Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized ...Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.展开更多
Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess...Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess the association between the trajectory of prealbumin(PAB)during the early phase of acute pancreatitis(AP)and the incidence of IPN and other clinical outcomes.Methods:This retrospective,dual-centered study screened patients with AP admitted to the Center of Acute Pancreatitis,Jinling Hospital and the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022.The PAB levels during the first week after admission were collected.The primary outcome was the incidence of IPN within 90 days after AP onset.Group-based trajectory modelling was performed to describe the trajectory of PAB levels over time.A Cox proportional hazard model was used to facilitate the interpretation of the time-varying hazard ratio(HR)between PAB and outcomes.Fine-Gray sub-distribution hazard model was adopted for sensitivity analysis.Results:A total of 373 patients were included,of whom 82(22.0%)were diagnosed with IPN within 90 days.The trajectory model assigned 232 patients to the low-level PAB(L-PAB)group and 141 to the high-level PAB(H-PAB)group.The incidence of 90-day IPN in the L-PAB group was significantly higher than that in the H-PAB group(26.7%vs.14.2%,P=0.005).The multivariate Cox regression model showed that a high PAB trajectory was associated with a lower incidence of IPN(HR=0.52,95%CI:0.30-0.89;P=0.017)after adjustment for potential confounders.In the sensitivity analysis,taking death as a com-peting risk,high PAB trajectory remained significantly associated with a lower incidence of IPN in the Fine-Gray model(HR=0.55,95%CI:0.33-0.92;P=0.022).Conclusions:A high PAB trajectory within the first week of AP was significantly associated with a lower incidence of IPN within 90 days after AP onset.Dynamic monitoring of PAB levels in the early phase of AP may play an important role in stratifying patients at high risk of developing IPN.展开更多
The regeneration of infected bone defects is still challenging and time-consuming,due to the adverse osteogenic microenvironment caused by bacterial contamination and pronounced ischemia.Biodegradable magnesium(Mg)-ba...The regeneration of infected bone defects is still challenging and time-consuming,due to the adverse osteogenic microenvironment caused by bacterial contamination and pronounced ischemia.Biodegradable magnesium(Mg)-based alloys are desirable for orthopedic implants due to the mechanical properties approximating those of human bone and the released Mg^(2+)ions essential to osteogenic activity.However,the fast and uncontrolled self-degradation of Mg alloy,along with the inadequate antimicrobial activity,limit their strength in the osteogenic microenvironment.Inspired by the structural and physiological characteristics of“fish scales,”two-dimensional(2D)nanomaterials,black phosphorus(BP)and graphene oxide(GO),were assembled together under the action of pulsed electric field.The bionic 2D layered BP/GO nano-coating was constructed for infection resistance,osteogenic microenvironment optimization,and biodegradation control.In the early stage of implantation,it exerted a photothermal effect to ablate bacterial biofilms and avoid contaminating the microenvironment.The blocking effect of the“nano fish scales”-2D material superposition regulated the degradation of implants.In the later stage,it attracted the migration of vascular endothelial cells(VECs)and released phosphate slowly for in situ mineralization to create the microenvironment favoring vascularized bone formation.It is indicated that the enhancement of microtubule deacetylation and cytoskeletal reorganization played a key role in the effect of VEC migration and angiogenesis.This study provided a promising bionic strategy for creating osteogenic microenvironments that match the sequential healing process of infected bone defects.展开更多
BACKGROUND Skin wounds are highly common in diabetic patients,and with increasing types of pathogenic bacteria and antibiotic resistance,wounds and infections in diabetic patients are difficult to treat and heal.AIM T...BACKGROUND Skin wounds are highly common in diabetic patients,and with increasing types of pathogenic bacteria and antibiotic resistance,wounds and infections in diabetic patients are difficult to treat and heal.AIM To explore the effects of betaine ointment(BO)in promoting the healing of skin wounds and reducing the inflammation and apoptosis of skin cells in microbially infected diabetic mice.METHODS By detecting the minimum inhibitory concentrations(MICs)of betaine and plant monomer components such as psoralen,we prepared BO with betaine as the main ingredient,blended it with traditional Chinese medicines such as gromwell root and psoralen,and evaluated its antibacterial effects and safety in vitro and in vivo.The skin infection wound models of ordinary mice and diabetic mice were constructed,and the OTC drugs mupirocin ointment and Zicao ointment were used as controls to evaluate the antibacterial effects in vivo and the anti-inflammatory and anti-apoptotic effects of BO.RESULTS The MICs of betaine against microorganisms such as Staphylococcus aureus(S.aureus),Candida albicans and Cryptococcus neoformans ranged from 4 to 32μg/mL.Gromwell root and psoralea,both of which contain antimicrobial components,mixed to prepare BO with MICs ranging from 16 to 64μg/mL,which is 32-256 times lower than those of Zicao ointment,although the MIC is greater than that of betaine.After 15 days of treatment with BO for USA300-infected ordinary mice,the wound scab removal rates were 83.3%,while those of mupirocin ointment and Zicao ointment were 66.7%and 0%,respectively,and the differences were statistically significant.In diabetic mice,the wound scab removal rate of BO and mupirolacin ointment was 80.0%,but BO reduced wound inflammation and the apoptosis of skin cells and facilitated wound healing.CONCLUSION The ointment prepared by mixing betaine and traditional Chinese medicine can effectively inhibit common skin microorganisms and has a strong effect on the skin wounds of sensitive or drug-resistant S.aureus-infected ordinary mice and diabetic mice.展开更多
Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous g...Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous grafting and the Masquelet induced membrane technique(IMT).The IMT is aimed at reducing extensive defect treatment duration and for this reason has gained great popularity.However,the assessment of its effectiveness is difficult due to a limited number of clinical series.The varying clinical manifestations of bone defect severity do not allow a comprehensive evaluation of IMT effectiveness.One of them is infection in the defect area.The purpose of our literature review is an analysis of studies on IMT application in infected vs non-infected long-bone defects of the lower extremities published over the last 10 years.It focuses on the investigation of similarities and fundamental differences in the need for antibiotics,timing of spacer fixation,methods of collecting donor bone and fixators used for consolidation.The studies show that the IMT has been globally used in aseptic and osteomyelitic defects due to its clinical effectiveness.Authors’variations and improvements in its practical implementation indicate the ongoing development and the interest of researchers in this technique.展开更多
Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN m...Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.展开更多
BACKGROUND Infected acute necrotic collection(ANC)is a fatal complication of acute pancre-atitis with substantial morbidity and mortality.Drainage plays an exceedingly important role as the first step in invasive inte...BACKGROUND Infected acute necrotic collection(ANC)is a fatal complication of acute pancre-atitis with substantial morbidity and mortality.Drainage plays an exceedingly important role as the first step in invasive intervention for infected necrosis;however,there is great controversy about the optimal drainage time,and better treatment should be explored.CASE SUMMARY We report the case of a 43-year-old man who was admitted to the hospital with severe intake reduction due to early satiety 2 wk after treatment for acute pancre-atitis;conservative treatment was ineffective,and a pancreatic pseudocyst was suspected on contrast-enhanced computed tomography(CT).Endoscopic ultra-sonography(EUS)suggested hyperechoic necrotic tissue within the cyst cavity.The wall was not completely mature,and the culture of the puncture fluid was positive for A-haemolytic Streptococcus.Thus,the final diagnosis of ANC in-fection was made.The necrotic collection was not walled off and contained many solid components;therefore,the patient underwent EUS-guided aspiration and lavage.Two weeks after the collection was completely encapsulated,pancreatic duct stent drainage via endoscopic retrograde cholangiopancreatography(ERCP)was performed,and the patient was subsequently successfully discharged.On repeat CT,the pancreatic cysts had almost disappeared during the 6-month fo-llow-up period after surgery.CONCLUSION Early EUS-guided aspiration and lavage combined with late ERCP catheter drainage may be effective methods for intervention in infected ANCs.展开更多
Objective:We aim to develop a dual-functional bone regeneration scaffold(Qx-D)with antibacterial and osteogenic properties for infected bone defect treatment.Impact Statement:This study provides insights into antibact...Objective:We aim to develop a dual-functional bone regeneration scaffold(Qx-D)with antibacterial and osteogenic properties for infected bone defect treatment.Impact Statement:This study provides insights into antibacterial components that could be combined with naturally derived materials through a facile Schiff base reaction,offering a potential strategy to enhance antibacterial properties.Introduction:Naturally derived decalcified bone matrix(DBM)has been reported to be porous and biodegradable.DBM can induce various cell differentiations and participate in immune regulation,making it an ideal bone regeneration scaffold for bone defects.However,DBM does not exhibit antimicrobial properties.Therefore,it is essential to develop antibacterial functionalization method for DBM.Methods:DBM was modified with a macromolecular quaternary ammonium salt(QPEI).A series of Qx-D with tunable feeding ratios were synthesized through Schiff base reaction.The morphology,chemical property,in vitro antibacterial efficiency,in vitro biocompatibility,osteogenic property,and in vivo anti-infection performances were characterized.Results:All Qx-D exhibited marked antibacterial properties.Small adjustments in feed concentration could not induce changes in antibacterial properties.However,cell viability slightly decreased with increasing feed concentration.Q10-D demonstrated significant antibacterial properties and could promote recovery of infected bone defect in an animal model.Conclusion:Qx-D shows marked antibacterial properties and good biocompatibility.Moreover,Q10-D could be a potential choice for infected bone defects.展开更多
Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical wast...Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.展开更多
The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worl...The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.展开更多
The theory of network science has attracted great interest of many researchers in the realm of biomathematics and public health,and numerous valuable epidemic models have been developed.In previous studies,it is commo...The theory of network science has attracted great interest of many researchers in the realm of biomathematics and public health,and numerous valuable epidemic models have been developed.In previous studies,it is common to set up a one-to-one correspondence between the nodes of a multi-layer network,ignoring the more complex situations in reality.In the present work,we explore this situation by setting up a partially coupled model of a two-layer network and investigating the impact of asymptomatic infected individuals on epidemics.We propose a self-discovery mechanism for asymptomatic infected individuals,taking into account situations such as nucleic acid testing in the community and individuals performing self-antigen testing during the epidemic.Considering these factors together,through the microscopic Markov chain approach(MMCA)and extensive Monte Carlo(MC)numerical simulations,we find that the greater the coupling between the networks,the more information dissemination is facilitated.In order to control the epidemics,more asymptomatic infected individuals should be made aware of their infection.Massive adoption of nucleic acid testing and individual adoption of antigenic self-testing can help to contain epidemic outbreaks.Meanwhile,the epidemic threshold of the proposed model is derived,and then miscellaneous factors affecting the epidemic threshold are also discussed.Current results are conducive to devising the prevention and control policies of pandemics.展开更多
