To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor ...To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor expression in ocular tissues,and associated clinical manifestations.This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular,histological,or clinical evidence.The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2(ACE2),including transmembrane serine protease 2(TMPRSS2),CD147,alanyl aminopeptidase N(ANPEP),dipeptidyl peptidase 4(DPP4),angiotensin II receptor type 2(AGTR2),and polymeric immunoglobulin receptor(PIGR),which are expressed in retinal,conjunctival,corneal,limbal,and photoreceptor cells.The virus may also reach ocular structures via neurovascular invasion.Clinically,patients with coronavirus disease 2019(COVID-19)may present with a broad spectrum of ophthalmic manifestations,including conjunctivitis,hyperreflective lesions in the inner retinal layers,flame-shaped hemorrhages,cottonwool spots,retinal pallor,hard exudates,and various forms of maculopathy,such as paracentral acute middle maculopathy and acute macular neuroretinopathy(AMN).These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury.Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis,appropriate ophthalmologic care,and the prevention of long-term visual sequelae in patients affected by COVID-19.展开更多
Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidec...BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.展开更多
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 Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is ...BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.展开更多
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
[Objective] The purpose was to supply reference basis for studying invasion region of Metarhizium anisoplia in Brontispa longissima, invasion process and its control measures. [Method] The surface of B. longissima nat...[Objective] The purpose was to supply reference basis for studying invasion region of Metarhizium anisoplia in Brontispa longissima, invasion process and its control measures. [Method] The surface of B. longissima naturally infected by M. anisoplia which were collected from field were scanned and observed by scanning electron microscope. [Result] The regions naturally infected by M. anisoplia on surface of B. longissima included not only arthrodial membrane between abdomen and prothorax, but also both sides of abdomen and the rear part of end node of abdomen, where a large amount of structural material closely related to infection had been formed and observed, such as infection peg, mycelia and spore. [Conclusion] Damage degree of insect surface were different when M. anisopliae infected B. longissima under different environmental conditions, such as nutrient material, PH value, temperature and humidity, etc.展开更多
Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus(HIV)-infected patients have several non-acquired immunodeficiency syndrome(AID...Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus(HIV)-infected patients have several non-acquired immunodeficiency syndrome(AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus(HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.展开更多
Polymeric immunoglobulin receptors（pIgR） are key participants in the formation and secretion of secretory Ig A（S-Ig A）, which is critical for the prevention of microbial infection and colonization in the respirato...Polymeric immunoglobulin receptors（pIgR） are key participants in the formation and secretion of secretory Ig A（S-Ig A）, which is critical for the prevention of microbial infection and colonization in the respiratory system. Although increased respiratory colonization and infections are common in HIV/AIDS, little is known about the expression of pIgR in the airway mucosa of these patients. To address this, the expression levels of pIgR in the tracheal mucosa and lungs of SHIV/SIV-infected rhesus macaques were examined by real-time RTPCR and confocal microscopy. We found that the levels of both PIGR m RNA and pIgR immunoreactivity were lower in the tracheal mucosa of SHIV/SIVinfected rhesus macaques than that in non-infected rhesus macaques, and the difference in pIgR immunoreactivity was statistically significant. IL-17 A, which enhances pIgR expression, was also changed in the same direction as that of pIgR. In contrast to changes in the tracheal mucosa, pIgR and IL-17 A levels were higher in the lungs of infected rhesus macaques. These results indicated abnormal pIgR expression in SHIV/SIV, and by extension HIV infections, which might partially result from IL-17 A alterations and might contribute to the increased microbial colonization and infection related to pulmonary complications in HIV/AIDS.展开更多
Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus(SARS-CoV-2),has become an unprecedented global health emergency.At present,SARS-CoV-2-infected nonhuman primates are ...Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus(SARS-CoV-2),has become an unprecedented global health emergency.At present,SARS-CoV-2-infected nonhuman primates are considered the gold standard animal model for COVID-19 research.Here,we showed that northern pig-tailed macaques(Macaca leonina,NPMs)supported SARS-CoV-2 replication.Furthermore,compared with rhesus macaques,NPMs showed rapid viral clearance in lung tissues,nose swabs,throat swabs,and rectal swabs,which may be due to higher expression of interferon(IFN)-αin lung tissue.However,the rapid viral clearance was not associated with good outcome.In the second week post infection,NPMs developed persistent or even more severe inflammation and body injury compared with rhesus macaques.These results suggest that viral clearance may have no relationship with COVID-19 progression and SARS-CoV-2-infected NPMs could be considered as a critically ill animal model in COVID-19 research.展开更多
