Dengue fever is an acute infectious disease caused by the dengue virus and transmitted by mosquito vectors[1].Its clinical manifestations include high fever,headache,muscle and joint pain,and rash.It holds a significa...Dengue fever is an acute infectious disease caused by the dengue virus and transmitted by mosquito vectors[1].Its clinical manifestations include high fever,headache,muscle and joint pain,and rash.It holds a significant position in global public health.In recent years,its incidence has continued to rise worldwide[2],making it one of the major diseases threatening human health.The disease course of dengue fever is divided into three typical phases:the acute febrile phase,the critical phase,and the recovery phase.While most patients experience mild symptoms,some may progress to severe dengue and potentially fatal outcomes if not promptly and effectively treated during the critical phase.展开更多
Acute severe ulcerative colitis(UC) is a highly morbid con dition that requires both medical and surgical managementhrough the collaboration of gastroenterologists and colorectal surgeons. First line treatment for pat...Acute severe ulcerative colitis(UC) is a highly morbid con dition that requires both medical and surgical managementhrough the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery. Unfortunately, protracted medical therapy has led to patients presenting for surgery in a poorer state of health leading to poorer post-operative outcomes. In this era of multiple medical modalities available in the treatment of acute severe UC, physicians must consider the advantages and disadvantages of prolonged medical therapy in an attempt to avoid surgery. Colectomy remains a mainstay in the treatment of severe ulcerative colitis not responsive to corticosteroids and rescue therapy, and timely referral for surgery allows for improved post-operative outcomes with lower risk of sepsis and improved patient survival. Options for reconstructive surgery include three-stage ileal pouchanal anastomosis or a modified two-stage procedure that can be performed either open or laparoscopically. The numerous avenues of medical and surgical therapy have allowed for great advances in the treatment of patients with UC. In this era of options, it is important to maintain a global view, utilize biologic therapy when indicated, and then maintain an appropriate threshold for surgery. The purpose of this review is to summarize the growing number of medical and surgical options available in the treatment of acute, severe UC.展开更多
Hubei Province is a major epidemic area of severe fever with thrombocytopenia syndrome bunyavirus(SFTSV) in China. However, to date, a few SFTSV strains have been isolated from Hubei Province, preventing effective stu...Hubei Province is a major epidemic area of severe fever with thrombocytopenia syndrome bunyavirus(SFTSV) in China. However, to date, a few SFTSV strains have been isolated from Hubei Province, preventing effective studies of epidemic outbreaks. Here, we report three confirmed patients(2015–2016) with typical symptoms of severe fever with thrombocytopenia syndrome disease(SFTS) who were farmers resident in different regions in Hubei Province. Three new SFTSV strains were isolated from the serum samples of each patient. Characterization of viral growth properties showed that there were no significant differences in virus production. All strains were completely sequenced, and phylogenetic analysis showed that unlike the other strains from Hubei province, which belonged to the SFTSV C3 genotype, one of the three strains belonged to the SFTSV C2 genotype. These results suggested that multiple SFTSV genotypes have been circulating in Hubei Province, providing insights into SFTSV evolution and improving our understanding of SFTSV prevalence in Hubei Province.展开更多
BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of ...BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of severe trauma,providing a reliable research tool.METHODS:Male C57BL/6J mice(aged 8-10 weeks and weighting approximately 20 g)were used to establish the severe trauma model.Under anesthesia,a midshaft femoral fracture was created and packed with sterile cotton.A midline incision was made from the inguinal region to the sternum,exposing the abdominal organs for 30 min.The right femoral artery was cannulated to induce controlled blood loss at 30%,35%,40%,and 50%of the total blood volume.Survival rates were monitored for 24 h post-induction.In the mice that experienced 30%blood loss,the mean arterial pressure,body temperature,blood gas parameters,peripheral blood inflammatory markers,and major organ pathological changes were assessed.RESULTS:Mice with femoral fractures,soft tissue injuries,abdominal organ exposure,and 30%blood loss exhibited stable survival rates.Increased blood loss significantly reduced survival rates.Mean arterial pressure decreased initially,recovering within 0-15 min and returning to baseline by 50 min.Similarly,the body temperature decreased initially and gradually recovered to baseline within 50 min.Levels of peripheral blood inflammatory markers remained elevated for 12 h post-injury.Distant organs,including intestines,lungs,liver,spleen and kidneys,displayed varying degrees of injury.CONCLUSION:The established mouse model replicates the pathophysiological responses to severe trauma,indicating stability and reproducibility,which could be an useful tool for further trauma research.展开更多