Clinical practice has shown that kidney transplant recipients infected with COVID-19 are prone to developing critical illness and have a higher mortality rate.[1]Kidney transplant recipients require long-term oral ant...Clinical practice has shown that kidney transplant recipients infected with COVID-19 are prone to developing critical illness and have a higher mortality rate.[1]Kidney transplant recipients require long-term oral anti-rejection drugs to suppress the immune response.This result may be related to the strong immunosuppression in kidney transplant recipients compared to the general population.[2]Therefore,the treatment of kidney transplant recipients infected with severe COVID-19 is a difficult problem.Here,we report the use of extracorporeal membrane oxygenation(ECMO)-assisted treatment for a kidney transplant recipient who was infected with severe COVID-19.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection can cause extensive apoptosis of gastric epithelial cells,serving as a critical catalyst in the progression from chronic gastritis,gastrointestinal metaplasia,and atyp...BACKGROUND Helicobacter pylori(H.pylori)infection can cause extensive apoptosis of gastric epithelial cells,serving as a critical catalyst in the progression from chronic gastritis,gastrointestinal metaplasia,and atypical gastric hyperplasia to gastric carcinoma.Prompt eradication of H.pylori is paramount for ameliorating the pathophysiological conditions associated with chronic inflammation of the gastric mucosa and the primary prevention of gastric cancer.Acacetin,which has multifaceted pharmacological activities such as anti-cancer,anti-inflammatory,and antioxidative properties,has been extensively investigated across various domains.Nevertheless,the impact and underlying mechanisms of action of acacetin on H.pylori-infected gastric mucosal epithelial cells remain unclear.AIM To explore the defensive effects of acacetin on apoptosis in H.pylori-infected GES-1 cells and to investigate the underlying mechanisms.METHODS GES-1 cells were treated with H.pylori and acacetin in vitro.Cell viability was assessed using the CCK-8 assay,cell mortality rate via lactate dehydrogenase assay,alterations in cell migration and healing capacities through the wound healing assay,rates of apoptosis via flow cytometry and TUNEL staining,and expression levels of apoptosis-associated proteins through western blot analysis.RESULTS H.pylori infection led to decreased GES-1 cell viability,increased cell mortality,suppressed cell migration,increased rate of apoptosis,increased expressions of Bax and cle-caspase3,and decreased Bcl-2 expression.Conversely,acacetin treatment enhanced cell viability,mitigated apoptosis induced by H.pylori infection,and modulated the expression of apoptosis-regulatory proteins by upregulating Bcl-2 and downregulating Bax and cleaved caspase-3.CONCLUSION Acacetin significantly improved GES-1 cell viability and inhibited apoptosis in H.pylori-infected GES-1 cells,thereby exerting a protective effect on gastric mucosal epithelial cells.展开更多
BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium,which was first isolated from the condensate of the Russian peace space station in 2003.Most studies on this bacterium have been carried ...BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium,which was first isolated from the condensate of the Russian peace space station in 2003.Most studies on this bacterium have been carried out in the laboratory,and clinical case studies are rare.To date,a total of 6 clinical cases have been reported worldwide.CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola.The imaging character-istics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed.CONCLUSION Elizabethkingia miricola infection is rare.When pulmonary infection occurs,computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs,the air containing bronchial sign in local areas,thickening of bronchial vascular bundle,and pleural effusion.展开更多
Background:The continuing emergence of influenza virus has highlighted the value of public databases and related bioinformatic analysis tools in investigating transcriptomic change caused by different influenza virus ...Background:The continuing emergence of influenza virus has highlighted the value of public databases and related bioinformatic analysis tools in investigating transcriptomic change caused by different influenza virus infections in human and animal models.Methods:We collected a large amount of transcriptome research data related to influenza virus-i nfected human and animal models in public databases(GEO and ArrayExpress),and extracted and integrated array and metadata.The gene expression matrix was generated through strictly quality control,balance,standardization,batch correction,and gene annotation.We then analyzed gene expression in different species,virus,cells/tissues or after antibody/vaccine treatment and imported sample metadata and gene expression datasets into the database.Results:Overall,maintaining careful processing and quality control,we collected 8064 samples from 103 independent datasets,and constructed a comparative transcriptomics database of influenza virus named the Flu-CED database(Influenza comparative expression database,https://flu.com-med.org.cn/).Using integrated and processed transcriptomic data,we established a user-friendly website for realizing the integration,online retrieval,visualization,and exploration of gene expression of influenza virus infection in different species and the biological functions involved in differential genes.Flu-CED can quickly query single and multi-gene expression profiles,combining different experimental conditions for comparative transcriptome analysis,identifying differentially expressed genes(DEGs)between comparison groups,and conveniently finding DEGs.Conclusion:Flu-CED provides data resources and tools for analyzing gene expression in human and animal models infected with influenza virus that can deepen our understanding of the mechanisms underlying disease occurrence and development,and enable prediction of key genes or therapeutic targets that can be used for medical research.展开更多
Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of H...Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection(URTI)were explored.Methods In total,35 patients were enrolled in the study following an outbreak of HAdV-7 in the army,of whom 14 had pneumonia and 21 had URTI.Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics.Results Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules,including glycerophospholipids,fatty acyls,and sphingolipids.The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways,including sphingolipid metabolism,glycerophospholipid metabolism,and linoleic acid metabolism.The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients,but not between the acute and recovery stages for the URTI patients.Ceramide and lactosylceramide,involved in sphingolipid metabolism,were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities[area under curve(AUC)0.742 and 0.716,respectively;combination AUC 0.801].Conclusion Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia,especially the sphingolipid metabolism involving ceramide and lactosylceramide,which might thus be a potential intervention target in the treatment of HAdV infection.展开更多