BACKGROUND:The surgical step-up approach often requires multiple debridements and might not be suitable for infected pancreatic necrosis(IPN)patients with various abscesses or no safe route for percutaneous catheter d...BACKGROUND:The surgical step-up approach often requires multiple debridements and might not be suitable for infected pancreatic necrosis(IPN)patients with various abscesses or no safe route for percutaneous catheter drainage(PCD).This case-control study aimed to investigate the safety and effectiveness of one-step laparoscopic pancreatic necrosectomy(LPN)in treating IPN.METHODS:This case-control study included IPN patients undergoing one-step LPN or surgical step-up in our center from January 2015 to December 2020.The short-term and long-term complications after surgery,length of hospital stay,and postoperative ICU stays in both groups were analyzed.Univariate and multivariate logistic regression analyses were performed to explore the risk factors of major complications or death.RESULTS:A total of 53 IPN patients underwent one-step LPN and 37 IPN patients underwent surgical step-up approach in this study.There was no significant difference in the incidence of death,major complications,new-onset diabetes,or new-onset pancreatic exocrine insufficiency between the two groups.However,the length of hospital stay in the one-step LPN group was significantly shorter than that in the surgical step-up group.Univariate regression analysis showed that the surgical approach(one-step/step-up)was not the risk factor for major complications or death.Multivariate logistic regression analysis indicated that computed tomography(CT)severity index,American Society of Anesthesiologists(ASA)class IV,and white blood cell(WBC)were the significant risk factors for major complications or death.CONCLUSION:One-step LPN is as safe and effective as the surgical step-up approach for treating IPN patients,and reduces total hospital stay.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze...Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.展开更多
Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influ...Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.展开更多
This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parame...This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.展开更多
文摘To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),we conducted a comprehensive review of current literature,focusing on viral entry pathways,receptor expression in ocular tissues,and associated clinical manifestations.This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular,histological,or clinical evidence.The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2(ACE2),including transmembrane serine protease 2(TMPRSS2),CD147,alanyl aminopeptidase N(ANPEP),dipeptidyl peptidase 4(DPP4),angiotensin II receptor type 2(AGTR2),and polymeric immunoglobulin receptor(PIGR),which are expressed in retinal,conjunctival,corneal,limbal,and photoreceptor cells.The virus may also reach ocular structures via neurovascular invasion.Clinically,patients with coronavirus disease 2019(COVID-19)may present with a broad spectrum of ophthalmic manifestations,including conjunctivitis,hyperreflective lesions in the inner retinal layers,flame-shaped hemorrhages,cottonwool spots,retinal pallor,hard exudates,and various forms of maculopathy,such as paracentral acute middle maculopathy and acute macular neuroretinopathy(AMN).These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury.Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis,appropriate ophthalmologic care,and the prevention of long-term visual sequelae in patients affected by COVID-19.
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
文摘BACKGROUND Due to the increasing rate of thyroid nodules diagnosis,and the desire to avoid the unsightly cervical scar,remote thyroidectomies were invented and are increasingly performed.Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches(TAA)are the two most commonly used remote approaches.No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.AIM To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.METHODS We searched PubMed MEDLINE,Google Scholar,and Cochrane Library from the date of the first published article up to August 2025.The term used were transoral thyroidectomy vestibular approach,trans areolar thyroidectomy,scarless thyroidectomy,remote thyroidectomy,infections,postoperative,inflammation,dysphagia,and swallowing difficulties.We identified 130 studies,of them,30 full texts were screened and only six studies were included in the final meta-analysis.RESULTS Postoperative infections were not different between the two approaches,odd ratio=1.33,95%confidence interval:0.50-3.53,theχ2 was 1.92 and the P-value for overall effect of 0.57.Similarly,transient swallowing difficulty was not different between the two forms of surgery,with odd ratio=0.91,95%confidence interval:0.35-2.40;theχ2 was 1.32,and the P-value for overall effect of 0.85.CONCLUSION No significant statistical differences were evident between trans-oral endoscopic Mirghani H.Infections and swallowing difficulty in scarless thyroidectomy WJCC https://www.wjgnet.com 2 January 6,2026 Volume 14 Issue 1 thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties.Further longer randomized trials are needed.
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.
文摘BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.
基金supported by 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 Analysis and Testing Center Director Fund Project in Chinese Academy of Tropical Agricultural Sciences~~
文摘[Objective] The purpose was to supply reference basis for studying invasion region of Metarhizium anisoplia in Brontispa longissima, invasion process and its control measures. [Method] The surface of B. longissima naturally infected by M. anisoplia which were collected from field were scanned and observed by scanning electron microscope. [Result] The regions naturally infected by M. anisoplia on surface of B. longissima included not only arthrodial membrane between abdomen and prothorax, but also both sides of abdomen and the rear part of end node of abdomen, where a large amount of structural material closely related to infection had been formed and observed, such as infection peg, mycelia and spore. [Conclusion] Damage degree of insect surface were different when M. anisopliae infected B. longissima under different environmental conditions, such as nutrient material, PH value, temperature and humidity, etc.
