Twenty-five pediatric patients (10 males,15 females) with inherited epidermolysis bullosa,aged 3-16 yr,weighing 11-29 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,underwent lysis and reconstructive surgery of both hands adhesions from July 2015 to April 2017 in our hospital.Ketamine 4-6 mg/kg and atropine 0.01 mg/kg were intramuscularly injected at 20 min before admission to the operating room.Oxygen 2 L/min was inhaled by mask after admission to the operating room.Anesthesia was induced by Ⅳ injection of midazolam 0.08 mg/kg and ketamine 2 mg/kg.Pediatric patients kept spontaneous breathing.Anesthesia was maintained by Ⅳ infusion of propofol 5 mg · kg-1 · min-1 and remifentanil 0.05-0.08 μg · kg 1 · min-1.Mepitel was used to protect skin during surgery,and sodium potassium magnesium calcium and glucose injection was intravenously infused to replace the physiological requirement,blood loss and continued loss.Anesthesia time was (130±43) min,surgery time (107±42) min,the amount of intraoperative fluid infused (352± 120) ml,blood loss (29± 10) ml and emergence time (15±6) min.Intraoperative respiratory depression was found in 5 cases (20％);postoperative new bullae occured in 3 eases,and among the 3 cases,one developed on the back and the other two on the buttocks.No cardiovascular events occurred during and after surgery in this study.

Sepsis-induced liver injury (SILI) is an important cause of septicemia deaths. BaWeiBaiDuSan (BWBDS) was extracted from a formula of Panax ginseng C. A. Meyer, Lilium brownie F. E. Brown ex Miellez var. viridulum Baker, Polygonatum sibiricum Delar. ex Redoute, Lonicera japonica Thunb., Hippophae rhamnoides Linn., Amygdalus Communis Vas, Platycodon grandiflorus (Jacq.) A. DC., and Cortex Phelloderdri. Herein, we investigated whether the BWBDS treatment could reverse SILI by the mechanism of modulating gut microbiota. BWBDS protected mice against SILI, which was associated with promoting macrophage anti-inflammatory activity and enhancing intestinal integrity. BWBDS selectively promoted the growth of Lactobacillus johnsonii (L. johnsonii) in cecal ligation and puncture treated mice. Fecal microbiota transplantation treatment indicated that gut bacteria correlated with sepsis and was required for BWBDS anti-sepsis effects. Notably, L. johnsonii significantly reduced SILI by promoting macrophage anti-inflammatory activity, increasing interleukin-10⁺ M2 macrophage production and enhancing intestinal integrity. Furthermore, heat inactivation L. johnsonii (HI-L. johnsonii) treatment promoted macrophage anti-inflammatory activity and alleviated SILI. Our findings revealed BWBDS and gut microbiota L. johnsonii as novel prebiotic and probiotic that may be used to treat SILI. The potential underlying mechanism was at least in part, via L. johnsonii-dependent immune regulation and interleukin-10⁺ M2 macrophage production.

[This corrects the article DOI: 10.1016/j.apsb.2022.10.016.].