Human cytomegalovirus(HCMV)is a common herpesvirus that persistently infects a large portion of the world's population.Despite the robust host immune response,HCMV is able to replicate,evade host defenses,and esta...Human cytomegalovirus(HCMV)is a common herpesvirus that persistently infects a large portion of the world's population.Despite the robust host immune response,HCMV is able to replicate,evade host defenses,and establish latency throughout the lifespan by developing multiple immunomodulatory strategies,making the studies on the interaction between HCMV infection and host response particularly important.HCMV has a strict host specificity that specifically infects humans.Therefore,most of the in vivo researches of HCMV rely on clinical samples.Fortunately,the establishment of humanized mouse models allows for convenient in-lab animal experiments involving HCMV infection.Single-cell RNA sequencing enables the study of the relationship between viral and host gene expressions at the single-cell level within host cells.In this study,we assessed the gene expression alterations of PBMCs at the single-cell level within HCMV-infected humanized mice,which sheds light onto the virus-host interactions in the context of HCMV infection of humanized mice and provides a valuable dataset for the related researches.展开更多
According to the report from the Chinese Center for Disease Control and Prevention,the prevalence of human immunodeficiency virus(HIV)infection exceeded 1.2 million individuals by the year 2022,with an annual increase...According to the report from the Chinese Center for Disease Control and Prevention,the prevalence of human immunodeficiency virus(HIV)infection exceeded 1.2 million individuals by the year 2022,with an annual increase of about 80000 cases.The overall prevalence of hepatitis B surface antigen among individuals co-infected with HIV reached 13.7%,almost twice the rate of the general population in China.In addition to the well-documented susceptibility to opportunistic infections and new malignancies,HIV infected patients frequently experience liver-related organ damage,with the liver and kidneys being the most commonly affected.This often leads to the development of end-stage liver and kidney diseases.Therefore,organ transplantation has emerged as an important part of active treatment for HIV infected patients.However,the curative effect is not satisfactory.HIV infection has been considered a contraindication for organ transplantation.Until the emergence of highly active anti-retroviral therapy in 1996,the once intractable replication of retrovirus was effectively inhibited.With prolonged survival,the failure of important organs has become the main cause of death among HIV patients.Therefore,transplant centers worldwide have resu-med exploration of organ transplantation for HIV-infected individuals and reached a positive conclusion.This study provides an overview of the current landscape of HIV-positive patients receiving liver transplantation(LT)in main-land China.To date,our transplant center has conducted LT for eight end-stage liver disease patients co-infected with HIV,and all but one,who died two months postoperatively due to sepsis and progressive multi-organ failure,have survived.Comparative analysis with hepatitis B virus-infected patients during the same period revealed no statistically significant differences in acute rejection reactions,cytomegalovirus infection,bacteremia,pulmonary infections,acute kidney injury,new-onset cancers,or vascular and biliary complications.展开更多
Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and se...Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and serious complications such as tissue necrosis and osteomyelitis, can result without the timely control of infections. Recent studies have also reported an increase in the association of fungal infections with chronic non-healing ulcers. Aim: To determine the prevalence of bacterial and fungal infections among patients reporting with chronic leg ulcers in participants without co-morbidities. Methods: A prospective cross-sectional study was conducted among patients with chronic leg ulcers at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital (NRPS/BC-KBTH) and those who consented were enrolled. Characteristics of the wound as well as micro-organisms cultured from wound swabs were recorded. Results: A total of 50 participants were enrolled for the study with the mean (SD) age of 40.7 (10.7) years. Eighty percent of the participants presented with post traumatic leg ulcers with 80% being artisans and traders in the age group 31 - 50 years. There was no statistically significant association between sex and the organism cultured for post traumatic and cellulitis (p-value > 0.05). The prevalence of bacterial and fungal infection was 79.3% and 20.7% respectively. Pseudomonas species was the most isolated bacteria (61.5%) while Aspergillus niger was the most isolated fungi (41%). Conclusion: From this study, fungal infections should be included in managing chronic leg ulcers, especially among artisans, famers and gardeners even though there was a significantly higher burden of bacterial infections.展开更多
AIM: To analyze outcomes of delayed single-stage necrosectomy after early conservative management of patients with infected pancreatic necrosis (IPN) associated with severe acute pancreatitis (SAP). METHODS: Between J...AIM: To analyze outcomes of delayed single-stage necrosectomy after early conservative management of patients with infected pancreatic necrosis (IPN) associated with severe acute pancreatitis (SAP). METHODS: Between January 1998 and December 2009, data from patients with SAP who developed IPN and were managed by pancreatic necrosectomy were analyzed. RESULTS: Fifty-nine of 61 pancreatic necrosectomies were performed by open surgery and 2 laparoscopically. In 55 patients, single-stage necrosectomy could be performed (90.2%). Patients underwent surgery at a median of 29 d (range 13-46 d) after diagnosis of acute pancreatitis. Sepsis and multiple organ failure accounted for the 9.8% mortality rate. Pancreatic fistulae (50.8%) predominantly accounted for the morbidity. The median hospital stay was 23 d, and the median interval for return to regular activities was 110 d.CONCLUSION: This series supports the concept of delayed single-stage open pancreatic necrosectomy for IPN. Advances in critical care, antibiotics and interventional radiology have played complementary role in improving the outcomes.展开更多
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Xizang Autonomous Region,No.XZ2024ZR-ZY100(Z)Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.
文摘Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.
基金supported by a grant from the National Natural Science Foundation of China(82470680).
