach,combining conventional antibiotics,emerging therapies,and comprehensive care strategies.Among these methods,early intervention,precise treatment administration,and prevention and control are critical to improving patient survival and prognosis.In recent years,drug-loaded hydrogels,as a class of wound repair materials characterized by biocompatibility,controlled drug release,and multifunctional integration,have demonstrated significant advantages in the treatment of burn infections.They can effectively inhibit pathogenic microorganisms,alleviate inflammation,and promote tissue regeneration.This review systematically summarizes recent research advances in the application of drug-loaded hydrogels for the treatment of infected burn wounds,aiming to provide a reference for their further development and clinical translation.
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
文摘White-nose syndrome(WNS)has caused recent catastrophic declines among multiple species of bats in eastern North America.The disease's name derives from a visually apparent white growth of the newly discovered fungus Geomyces destructans on the skin(including the muzzle)of hibernating bats.Colonization of skin by this fungus is associated with characteristic cutaneous lesions that are the only consistent pathological finding related to WNS.However,the role of G.destructans in WNS remains controversial because evidence to implicate the fungus as the primary cause of this disease is lacking.The debate is fuelled,in part,by the assumption that fungal infections in mammals are most commonly associated with immune system dysfunction.Additionally,the recent discovery that G.destructans commonly colonizes the skin of bats of Europe,where no unusual bat mortality events have been reported,has generated further speculation that the fungus is an opportunistic pathogen and that other unidentified factors are the primary cause of WNS.
文摘BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.
文摘BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.
基金supported by Texas Alzheimer’s Research and Care Consortium-TARCC 2022-26,The National Football League Players Association-NFLPA,NIH/NIA Grant 1R01 AG072491 to TB and FDP.
文摘Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Heneka,2024).This perspective article,which draws on insights from diverse fields including neuroscience,immunology,and pathology,p rovides a critical analysis of ongoing research efforts in inflammasome biology,with specific emphasis on Nod-like receptor(NLR)and pyrin domain-containing protein 3(NLRP3).
基金the MOST Key Research and Development Program of China(grant number 2022YFC2304703)the Natural Science Foundation of China(grant number 32422004)+5 种基金The Medicine and Engineering Interdisciplinary Research Fund of Shanghai Jiao Tong University(grant number 24X010301328)the Natural Science Foundation of China(grant number 32270202)the Computational Biology Program of Science and Technology Commission of Shanghai Municipality(STCSM)(grant number 25JS2810200)the MOST Key Research and Development Program of China(grant number 2020YFA0907200)Program of Shanghai Academic Research Leader(grant number 23XD1422300)Innovative research team of high-level local universities in Shanghai.All funding sources are attributed to N.N.L.
文摘Postoperative infection is a major global health concern,affecting 5%-10%of surgical patients and nearly doubling mortality in severe cases[1].Transplant recipients are particularly vulnerable,with 30%-80%developing infections within 30 days,often from opportunistic pathogens[2,3].Key risk factors include epidemiological exposure,net immunosuppression,age,transplant type,and surgical history[4].Despite known infection risks,current evidence remains transplantation type-specific and neglects behavioral modulators[5].Different types of transplantation may share similar risk factors[6].To identify common factors affecting postoperative infection,this study collected standardized clinical data-including diet,psychological response,medication use,and biochemical indicators-from liver and kidney transplant patients across six hospitals using a unified standard operating procedure(SOP).
文摘As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding NK cell regulation is of considerable clinical importance.This article reviews the role of circadian processes(melatonin and the cortisol system),aryl hydrocarbon receptor,and vagal nerve in the modulation of NK cell function,highlighting the importance of the endogenous mitochondrial melatonergic pathway in NK cells.As circadian and exogenous melatonin increase NK cell cytotoxicity,the presence of the endogenous melatonergic pathway may be of some importance not only to NK function and immune checkpoint regulation but also from the efflux of melatonin,which decreases tumor cell survival,proliferation,and metastasis,as well as decreasing immune checkpoint ligands,such as programmed cell ligand 1(PD-L1).NK cell melatonergic pathway regulation may therefore have significant impacts not only on NK cell cytotoxicity but also on the intercellular interactions within tumors and other pathological microenvironments.As melatonin has anti-viral effects,the regulation of the NK cell melatonergic pathway can have wider impacts on how NK cells regulate viral infections,including in the course of viral-induced susceptibility to neurodegenerative conditions.Recent data indicate that the endogenous melatonergic pathway is regulated by interactions of signal transducer and activator of transcription(STAT)3 and nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB)dimer composition.As both STAT3 and NF-κB dimer composition modulate NK cells,their interaction in the modulation of the NK cell melatonergic pathway will be important to determine.This has significant future research and treatment implications,including improving the clinical efficacy of current treatment approaches such as immune checkpoint inhibition and chimeric antigen receptor(CAR)NK cell therapy,and may accelerate a means of preventing cancer.
基金supported by funds from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico do Brasil(CNPq)(312286/2023-6,307201/2023-6,and Instituto Nacional Saude Cerebral INSC,No.406020/2022-1)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro-FAPERJ(E-26/010.002260/2019,E-26/010.001652/2019,E-26/010.101036/2018,E-26/202.774/2018,E-26/210.240/2020,E-26/211.138/2021,26/210.823/2021,E-26/211.325/2021,E-26/210.779/2021,E-26/201.086/2022,E-26/210.312/2022,E-26/203.262/2023,E-26/200.195/2023)(to LEBS)。
文摘Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
基金supported by the National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affiliated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Mucormycosis is an invasive fungal infection with an acute onset,rapid progression,and high mortality rate.Since its incidence is lower than that of common fungal infections such as Aspergillus,Candida,and Cryptococcus,it is often overlooked in clinical practice.[1]However,in recent years,the incidence of mucormycosis has increased worldwide,potentially correlating with the growing population of diabetic patients.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
基金supported by the Beijing Science and Technology Planning Project of the Beijing Science and Technology Commission(Z241100009024047)the High-Level Public Health Technical Talent Training Plan(lingjunrencai-01-02).
文摘Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.