基金Supported by Instituto de Salud Carlos III,Plan Nacional de I+D+I 2008-2011No.PI11/00605 and Plan Estatal de I+D+I 2013-2016+1 种基金No.PI14/01779Co-financed by FEDER(Fondo Europeo de Desarrollo Regional)
文摘Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus(HIV)-infected patients have several non-acquired immunodeficiency syndrome(AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus(HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.
基金supported by the Beijing Natural Science Foundation(7162136)
文摘Polymeric immunoglobulin receptors（pIgR） are key participants in the formation and secretion of secretory Ig A（S-Ig A）, which is critical for the prevention of microbial infection and colonization in the respiratory system. Although increased respiratory colonization and infections are common in HIV/AIDS, little is known about the expression of pIgR in the airway mucosa of these patients. To address this, the expression levels of pIgR in the tracheal mucosa and lungs of SHIV/SIV-infected rhesus macaques were examined by real-time RTPCR and confocal microscopy. We found that the levels of both PIGR m RNA and pIgR immunoreactivity were lower in the tracheal mucosa of SHIV/SIVinfected rhesus macaques than that in non-infected rhesus macaques, and the difference in pIgR immunoreactivity was statistically significant. IL-17 A, which enhances pIgR expression, was also changed in the same direction as that of pIgR. In contrast to changes in the tracheal mucosa, pIgR and IL-17 A levels were higher in the lungs of infected rhesus macaques. These results indicated abnormal pIgR expression in SHIV/SIV, and by extension HIV infections, which might partially result from IL-17 A alterations and might contribute to the increased microbial colonization and infection related to pulmonary complications in HIV/AIDS.
基金This work was partly supported by the National Key R&D Program of China(2020YFC0842000)National Science and Technology Major Projects of Infectious Disease Funds(2017ZX10304402,2018ZX10301406-003)+1 种基金the National Natural Science Foundation of China(U1802284,U1902210)National Resource Center for Non-Human Primates。
文摘Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus(SARS-CoV-2),has become an unprecedented global health emergency.At present,SARS-CoV-2-infected nonhuman primates are considered the gold standard animal model for COVID-19 research.Here,we showed that northern pig-tailed macaques(Macaca leonina,NPMs)supported SARS-CoV-2 replication.Furthermore,compared with rhesus macaques,NPMs showed rapid viral clearance in lung tissues,nose swabs,throat swabs,and rectal swabs,which may be due to higher expression of interferon(IFN)-αin lung tissue.However,the rapid viral clearance was not associated with good outcome.In the second week post infection,NPMs developed persistent or even more severe inflammation and body injury compared with rhesus macaques.These results suggest that viral clearance may have no relationship with COVID-19 progression and SARS-CoV-2-infected NPMs could be considered as a critically ill animal model in COVID-19 research.
基金This work was supported by the Clinical Research Physician Program of Tongji Medical College,Huazhong University of Science and Technology。
文摘BACKGROUND:The surgical step-up approach often requires multiple debridements and might not be suitable for infected pancreatic necrosis(IPN)patients with various abscesses or no safe route for percutaneous catheter drainage(PCD).This case-control study aimed to investigate the safety and effectiveness of one-step laparoscopic pancreatic necrosectomy(LPN)in treating IPN.METHODS:This case-control study included IPN patients undergoing one-step LPN or surgical step-up in our center from January 2015 to December 2020.The short-term and long-term complications after surgery,length of hospital stay,and postoperative ICU stays in both groups were analyzed.Univariate and multivariate logistic regression analyses were performed to explore the risk factors of major complications or death.RESULTS:A total of 53 IPN patients underwent one-step LPN and 37 IPN patients underwent surgical step-up approach in this study.There was no significant difference in the incidence of death,major complications,new-onset diabetes,or new-onset pancreatic exocrine insufficiency between the two groups.However,the length of hospital stay in the one-step LPN group was significantly shorter than that in the surgical step-up group.Univariate regression analysis showed that the surgical approach(one-step/step-up)was not the risk factor for major complications or death.Multivariate logistic regression analysis indicated that computed tomography(CT)severity index,American Society of Anesthesiologists(ASA)class IV,and white blood cell(WBC)were the significant risk factors for major complications or death.CONCLUSION:One-step LPN is as safe and effective as the surgical step-up approach for treating IPN patients,and reduces total hospital stay.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
基金supported by the National High Level Hospital Clinical Research Funding(No.BJ-2023-066).
文摘Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
基金supported by the Emergency Science and Technology Project in Hubei Province(2020FCA008)
文摘Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.
基金supported by the Yunnan Provincial Key Laboratory of Clinical Virology(No.202002AG070062)the Key Projects of Yunnan Province Science and Technology Department(No.202302AA310044)the National Natural Science Foundation of China(No.82060664).
文摘This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.