文摘Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess the association between the trajectory of prealbumin(PAB)during the early phase of acute pancreatitis(AP)and the incidence of IPN and other clinical outcomes.Methods:This retrospective,dual-centered study screened patients with AP admitted to the Center of Acute Pancreatitis,Jinling Hospital and the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022.The PAB levels during the first week after admission were collected.The primary outcome was the incidence of IPN within 90 days after AP onset.Group-based trajectory modelling was performed to describe the trajectory of PAB levels over time.A Cox proportional hazard model was used to facilitate the interpretation of the time-varying hazard ratio(HR)between PAB and outcomes.Fine-Gray sub-distribution hazard model was adopted for sensitivity analysis.Results:A total of 373 patients were included,of whom 82(22.0%)were diagnosed with IPN within 90 days.The trajectory model assigned 232 patients to the low-level PAB(L-PAB)group and 141 to the high-level PAB(H-PAB)group.The incidence of 90-day IPN in the L-PAB group was significantly higher than that in the H-PAB group(26.7%vs.14.2%,P=0.005).The multivariate Cox regression model showed that a high PAB trajectory was associated with a lower incidence of IPN(HR=0.52,95%CI:0.30-0.89;P=0.017)after adjustment for potential confounders.In the sensitivity analysis,taking death as a com-peting risk,high PAB trajectory remained significantly associated with a lower incidence of IPN in the Fine-Gray model(HR=0.55,95%CI:0.33-0.92;P=0.022).Conclusions:A high PAB trajectory within the first week of AP was significantly associated with a lower incidence of IPN within 90 days after AP onset.Dynamic monitoring of PAB levels in the early phase of AP may play an important role in stratifying patients at high risk of developing IPN.
基金supported by the National Natural Science Foundation of China[81801007]the Traditional Chinese Medicine Bureau of Guangdong Province[20242062]+2 种基金the Major of Basic and Applied Basic Research Project of Guangzhou City[202201011601]the Science and Cultivation Foundation of Stomatological Hospital of Southern Medical University[PY2021016]the Guangdong Province Clinical Teaching Base Teaching Reform Research Project[2023JD054].
文摘The regeneration of infected bone defects is still challenging and time-consuming,due to the adverse osteogenic microenvironment caused by bacterial contamination and pronounced ischemia.Biodegradable magnesium(Mg)-based alloys are desirable for orthopedic implants due to the mechanical properties approximating those of human bone and the released Mg^(2+)ions essential to osteogenic activity.However,the fast and uncontrolled self-degradation of Mg alloy,along with the inadequate antimicrobial activity,limit their strength in the osteogenic microenvironment.Inspired by the structural and physiological characteristics of“fish scales,”two-dimensional(2D)nanomaterials,black phosphorus(BP)and graphene oxide(GO),were assembled together under the action of pulsed electric field.The bionic 2D layered BP/GO nano-coating was constructed for infection resistance,osteogenic microenvironment optimization,and biodegradation control.In the early stage of implantation,it exerted a photothermal effect to ablate bacterial biofilms and avoid contaminating the microenvironment.The blocking effect of the“nano fish scales”-2D material superposition regulated the degradation of implants.In the later stage,it attracted the migration of vascular endothelial cells(VECs)and released phosphate slowly for in situ mineralization to create the microenvironment favoring vascularized bone formation.It is indicated that the enhancement of microtubule deacetylation and cytoskeletal reorganization played a key role in the effect of VEC migration and angiogenesis.This study provided a promising bionic strategy for creating osteogenic microenvironments that match the sequential healing process of infected bone defects.
基金Supported by Guangxi Science and Technology Major Projects,No.2023AA20009National Natural Science Foundation of China,No.32360035 and No.32060018.
文摘BACKGROUND Skin wounds are highly common in diabetic patients,and with increasing types of pathogenic bacteria and antibiotic resistance,wounds and infections in diabetic patients are difficult to treat and heal.AIM To explore the effects of betaine ointment(BO)in promoting the healing of skin wounds and reducing the inflammation and apoptosis of skin cells in microbially infected diabetic mice.METHODS By detecting the minimum inhibitory concentrations(MICs)of betaine and plant monomer components such as psoralen,we prepared BO with betaine as the main ingredient,blended it with traditional Chinese medicines such as gromwell root and psoralen,and evaluated its antibacterial effects and safety in vitro and in vivo.The skin infection wound models of ordinary mice and diabetic mice were constructed,and the OTC drugs mupirocin ointment and Zicao ointment were used as controls to evaluate the antibacterial effects in vivo and the anti-inflammatory and anti-apoptotic effects of BO.RESULTS The MICs of betaine against microorganisms such as Staphylococcus aureus(S.aureus),Candida albicans and Cryptococcus neoformans ranged from 4 to 32μg/mL.Gromwell root and psoralea,both of which contain antimicrobial components,mixed to prepare BO with MICs ranging from 16 to 64μg/mL,which is 32-256 times lower than those of Zicao ointment,although the MIC is greater than that of betaine.After 15 days of treatment with BO for USA300-infected ordinary mice,the wound scab removal rates were 83.3%,while those of mupirocin ointment and Zicao ointment were 66.7%and 0%,respectively,and the differences were statistically significant.In diabetic mice,the wound scab removal rate of BO and mupirolacin ointment was 80.0%,but BO reduced wound inflammation and the apoptosis of skin cells and facilitated wound healing.CONCLUSION The ointment prepared by mixing betaine and traditional Chinese medicine can effectively inhibit common skin microorganisms and has a strong effect on the skin wounds of sensitive or drug-resistant S.aureus-infected ordinary mice and diabetic mice.