Hydrostatic cyclic expansion extrusion(HCEE) process at elevated temperatures is proposed as a method for processing less deformable materials such as magnesium and for producing long ultrafine-grained rods. In the HC...Hydrostatic cyclic expansion extrusion(HCEE) process at elevated temperatures is proposed as a method for processing less deformable materials such as magnesium and for producing long ultrafine-grained rods. In the HCEE process at elevated temperatures, high-pressure molten linear low-density polyethylene(LLDPE) was used as a fluid to eliminate frictional forces. To study the capability of the process,AM60 magnesium rods were processed and the properties were investigated. The mechanical properties were found to improve significantly after the HCEE process. The yield and ultimate strengths increased from initial values of 138 and 221 MPa to 212 and 317 MPa, respectively.Moreover, the elongation was enhanced due to the refined grains and the existence of high hydrostatic pressure. Furthermore, the microhardness was increased from HV 55.0 to HV 72.5. The microstructural analysis revealed that ultrafine-grained structure could be produced by the HCEE process. Moreover, the size of the particles decreased, and these particles thoroughly scattered between the grains. Finite element analysis showed that the HCEE was independent of the length of the sample, which makes the process suitable for industrial applications.展开更多
Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms ...Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms of detection of viral RNA or antibody levels is critical for SFTS diagnosis and therapy.In this study,a new luciferase immunoprecipitation system(LIPS)assay based on p REN2 plasmid expressing SFTSV NP gene and tagged with Renilla luciferase(Rluc),was established and used to investigate the levels of antibody responses to SFTSV.Totally 464 serum samples from febrile patients were collected in the hospital of Shaoxing City in Zhejiang Province in 2019.The results showed that 82 of the 464 patients(17.7%)had antibody response to SFTSV,which were further supported by immunofluorescence assays(IFAs).Further,q RT-PCR and microneutralization tests showed that among the 82 positive cases,15 patients had viremia,10 patients had neutralizing antibody,and one had both(totally 26 patient).However,none of these patients were diagnosed as SFTS in the hospital probably because of their mild symptoms or subclinical manifestations.All the results indicated that at least the 26 patients having viremia or neutralizing antibody were the missed diagnosis of SFTS cases.The findings suggested the occurrence of SFTS and the SFTS incidence were higher than the reported level in Shaoxing in 2019,and that LIPS may provide an alternative strategy to confirm SFTSV infection in the laboratory.展开更多
BACKGROUND Neonatal hyperbilirubinemia is one of the common diseases of newborns that typically presents with yellow staining of skin,resulting in sequelaes such as hearing loss,motor and intellectual development diso...BACKGROUND Neonatal hyperbilirubinemia is one of the common diseases of newborns that typically presents with yellow staining of skin,resulting in sequelaes such as hearing loss,motor and intellectual development disorders,and even death.The pathogenic factors of neonatal hyperbilirubinemia are complex.Different cases of hyperbilirubinemia may have a single or mixed etiology.AIM To explore the etiological characteristics of severe hyperbilirubinemia in term newborns of eastern Guangdong of China.METHODS Term newborns with severe hyperbilirubinemia in one hospital from January 2012 to December 2021 were retrospectively analyzed.The etiology was determined according to the laboratory results and clinical manifestations.RESULTS Among 1602 term newborns with hyperbilirubinemia in eastern Guangdong of China,32.20%(580/1602)was severe hyperbilirubinemia.Among the causes of severe hyperbilirubinemia,neonatal hemolysis accounted for 15.17%,breast milk jaundice accounted for 12.09%,infection accounted for 10.17%,glucose-6-phosphate dehydrogenase(G6PD)deficiency accounted for 9.14%,and the coexistence of multiple etiologies accounted for 6.55%,unknown etiology accounted for 41.72%.ABO hemolysis and G6PD deficiency were the most common causes in the 20 cases with bilirubin encephalopathy.94 severe hyperbilirubinemia newborns were tested for uridine diphosphate glucuronosyl transferase 1A1(UGT1A1)*6 variant(rs4148323,c.211G>A,p.Arg71Gly),9 cases were 211 G to A homozygous variant,37 cases were 211 G to A heterozygous variant,and 48 cases were wild genotypes.CONCLUSION The main cause for severe hyperbilirubinemia and bilirubin encephalopathy in eastern Guangdong of China were the hemolytic disease of the newborns,G6PD deficiency and infection.UGT1A1 gene variant was also a high-risk factor for neonatal hyperbilirubinemia.Targeted prevention and treatment according to the etiology may reduce the occurrence of bilirubin encephalopathy and kernicterus.展开更多
Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has ...Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.展开更多
Methylenetetrahydrofolate reductase(MTHFR)deficiency is a rare autosomal recessive genetic disorder caused by mutations in the MTHFR gene,leading to a variety of clinical manifestations.In October 2022,the Second Xian...Methylenetetrahydrofolate reductase(MTHFR)deficiency is a rare autosomal recessive genetic disorder caused by mutations in the MTHFR gene,leading to a variety of clinical manifestations.In October 2022,the Second Xiangya Hospital of Central South University admitted a 21-year-old male patient with neuropsychiatric disorders,presenting primarily with cognitive decline,limb tremors,abnormal mental and behavioral symptoms,seizures,and gait disturbances.These symptoms had gradually developed over 5 years,worsening significantly in the past year.The patient’s plasma homocysteine levels were 10 times higher than normal,and brain MRI revealed brain atrophy and significant abnormal signals in the bilateral paraventricular nuclei and heads of the bilateral caudate nuclei.Further genetic testing identified a paternal mutation c.1604G>A(p.R535Q)and a maternal mutation c.227T>G(p.L76R)of the MTHFR gene.After betaine supplementation,the plasma homocysteine levels decreased within a week,and the symptoms improved.The patient was ultimately diagnosed with severe hyperhomocysteinemia due to MTHFR deficiency.The c.227T>G(p.L76R)mutation represents a novel missense mutation in the MTHFR gene associated with MTHFR deficiency,but further research is needed to confirm its potential pathogenicity.Early treatment with betaine can fully reverse the symptoms.展开更多
Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 3...Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.展开更多
Objective:To investigate the expression level of interleukin-17D(IL-17D)in the serum of patients with severe pneumonia and its correlation with disease severity.Methods:This study included 50 patients with severe pneu...Objective:To investigate the expression level of interleukin-17D(IL-17D)in the serum of patients with severe pneumonia and its correlation with disease severity.Methods:This study included 50 patients with severe pneumonia who were diagnosed and treated in the hospital from May 2024 to May 2025.The expression level of IL-17D in the serum of all patients was recorded.Patients were divided into severe and mild groups based on their disease severity.Gender,age,disease duration,presence of fever,atelectasis,pneumothorax,interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),and interleukin-17D were selected as independent variables.Statistical software SPSS 22.00 was used for univariate analysis,and variables with statistical significance in the univariate analysis were included in a multivariate logistic regression analysis to determine the correlation between IL-17D and the severity of severe pneumonia.Results:The results of this study showed that the level of IL-17D in patients with severe pneumonia was significantly higher than the normal threshold.Univariate analysis indicated that atelectasis,IL-2,IL-6,and IL-17D were statistically significant(P<0.05)and could be considered as influencing factors for the severity of severe pneumonia.Multivariate logistic regression analysis revealed that atelectasis(OR=2.141,95%CI:1.684–2.391),IL-2(OR=2.884,95%CI:2.240–3.614),IL-6(OR=2.571,95%CI:2.190–2.943),and IL-17D(OR=2.416,95%CI:2.093–2.735)were positively correlated with the severity of severe pneumonia.Conclusion:The expression level of IL-17D in the serum of patients with severe pneumonia is higher than the normal threshold and is positively correlated with disease severity.展开更多
Dengue is an arboviral disease caused by the dengue virus,with 390 million infections reported annually worldwide.It is classified into two categories:dengue without or with warning signs and severe dengue.[1]Given th...Dengue is an arboviral disease caused by the dengue virus,with 390 million infections reported annually worldwide.It is classified into two categories:dengue without or with warning signs and severe dengue.[1]Given the moderate efficacy of the dengue vaccine,[2]there is an urgent necessity to design host-directed therapeutic strategies,such as the repurposing of FDA-approved drugs,to combat dengue virus infection.展开更多
The clinical treatment of severe trauma withsternoclavicular joint injury is challenging,primarilydue to the irregular shape of the bones surrounding thesternoclavicular joint,as well as the posterior clavicle beingcl...The clinical treatment of severe trauma withsternoclavicular joint injury is challenging,primarilydue to the irregular shape of the bones surrounding thesternoclavicular joint,as well as the posterior clavicle beingclose to the aorta and mediastinal organs.^([1])These patientsnot only suffer direct injuries to the sternoclavicularjoint,but also frequently experience severe injuries toother body parts.The systemic physiological disordersand multi-organ dysfunction caused by severe traumaincrease the surgery di?culty and mortality risk.^([2])展开更多
Taking short-duration heavy rainfall and convective wind gusts as examples, the present study examined the characteristics of radar reflectivity and several convective parameters. We analyzed nowcasting techniques by ...Taking short-duration heavy rainfall and convective wind gusts as examples, the present study examined the characteristics of radar reflectivity and several convective parameters. We analyzed nowcasting techniques by integrating a high-resolution numerical weather prediction model with these convective parameters. Based on the CMA-GD 1-km model and its assimilation system, we conducted repeated tests on radar reflectivity data assimilation and analyzed their impact on nowcasting accuracy. Based on these analyses, we proposed a method to improve model forecasts using the useful indicative information provided by high-frequency radar reflectivity data and convective parameters. The improved method was applied to the CMA-GD 1-km model for nowcasting tests. Evaluations from batch tests and case analysis show that the proposed method significantly reduced the model's false alarm rates and improved its nowcasting performance.展开更多
Objective:To explore the clinical effects of applying responsibility-based holistic nursing in elderly patients with severe pneumonia.Methods:Ninety-six elderly patients with severe pneumonia admitted to a hospital fr...Objective:To explore the clinical effects of applying responsibility-based holistic nursing in elderly patients with severe pneumonia.Methods:Ninety-six elderly patients with severe pneumonia admitted to a hospital from January 2023 to December 2024 were selected and divided into an observation group(52 cases)and a control group(44 cases)based on a random number table method.The observation group received responsibility-based holistic nursing,while the control group received basic nursing.The clinical effects(time to normalize body temperature,disappearance of cough,disappearance of dyspnea symptoms,disappearance of lung rales,changes in oxygenation index)and nursing satisfaction were observed in both groups.Results:The observation group showed superior results compared to the control group in terms of time to normalize body temperature,disappearance of cough,disappearance of dyspnea symptoms,disappearance of lung rales,and changes in oxygenation index,with statistically significant differences(P<0.05).The satisfaction rate with nursing services in the observation group(92.31%)was significantly higher than that in the control group(86.36%)(P<0.05).Conclusion:Implementing responsibility-based holistic nursing in elderly patients with severe pneumonia can improve their oxygenation function,enhance quality of life,and increase nursing satisfaction.展开更多
This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadi...This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.展开更多
Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for...Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding.The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram,which could facilitate early prediction,and timely appropriate interventions.Methods:We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics,disease severity,laboratory indexes and local pancreatic complications.A novel nomogram was constructed based on these factors,and was vali-dated both internally and externally assessing its discrimination,calibration,and clinical applicability.Results:The study involved 351 patients in the training cohort,104 patients in the internal validation cohort,and 123 patients in the external validation cohort.Logistic regression analysis identified several independent risk factors for massive bleeding,including computed tomography severity index score above 8 points,Acute Physiology and Chronic Health Evaluation II score greater than 16 points,abdominal com-partment syndrome,pancreatic fistula,and sepsis.The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve(AUC)of 0.896 and a coefficient of determination(R²)of 0.093.The Hosmer-Lemeshow test indicated good model fitness(P=0.654).Furthermore,the nomogram demonstrated reliable performance in both validation cohorts.Conclusions:The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.展开更多
Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A tot...Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.展开更多
To date,nanostructuring through plastic deformation has rarely been reported in biodegradable zinc(Zn)based alloys that have great potential in load-bearing conditions.Here,typical high-strength Zn-Li-based alloys wer...To date,nanostructuring through plastic deformation has rarely been reported in biodegradable zinc(Zn)based alloys that have great potential in load-bearing conditions.Here,typical high-strength Zn-Li-based alloys were subjected to SPD processes,including equal channel angular pressing(ECAP)and high-pressure torsion(HPT),to achieve nanostructured microstructures.The effects of SPD on the microstructures,mechanical properties,and corrosion behaviors were generally investigated.The two SPD routes resulted in totally different microstructures.ECAPed samples processed at 150℃ exhibited a complicated multilevel structure(nm toμm)with mixed Zn equiaxed grains and lamellar-like eutectoid regions(Zn+α-LiZn_(4)),and HPTed ones(25℃)possessed a fully dynamically recrystallized(DRXed)microstructure with an average grain size below 0.4μm.The tensile strength of the SPD samples could reach 500 MPa.Meanwhile,HPTed samples exhibited extraordinary fracture elongations higher than 100%,because of a different grain boundary sliding deformation mechanism.HPTed samples and ECAPed samples displayed different corrosion patterns,and the former exhibited a much higher corrosion rate in Hank's solution,possibly due to the accelerated corrosion at grain boundaries.In summary,SPD is an efficient way to refine the microstructure of biodegradable Zn-based alloys,possibly improving their performances and clinical applications.展开更多
Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary su...Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary surgery subsequent to experiencing breakthrough infection of coronavirus disease 2019(COVID-19).This study aimed to find factors predicting postoperative complications and construct an innovative nomogram to pinpoint patients who were susceptible to developing severe complications following breakthrough infection of COVID-19 after undergoing elective hepato-pancreato-biliary surgery.Methods:This multicenter retrospective cohort study included consecutive patients who underwent elective hepato-pancreato-biliary surgeries between January 3 and April 1,2023 from four hospitals in China.All of these patients had experienced breakthrough infection of COVID-19 prior to their surgeries.Additionally,two groups of patients without preoperative COVID-19 infection were included as comparative controls.Surgical complications were meticulously documented and evaluated using the comprehensive complication index(CCI),which ranged from 0(uneventful course)to 100(death).A CCI value of 20.9 was identified as the threshold for defining severe complications.Results:Among 2636 patients who were included in this study,873 were included in the reference group I,941 in the reference group II,389 in the internal cohort,and 433 in the external validation cohort.Multivariate logistic regression analysis revealed that completing a full course of COVID-19 vaccination>6 months before surgery,undergoing surgery within 4 weeks of diagnosis of COVID-19 breakthrough infection,operation duration of 4 h or longer,cancer-related surgery,and major surgical procedures were significantly linked to a CCI>20.9.A nomogram model was constructed utilizing CCI>20.9 in the training cohort[area under the curve(AUC):0.919,95%confidence interval(CI):0.881–0.957],the internal validation cohort(AUC:0.910,95%CI:0.847–0.973),and the external validation cohort(AUC:0.841,95%CI:0.799–0.883).The calibration curve for the probability of CCI>20.9 demonstrated good agreement between the predictions made by the nomogram and the actual observations.Conclusions:The developed model holds significant potential in aiding clinicians with clinical decisionmaking and risk stratification for patients who have experienced breakthrough infection of COVID-19 prior to undergoing elective hepato-pancreato-biliary surgery.展开更多
文摘Dengue fever is an acute infectious disease caused by the dengue virus and transmitted by mosquito vectors[1].Its clinical manifestations include high fever,headache,muscle and joint pain,and rash.It holds a significant position in global public health.In recent years,its incidence has continued to rise worldwide[2],making it one of the major diseases threatening human health.The disease course of dengue fever is divided into three typical phases:the acute febrile phase,the critical phase,and the recovery phase.While most patients experience mild symptoms,some may progress to severe dengue and potentially fatal outcomes if not promptly and effectively treated during the critical phase.