文摘Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous grafting and the Masquelet induced membrane technique(IMT).The IMT is aimed at reducing extensive defect treatment duration and for this reason has gained great popularity.However,the assessment of its effectiveness is difficult due to a limited number of clinical series.The varying clinical manifestations of bone defect severity do not allow a comprehensive evaluation of IMT effectiveness.One of them is infection in the defect area.The purpose of our literature review is an analysis of studies on IMT application in infected vs non-infected long-bone defects of the lower extremities published over the last 10 years.It focuses on the investigation of similarities and fundamental differences in the need for antibiotics,timing of spacer fixation,methods of collecting donor bone and fixators used for consolidation.The studies show that the IMT has been globally used in aseptic and osteomyelitic defects due to its clinical effectiveness.Authors’variations and improvements in its practical implementation indicate the ongoing development and the interest of researchers in this technique.
文摘Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.
文摘BACKGROUND Infected acute necrotic collection(ANC)is a fatal complication of acute pancre-atitis with substantial morbidity and mortality.Drainage plays an exceedingly important role as the first step in invasive intervention for infected necrosis;however,there is great controversy about the optimal drainage time,and better treatment should be explored.CASE SUMMARY We report the case of a 43-year-old man who was admitted to the hospital with severe intake reduction due to early satiety 2 wk after treatment for acute pancre-atitis;conservative treatment was ineffective,and a pancreatic pseudocyst was suspected on contrast-enhanced computed tomography(CT).Endoscopic ultra-sonography(EUS)suggested hyperechoic necrotic tissue within the cyst cavity.The wall was not completely mature,and the culture of the puncture fluid was positive for A-haemolytic Streptococcus.Thus,the final diagnosis of ANC in-fection was made.The necrotic collection was not walled off and contained many solid components;therefore,the patient underwent EUS-guided aspiration and lavage.Two weeks after the collection was completely encapsulated,pancreatic duct stent drainage via endoscopic retrograde cholangiopancreatography(ERCP)was performed,and the patient was subsequently successfully discharged.On repeat CT,the pancreatic cysts had almost disappeared during the 6-month fo-llow-up period after surgery.CONCLUSION Early EUS-guided aspiration and lavage combined with late ERCP catheter drainage may be effective methods for intervention in infected ANCs.
基金supported by the National Natural Science Foundation of China(grant nos.52122304,52293382,52221006,and 52073024)the Beijing Municipal Administration of Hospitals Incubating Program(grant no.PX2021005).
文摘Objective:We aim to develop a dual-functional bone regeneration scaffold(Qx-D)with antibacterial and osteogenic properties for infected bone defect treatment.Impact Statement:This study provides insights into antibacterial components that could be combined with naturally derived materials through a facile Schiff base reaction,offering a potential strategy to enhance antibacterial properties.Introduction:Naturally derived decalcified bone matrix(DBM)has been reported to be porous and biodegradable.DBM can induce various cell differentiations and participate in immune regulation,making it an ideal bone regeneration scaffold for bone defects.However,DBM does not exhibit antimicrobial properties.Therefore,it is essential to develop antibacterial functionalization method for DBM.Methods:DBM was modified with a macromolecular quaternary ammonium salt(QPEI).A series of Qx-D with tunable feeding ratios were synthesized through Schiff base reaction.The morphology,chemical property,in vitro antibacterial efficiency,in vitro biocompatibility,osteogenic property,and in vivo anti-infection performances were characterized.Results:All Qx-D exhibited marked antibacterial properties.Small adjustments in feed concentration could not induce changes in antibacterial properties.However,cell viability slightly decreased with increasing feed concentration.Q10-D demonstrated significant antibacterial properties and could promote recovery of infected bone defect in an animal model.Conclusion:Qx-D shows marked antibacterial properties and good biocompatibility.Moreover,Q10-D could be a potential choice for infected bone defects.
基金supported by the National Natural Science Foundation of China(Nos.82370977,52073186)Medical Science and Technology Project of Sichuan Provincial Health Commission(No.21PJ059)+2 种基金Science and Technology Application Fundamental Project of Sichuan Province(No.2022YFS0124)Funding for Distinguished Young Scholars of Sichuan Province(No.23NSFJQ0001)Strategic Cooperation Projects of Yi Bin City and Sichuan University(No.2020CDYB-6)。
文摘Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.
文摘The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.
基金supported by the National Natural Science Foundation of China(Grant No.62173247).
文摘The theory of network science has attracted great interest of many researchers in the realm of biomathematics and public health,and numerous valuable epidemic models have been developed.In previous studies,it is common to set up a one-to-one correspondence between the nodes of a multi-layer network,ignoring the more complex situations in reality.In the present work,we explore this situation by setting up a partially coupled model of a two-layer network and investigating the impact of asymptomatic infected individuals on epidemics.We propose a self-discovery mechanism for asymptomatic infected individuals,taking into account situations such as nucleic acid testing in the community and individuals performing self-antigen testing during the epidemic.Considering these factors together,through the microscopic Markov chain approach(MMCA)and extensive Monte Carlo(MC)numerical simulations,we find that the greater the coupling between the networks,the more information dissemination is facilitated.In order to control the epidemics,more asymptomatic infected individuals should be made aware of their infection.Massive adoption of nucleic acid testing and individual adoption of antigenic self-testing can help to contain epidemic outbreaks.Meanwhile,the epidemic threshold of the proposed model is derived,and then miscellaneous factors affecting the epidemic threshold are also discussed.Current results are conducive to devising the prevention and control policies of pandemics.