文摘Acute severe ulcerative colitis(UC) is a highly morbid con dition that requires both medical and surgical managementhrough the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery. Unfortunately, protracted medical therapy has led to patients presenting for surgery in a poorer state of health leading to poorer post-operative outcomes. In this era of multiple medical modalities available in the treatment of acute severe UC, physicians must consider the advantages and disadvantages of prolonged medical therapy in an attempt to avoid surgery. Colectomy remains a mainstay in the treatment of severe ulcerative colitis not responsive to corticosteroids and rescue therapy, and timely referral for surgery allows for improved post-operative outcomes with lower risk of sepsis and improved patient survival. Options for reconstructive surgery include three-stage ileal pouchanal anastomosis or a modified two-stage procedure that can be performed either open or laparoscopically. The numerous avenues of medical and surgical therapy have allowed for great advances in the treatment of patients with UC. In this era of options, it is important to maintain a global view, utilize biologic therapy when indicated, and then maintain an appropriate threshold for surgery. The purpose of this review is to summarize the growing number of medical and surgical options available in the treatment of acute, severe UC.
基金supported by the Science and Technology Basic Work Program (2013FY113500)the National Key Research and Development Program (2016YFE 0113500) from the Ministry of Science and Technology of Chinathe European Union’s Horizon 2020 EVAg project (No 653316)
文摘Hubei Province is a major epidemic area of severe fever with thrombocytopenia syndrome bunyavirus(SFTSV) in China. However, to date, a few SFTSV strains have been isolated from Hubei Province, preventing effective studies of epidemic outbreaks. Here, we report three confirmed patients(2015–2016) with typical symptoms of severe fever with thrombocytopenia syndrome disease(SFTS) who were farmers resident in different regions in Hubei Province. Three new SFTSV strains were isolated from the serum samples of each patient. Characterization of viral growth properties showed that there were no significant differences in virus production. All strains were completely sequenced, and phylogenetic analysis showed that unlike the other strains from Hubei province, which belonged to the SFTSV C3 genotype, one of the three strains belonged to the SFTSV C2 genotype. These results suggested that multiple SFTSV genotypes have been circulating in Hubei Province, providing insights into SFTSV evolution and improving our understanding of SFTSV prevalence in Hubei Province.
基金supported by the National Natural Science Foundation of China(82102315).
文摘BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of severe trauma,providing a reliable research tool.METHODS:Male C57BL/6J mice(aged 8-10 weeks and weighting approximately 20 g)were used to establish the severe trauma model.Under anesthesia,a midshaft femoral fracture was created and packed with sterile cotton.A midline incision was made from the inguinal region to the sternum,exposing the abdominal organs for 30 min.The right femoral artery was cannulated to induce controlled blood loss at 30%,35%,40%,and 50%of the total blood volume.Survival rates were monitored for 24 h post-induction.In the mice that experienced 30%blood loss,the mean arterial pressure,body temperature,blood gas parameters,peripheral blood inflammatory markers,and major organ pathological changes were assessed.RESULTS:Mice with femoral fractures,soft tissue injuries,abdominal organ exposure,and 30%blood loss exhibited stable survival rates.Increased blood loss significantly reduced survival rates.Mean arterial pressure decreased initially,recovering within 0-15 min and returning to baseline by 50 min.Similarly,the body temperature decreased initially and gradually recovered to baseline within 50 min.Levels of peripheral blood inflammatory markers remained elevated for 12 h post-injury.Distant organs,including intestines,lungs,liver,spleen and kidneys,displayed varying degrees of injury.CONCLUSION:The established mouse model replicates the pathophysiological responses to severe trauma,indicating stability and reproducibility,which could be an useful tool for further trauma research.
基金This work was financially supported by the Iran National Science Foundation(No.96000854).
文摘Hydrostatic cyclic expansion extrusion(HCEE) process at elevated temperatures is proposed as a method for processing less deformable materials such as magnesium and for producing long ultrafine-grained rods. In the HCEE process at elevated temperatures, high-pressure molten linear low-density polyethylene(LLDPE) was used as a fluid to eliminate frictional forces. To study the capability of the process,AM60 magnesium rods were processed and the properties were investigated. The mechanical properties were found to improve significantly after the HCEE process. The yield and ultimate strengths increased from initial values of 138 and 221 MPa to 212 and 317 MPa, respectively.Moreover, the elongation was enhanced due to the refined grains and the existence of high hydrostatic pressure. Furthermore, the microhardness was increased from HV 55.0 to HV 72.5. The microstructural analysis revealed that ultrafine-grained structure could be produced by the HCEE process. Moreover, the size of the particles decreased, and these particles thoroughly scattered between the grains. Finite element analysis showed that the HCEE was independent of the length of the sample, which makes the process suitable for industrial applications.