文摘Clinical practice has shown that kidney transplant recipients infected with COVID-19 are prone to developing critical illness and have a higher mortality rate.[1]Kidney transplant recipients require long-term oral anti-rejection drugs to suppress the immune response.This result may be related to the strong immunosuppression in kidney transplant recipients compared to the general population.[2]Therefore,the treatment of kidney transplant recipients infected with severe COVID-19 is a difficult problem.Here,we report the use of extracorporeal membrane oxygenation(ECMO)-assisted treatment for a kidney transplant recipient who was infected with severe COVID-19.
基金Supported by the Doctoral Research Initiation Fund of Affiliated Hospital of Southwest Medical University,No.21037.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection can cause extensive apoptosis of gastric epithelial cells,serving as a critical catalyst in the progression from chronic gastritis,gastrointestinal metaplasia,and atypical gastric hyperplasia to gastric carcinoma.Prompt eradication of H.pylori is paramount for ameliorating the pathophysiological conditions associated with chronic inflammation of the gastric mucosa and the primary prevention of gastric cancer.Acacetin,which has multifaceted pharmacological activities such as anti-cancer,anti-inflammatory,and antioxidative properties,has been extensively investigated across various domains.Nevertheless,the impact and underlying mechanisms of action of acacetin on H.pylori-infected gastric mucosal epithelial cells remain unclear.AIM To explore the defensive effects of acacetin on apoptosis in H.pylori-infected GES-1 cells and to investigate the underlying mechanisms.METHODS GES-1 cells were treated with H.pylori and acacetin in vitro.Cell viability was assessed using the CCK-8 assay,cell mortality rate via lactate dehydrogenase assay,alterations in cell migration and healing capacities through the wound healing assay,rates of apoptosis via flow cytometry and TUNEL staining,and expression levels of apoptosis-associated proteins through western blot analysis.RESULTS H.pylori infection led to decreased GES-1 cell viability,increased cell mortality,suppressed cell migration,increased rate of apoptosis,increased expressions of Bax and cle-caspase3,and decreased Bcl-2 expression.Conversely,acacetin treatment enhanced cell viability,mitigated apoptosis induced by H.pylori infection,and modulated the expression of apoptosis-regulatory proteins by upregulating Bcl-2 and downregulating Bax and cleaved caspase-3.CONCLUSION Acacetin significantly improved GES-1 cell viability and inhibited apoptosis in H.pylori-infected GES-1 cells,thereby exerting a protective effect on gastric mucosal epithelial cells.
文摘BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium,which was first isolated from the condensate of the Russian peace space station in 2003.Most studies on this bacterium have been carried out in the laboratory,and clinical case studies are rare.To date,a total of 6 clinical cases have been reported worldwide.CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola.The imaging character-istics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed.CONCLUSION Elizabethkingia miricola infection is rare.When pulmonary infection occurs,computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs,the air containing bronchial sign in local areas,thickening of bronchial vascular bundle,and pleural effusion.
基金Chinese Academy of Medical Sciences Initiative for Innovative MedicineGrant/Award Number:2021-I2M-1-035+3 种基金Beijing Municipal Natural Science FoundationGrant/Award Number:M21027National Key Research and Development Program of ChinaGrant/Award Number:2021YFF0702800。
文摘Background:The continuing emergence of influenza virus has highlighted the value of public databases and related bioinformatic analysis tools in investigating transcriptomic change caused by different influenza virus infections in human and animal models.Methods:We collected a large amount of transcriptome research data related to influenza virus-i nfected human and animal models in public databases(GEO and ArrayExpress),and extracted and integrated array and metadata.The gene expression matrix was generated through strictly quality control,balance,standardization,batch correction,and gene annotation.We then analyzed gene expression in different species,virus,cells/tissues or after antibody/vaccine treatment and imported sample metadata and gene expression datasets into the database.Results:Overall,maintaining careful processing and quality control,we collected 8064 samples from 103 independent datasets,and constructed a comparative transcriptomics database of influenza virus named the Flu-CED database(Influenza comparative expression database,https://flu.com-med.org.cn/).Using integrated and processed transcriptomic data,we established a user-friendly website for realizing the integration,online retrieval,visualization,and exploration of gene expression of influenza virus infection in different species and the biological functions involved in differential genes.Flu-CED can quickly query single and multi-gene expression profiles,combining different experimental conditions for comparative transcriptome analysis,identifying differentially expressed genes(DEGs)between comparison groups,and conveniently finding DEGs.Conclusion:Flu-CED provides data resources and tools for analyzing gene expression in human and animal models infected with influenza virus that can deepen our understanding of the mechanisms underlying disease occurrence and development,and enable prediction of key genes or therapeutic targets that can be used for medical research.
基金supported by the National Natural Science Foundation of China(No.82073617)Joint Research Fund for Beijing Natural Science Foundation and Haidian Original Innovation(No.L202007)+1 种基金Fundamental Research Funds for the Central Universities and Peking University Health Science Center(No.BMU2021YJ041)Peking University Medicine Fund of Fostering Young Scholars'Scientific&Technological Innovation(No.BMU2021PY005).
文摘Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection(URTI)were explored.Methods In total,35 patients were enrolled in the study following an outbreak of HAdV-7 in the army,of whom 14 had pneumonia and 21 had URTI.Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics.Results Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules,including glycerophospholipids,fatty acyls,and sphingolipids.The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways,including sphingolipid metabolism,glycerophospholipid metabolism,and linoleic acid metabolism.The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients,but not between the acute and recovery stages for the URTI patients.Ceramide and lactosylceramide,involved in sphingolipid metabolism,were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities[area under curve(AUC)0.742 and 0.716,respectively;combination AUC 0.801].Conclusion Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia,especially the sphingolipid metabolism involving ceramide and lactosylceramide,which might thus be a potential intervention target in the treatment of HAdV infection.