基金supported by the National Program on Key Research Project of China(2018YFE0200400,2019YFC1200700)the National Natural Science Foundation of China(U20A20135)+1 种基金the Strategic Biological Resources Capacity Building Project of Chinese Academy of Sciences(KFJ-BRP-017-06)the Key deployment projects of Chinese Academy of Sciences(KJZD-SW-L11)
文摘Severe fever with thrombocytopenia syndrome(SFTS),caused by SFTS virus(SFTSV)infection,was first reported in 2010 in China with an initial fatality of up to 30%.The laboratory confirmation of SFTSV infection in terms of detection of viral RNA or antibody levels is critical for SFTS diagnosis and therapy.In this study,a new luciferase immunoprecipitation system(LIPS)assay based on p REN2 plasmid expressing SFTSV NP gene and tagged with Renilla luciferase(Rluc),was established and used to investigate the levels of antibody responses to SFTSV.Totally 464 serum samples from febrile patients were collected in the hospital of Shaoxing City in Zhejiang Province in 2019.The results showed that 82 of the 464 patients(17.7%)had antibody response to SFTSV,which were further supported by immunofluorescence assays(IFAs).Further,q RT-PCR and microneutralization tests showed that among the 82 positive cases,15 patients had viremia,10 patients had neutralizing antibody,and one had both(totally 26 patient).However,none of these patients were diagnosed as SFTS in the hospital probably because of their mild symptoms or subclinical manifestations.All the results indicated that at least the 26 patients having viremia or neutralizing antibody were the missed diagnosis of SFTS cases.The findings suggested the occurrence of SFTS and the SFTS incidence were higher than the reported level in Shaoxing in 2019,and that LIPS may provide an alternative strategy to confirm SFTSV infection in the laboratory.
基金Supported by the Natural Science Foundation of Guangdong Province,No.2016A030307035Special Research Plan 2019 of Chaozhou,No.2020xg01High-Level Development Plan of People’s Hospital of Yangjiang,No.G2020007.
文摘BACKGROUND Neonatal hyperbilirubinemia is one of the common diseases of newborns that typically presents with yellow staining of skin,resulting in sequelaes such as hearing loss,motor and intellectual development disorders,and even death.The pathogenic factors of neonatal hyperbilirubinemia are complex.Different cases of hyperbilirubinemia may have a single or mixed etiology.AIM To explore the etiological characteristics of severe hyperbilirubinemia in term newborns of eastern Guangdong of China.METHODS Term newborns with severe hyperbilirubinemia in one hospital from January 2012 to December 2021 were retrospectively analyzed.The etiology was determined according to the laboratory results and clinical manifestations.RESULTS Among 1602 term newborns with hyperbilirubinemia in eastern Guangdong of China,32.20%(580/1602)was severe hyperbilirubinemia.Among the causes of severe hyperbilirubinemia,neonatal hemolysis accounted for 15.17%,breast milk jaundice accounted for 12.09%,infection accounted for 10.17%,glucose-6-phosphate dehydrogenase(G6PD)deficiency accounted for 9.14%,and the coexistence of multiple etiologies accounted for 6.55%,unknown etiology accounted for 41.72%.ABO hemolysis and G6PD deficiency were the most common causes in the 20 cases with bilirubin encephalopathy.94 severe hyperbilirubinemia newborns were tested for uridine diphosphate glucuronosyl transferase 1A1(UGT1A1)*6 variant(rs4148323,c.211G>A,p.Arg71Gly),9 cases were 211 G to A homozygous variant,37 cases were 211 G to A heterozygous variant,and 48 cases were wild genotypes.CONCLUSION The main cause for severe hyperbilirubinemia and bilirubin encephalopathy in eastern Guangdong of China were the hemolytic disease of the newborns,G6PD deficiency and infection.UGT1A1 gene variant was also a high-risk factor for neonatal hyperbilirubinemia.Targeted prevention and treatment according to the etiology may reduce the occurrence of bilirubin encephalopathy and kernicterus.
基金supported by the National Natural Science Foundation of China(32170144 and 32470146).
文摘Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.
基金supported by the National Natural Science Foundation(81971696)the Natural Science Foundation of Hunan Province(2022JJ30861),China.
文摘Methylenetetrahydrofolate reductase(MTHFR)deficiency is a rare autosomal recessive genetic disorder caused by mutations in the MTHFR gene,leading to a variety of clinical manifestations.In October 2022,the Second Xiangya Hospital of Central South University admitted a 21-year-old male patient with neuropsychiatric disorders,presenting primarily with cognitive decline,limb tremors,abnormal mental and behavioral symptoms,seizures,and gait disturbances.These symptoms had gradually developed over 5 years,worsening significantly in the past year.The patient’s plasma homocysteine levels were 10 times higher than normal,and brain MRI revealed brain atrophy and significant abnormal signals in the bilateral paraventricular nuclei and heads of the bilateral caudate nuclei.Further genetic testing identified a paternal mutation c.1604G>A(p.R535Q)and a maternal mutation c.227T>G(p.L76R)of the MTHFR gene.After betaine supplementation,the plasma homocysteine levels decreased within a week,and the symptoms improved.The patient was ultimately diagnosed with severe hyperhomocysteinemia due to MTHFR deficiency.The c.227T>G(p.L76R)mutation represents a novel missense mutation in the MTHFR gene associated with MTHFR deficiency,but further research is needed to confirm its potential pathogenicity.Early treatment with betaine can fully reverse the symptoms.
文摘Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.
基金Chongqing Shapingba District Technology Innovation Project(Project No.:2024046)。
文摘Objective:To investigate the expression level of interleukin-17D(IL-17D)in the serum of patients with severe pneumonia and its correlation with disease severity.Methods:This study included 50 patients with severe pneumonia who were diagnosed and treated in the hospital from May 2024 to May 2025.The expression level of IL-17D in the serum of all patients was recorded.Patients were divided into severe and mild groups based on their disease severity.Gender,age,disease duration,presence of fever,atelectasis,pneumothorax,interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),and interleukin-17D were selected as independent variables.Statistical software SPSS 22.00 was used for univariate analysis,and variables with statistical significance in the univariate analysis were included in a multivariate logistic regression analysis to determine the correlation between IL-17D and the severity of severe pneumonia.Results:The results of this study showed that the level of IL-17D in patients with severe pneumonia was significantly higher than the normal threshold.Univariate analysis indicated that atelectasis,IL-2,IL-6,and IL-17D were statistically significant(P<0.05)and could be considered as influencing factors for the severity of severe pneumonia.Multivariate logistic regression analysis revealed that atelectasis(OR=2.141,95%CI:1.684–2.391),IL-2(OR=2.884,95%CI:2.240–3.614),IL-6(OR=2.571,95%CI:2.190–2.943),and IL-17D(OR=2.416,95%CI:2.093–2.735)were positively correlated with the severity of severe pneumonia.Conclusion:The expression level of IL-17D in the serum of patients with severe pneumonia is higher than the normal threshold and is positively correlated with disease severity.
基金funded by grants Pronaii 302979A1-S-9005 CONACyT (México) from RMDA。
文摘Dengue is an arboviral disease caused by the dengue virus,with 390 million infections reported annually worldwide.It is classified into two categories:dengue without or with warning signs and severe dengue.[1]Given the moderate efficacy of the dengue vaccine,[2]there is an urgent necessity to design host-directed therapeutic strategies,such as the repurposing of FDA-approved drugs,to combat dengue virus infection.
文摘The clinical treatment of severe trauma withsternoclavicular joint injury is challenging,primarilydue to the irregular shape of the bones surrounding thesternoclavicular joint,as well as the posterior clavicle beingclose to the aorta and mediastinal organs.^([1])These patientsnot only suffer direct injuries to the sternoclavicularjoint,but also frequently experience severe injuries toother body parts.The systemic physiological disordersand multi-organ dysfunction caused by severe traumaincrease the surgery di?culty and mortality risk.^([2])
基金Key-Area Research and Development Program of Guangdong (2020B1111200001)National Natural Science Foundation of China (42230105, U2142213, 42175167)。
文摘Taking short-duration heavy rainfall and convective wind gusts as examples, the present study examined the characteristics of radar reflectivity and several convective parameters. We analyzed nowcasting techniques by integrating a high-resolution numerical weather prediction model with these convective parameters. Based on the CMA-GD 1-km model and its assimilation system, we conducted repeated tests on radar reflectivity data assimilation and analyzed their impact on nowcasting accuracy. Based on these analyses, we proposed a method to improve model forecasts using the useful indicative information provided by high-frequency radar reflectivity data and convective parameters. The improved method was applied to the CMA-GD 1-km model for nowcasting tests. Evaluations from batch tests and case analysis show that the proposed method significantly reduced the model's false alarm rates and improved its nowcasting performance.
文摘Objective:To explore the clinical effects of applying responsibility-based holistic nursing in elderly patients with severe pneumonia.Methods:Ninety-six elderly patients with severe pneumonia admitted to a hospital from January 2023 to December 2024 were selected and divided into an observation group(52 cases)and a control group(44 cases)based on a random number table method.The observation group received responsibility-based holistic nursing,while the control group received basic nursing.The clinical effects(time to normalize body temperature,disappearance of cough,disappearance of dyspnea symptoms,disappearance of lung rales,changes in oxygenation index)and nursing satisfaction were observed in both groups.Results:The observation group showed superior results compared to the control group in terms of time to normalize body temperature,disappearance of cough,disappearance of dyspnea symptoms,disappearance of lung rales,and changes in oxygenation index,with statistically significant differences(P<0.05).The satisfaction rate with nursing services in the observation group(92.31%)was significantly higher than that in the control group(86.36%)(P<0.05).Conclusion:Implementing responsibility-based holistic nursing in elderly patients with severe pneumonia can improve their oxygenation function,enhance quality of life,and increase nursing satisfaction.
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.
基金supported by grants from the National Nature Science Foundation of China(82370651 and 82070657).