基金supported by the National Key R&D Program of China(2023YFC23066000 to Y.R.)the National Natural Science Foundation of China(32100106 to Y.R.,and U21A20423 and 32225004 to X.Z.)+2 种基金the CAS Youth Innovation Promotion Association(2023351 to Y.R.)Hubei Province Natural Science Funds(2023AFB582 to Y.R.and 2023AFA008 to X.Z)the Fund of the Science and Technology Bureau of Wuhan(2023020201010086 to Y.R.).
文摘Human cytomegalovirus(HCMV)is a common herpesvirus that persistently infects a large portion of the world's population.Despite the robust host immune response,HCMV is able to replicate,evade host defenses,and establish latency throughout the lifespan by developing multiple immunomodulatory strategies,making the studies on the interaction between HCMV infection and host response particularly important.HCMV has a strict host specificity that specifically infects humans.Therefore,most of the in vivo researches of HCMV rely on clinical samples.Fortunately,the establishment of humanized mouse models allows for convenient in-lab animal experiments involving HCMV infection.Single-cell RNA sequencing enables the study of the relationship between viral and host gene expressions at the single-cell level within host cells.In this study,we assessed the gene expression alterations of PBMCs at the single-cell level within HCMV-infected humanized mice,which sheds light onto the virus-host interactions in the context of HCMV infection of humanized mice and provides a valuable dataset for the related researches.
基金Supported by the Shenzhen Science and Technology R&D Fund,No.JCYJ20220530163011026Shenzhen Third People’s Hospital,No.G2022008 and No.G2021008.
文摘According to the report from the Chinese Center for Disease Control and Prevention,the prevalence of human immunodeficiency virus(HIV)infection exceeded 1.2 million individuals by the year 2022,with an annual increase of about 80000 cases.The overall prevalence of hepatitis B surface antigen among individuals co-infected with HIV reached 13.7%,almost twice the rate of the general population in China.In addition to the well-documented susceptibility to opportunistic infections and new malignancies,HIV infected patients frequently experience liver-related organ damage,with the liver and kidneys being the most commonly affected.This often leads to the development of end-stage liver and kidney diseases.Therefore,organ transplantation has emerged as an important part of active treatment for HIV infected patients.However,the curative effect is not satisfactory.HIV infection has been considered a contraindication for organ transplantation.Until the emergence of highly active anti-retroviral therapy in 1996,the once intractable replication of retrovirus was effectively inhibited.With prolonged survival,the failure of important organs has become the main cause of death among HIV patients.Therefore,transplant centers worldwide have resu-med exploration of organ transplantation for HIV-infected individuals and reached a positive conclusion.This study provides an overview of the current landscape of HIV-positive patients receiving liver transplantation(LT)in main-land China.To date,our transplant center has conducted LT for eight end-stage liver disease patients co-infected with HIV,and all but one,who died two months postoperatively due to sepsis and progressive multi-organ failure,have survived.Comparative analysis with hepatitis B virus-infected patients during the same period revealed no statistically significant differences in acute rejection reactions,cytomegalovirus infection,bacteremia,pulmonary infections,acute kidney injury,new-onset cancers,or vascular and biliary complications.
文摘Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and serious complications such as tissue necrosis and osteomyelitis, can result without the timely control of infections. Recent studies have also reported an increase in the association of fungal infections with chronic non-healing ulcers. Aim: To determine the prevalence of bacterial and fungal infections among patients reporting with chronic leg ulcers in participants without co-morbidities. Methods: A prospective cross-sectional study was conducted among patients with chronic leg ulcers at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital (NRPS/BC-KBTH) and those who consented were enrolled. Characteristics of the wound as well as micro-organisms cultured from wound swabs were recorded. Results: A total of 50 participants were enrolled for the study with the mean (SD) age of 40.7 (10.7) years. Eighty percent of the participants presented with post traumatic leg ulcers with 80% being artisans and traders in the age group 31 - 50 years. There was no statistically significant association between sex and the organism cultured for post traumatic and cellulitis (p-value > 0.05). The prevalence of bacterial and fungal infection was 79.3% and 20.7% respectively. Pseudomonas species was the most isolated bacteria (61.5%) while Aspergillus niger was the most isolated fungi (41%). Conclusion: From this study, fungal infections should be included in managing chronic leg ulcers, especially among artisans, famers and gardeners even though there was a significantly higher burden of bacterial infections.
文摘AIM: To analyze outcomes of delayed single-stage necrosectomy after early conservative management of patients with infected pancreatic necrosis (IPN) associated with severe acute pancreatitis (SAP). METHODS: Between January 1998 and December 2009, data from patients with SAP who developed IPN and were managed by pancreatic necrosectomy were analyzed. RESULTS: Fifty-nine of 61 pancreatic necrosectomies were performed by open surgery and 2 laparoscopically. In 55 patients, single-stage necrosectomy could be performed (90.2%). Patients underwent surgery at a median of 29 d (range 13-46 d) after diagnosis of acute pancreatitis. Sepsis and multiple organ failure accounted for the 9.8% mortality rate. Pancreatic fistulae (50.8%) predominantly accounted for the morbidity. The median hospital stay was 23 d, and the median interval for return to regular activities was 110 d.CONCLUSION: This series supports the concept of delayed single-stage open pancreatic necrosectomy for IPN. Advances in critical care, antibiotics and interventional radiology have played complementary role in improving the outcomes.