文摘Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding.The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram,which could facilitate early prediction,and timely appropriate interventions.Methods:We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics,disease severity,laboratory indexes and local pancreatic complications.A novel nomogram was constructed based on these factors,and was vali-dated both internally and externally assessing its discrimination,calibration,and clinical applicability.Results:The study involved 351 patients in the training cohort,104 patients in the internal validation cohort,and 123 patients in the external validation cohort.Logistic regression analysis identified several independent risk factors for massive bleeding,including computed tomography severity index score above 8 points,Acute Physiology and Chronic Health Evaluation II score greater than 16 points,abdominal com-partment syndrome,pancreatic fistula,and sepsis.The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve(AUC)of 0.896 and a coefficient of determination(R²)of 0.093.The Hosmer-Lemeshow test indicated good model fitness(P=0.654).Furthermore,the nomogram demonstrated reliable performance in both validation cohorts.Conclusions:The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.
文摘Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.
基金supported by the National Natural Science Foundation of China(Nos.U22A20121,52101283 and 52271243)the NSFC-RGC Joint Research Scheme(No.52361165619)+3 种基金The NSFC-RFBR Joint Research Scheme(No.82361138575)the Science and Technology Planning Project of Guangzhou(No.202201011454)the National Key R&D Program of China(Nos.2021YFC2400700 and 2021YFC2400704)the High-level Hospital Construction Project(No.KJ012019520).
文摘To date,nanostructuring through plastic deformation has rarely been reported in biodegradable zinc(Zn)based alloys that have great potential in load-bearing conditions.Here,typical high-strength Zn-Li-based alloys were subjected to SPD processes,including equal channel angular pressing(ECAP)and high-pressure torsion(HPT),to achieve nanostructured microstructures.The effects of SPD on the microstructures,mechanical properties,and corrosion behaviors were generally investigated.The two SPD routes resulted in totally different microstructures.ECAPed samples processed at 150℃ exhibited a complicated multilevel structure(nm toμm)with mixed Zn equiaxed grains and lamellar-like eutectoid regions(Zn+α-LiZn_(4)),and HPTed ones(25℃)possessed a fully dynamically recrystallized(DRXed)microstructure with an average grain size below 0.4μm.The tensile strength of the SPD samples could reach 500 MPa.Meanwhile,HPTed samples exhibited extraordinary fracture elongations higher than 100%,because of a different grain boundary sliding deformation mechanism.HPTed samples and ECAPed samples displayed different corrosion patterns,and the former exhibited a much higher corrosion rate in Hank's solution,possibly due to the accelerated corrosion at grain boundaries.In summary,SPD is an efficient way to refine the microstructure of biodegradable Zn-based alloys,possibly improving their performances and clinical applications.
基金supported by grants from the Science Fund for Creative Research Groups of the National Natural Science Founda-tion of China(81521091 and 82073031)the National Natural Sci-ence Foundation of China(92269204)Clinical Research Plan of SHDC(SHDC2020CR5007 and SHDC22020213)。
文摘Background:Currently,there is a deficiency in a strong risk prediction framework for precisely evaluating the likelihood of severe postoperative complications in patients undergoing elective hepato-pancreatobiliary surgery subsequent to experiencing breakthrough infection of coronavirus disease 2019(COVID-19).This study aimed to find factors predicting postoperative complications and construct an innovative nomogram to pinpoint patients who were susceptible to developing severe complications following breakthrough infection of COVID-19 after undergoing elective hepato-pancreato-biliary surgery.Methods:This multicenter retrospective cohort study included consecutive patients who underwent elective hepato-pancreato-biliary surgeries between January 3 and April 1,2023 from four hospitals in China.All of these patients had experienced breakthrough infection of COVID-19 prior to their surgeries.Additionally,two groups of patients without preoperative COVID-19 infection were included as comparative controls.Surgical complications were meticulously documented and evaluated using the comprehensive complication index(CCI),which ranged from 0(uneventful course)to 100(death).A CCI value of 20.9 was identified as the threshold for defining severe complications.Results:Among 2636 patients who were included in this study,873 were included in the reference group I,941 in the reference group II,389 in the internal cohort,and 433 in the external validation cohort.Multivariate logistic regression analysis revealed that completing a full course of COVID-19 vaccination>6 months before surgery,undergoing surgery within 4 weeks of diagnosis of COVID-19 breakthrough infection,operation duration of 4 h or longer,cancer-related surgery,and major surgical procedures were significantly linked to a CCI>20.9.A nomogram model was constructed utilizing CCI>20.9 in the training cohort[area under the curve(AUC):0.919,95%confidence interval(CI):0.881–0.957],the internal validation cohort(AUC:0.910,95%CI:0.847–0.973),and the external validation cohort(AUC:0.841,95%CI:0.799–0.883).The calibration curve for the probability of CCI>20.9 demonstrated good agreement between the predictions made by the nomogram and the actual observations.Conclusions:The developed model holds significant potential in aiding clinicians with clinical decisionmaking and risk stratification for patients who have experienced breakthrough infection of COVID-19 prior to undergoing elective hepato-pancreato-biliary surgery.
