OBJECTIVE To investigate the epidemiological characteristics,clinical features and distribution of pathogens isolated from the burn wound patients with infections in a northwestern hospital from 2014 to 2023 so as to provide bases for prevention and treatment of burn wound infections in the northwestern region.METHODS The epidemiological characteristics,clinical features and distribution of pathogenic isolated from the burn wound patients with infections who were treated in the 940th Hospital of Joint Logistic Support Force from 2014 to 2023 were retrospectively analyzed.RESULTS A total of 2122 burn wound patients were enrolled in the study,397(18.71％)of whom had infections,including 306(14.42％)patients with community-acquired infections and 91(4.29％)patients with hospital-acquired infections.The proportion infections was higher among the patients aged no less than 60 years old(63/154)than among the patients aged less than 14 years old(231/983)and the pa-tients aged between 14 and 60 years old(103/985)(x2=108.840,P＜0.001).The proportion of infections was higher among the patients with the burn wound depth no less than grade Ⅲ(146/458)than among the patients with the burn wound depth no less than grade Ⅱ(251/1664)(x2=66.600,P＜0.001).The proportion infections was higher among the patients with burn wounds in limbs(370/1881)than among the patients with burn wounds in other sites(1153/1987)(x2=47.244,P＜0.001).The isolation rates of methicillin-resistant Staphy-lococcus epidermidis and carbapenem-resistant Pseudomonas aeruginosa strains showed downward trends from 2014 to 2023,the isolation rates of carbapenem-resistant Klebsiella pneumoniae and the third generation cephalo-sporins-resistant Escherichia coli showed upward trends,however,there were no significant differences.CONCLUSIONS The patients with no less than 60 years of age,no lower than grade Ⅲ of burn wound depth and burn wounds in limbs are more likely to have burn wound infections.S.aureus is the predominant species of pathogens causing the infections.The isolation rates of carbapenem-resistant K.pneumoniae strains and the third generation cephalosporins-resistant E.coli strains show upward trends.It is necessary to take targeted prevention and treatment measures for the burn wound infections.

OBJECTIVE To investigate the epidemiological characteristics,clinical features and distribution of pathogens isolated from the burn wound patients with infections in a northwestern hospital from 2014 to 2023 so as to provide bases for prevention and treatment of burn wound infections in the northwestern region.METHODS The epidemiological characteristics,clinical features and distribution of pathogenic isolated from the burn wound patients with infections who were treated in the 940th Hospital of Joint Logistic Support Force from 2014 to 2023 were retrospectively analyzed.RESULTS A total of 2122 burn wound patients were enrolled in the study,397(18.71％)of whom had infections,including 306(14.42％)patients with community-acquired infections and 91(4.29％)patients with hospital-acquired infections.The proportion infections was higher among the patients aged no less than 60 years old(63/154)than among the patients aged less than 14 years old(231/983)and the pa-tients aged between 14 and 60 years old(103/985)(x2=108.840,P＜0.001).The proportion of infections was higher among the patients with the burn wound depth no less than grade Ⅲ(146/458)than among the patients with the burn wound depth no less than grade Ⅱ(251/1664)(x2=66.600,P＜0.001).The proportion infections was higher among the patients with burn wounds in limbs(370/1881)than among the patients with burn wounds in other sites(1153/1987)(x2=47.244,P＜0.001).The isolation rates of methicillin-resistant Staphy-lococcus epidermidis and carbapenem-resistant Pseudomonas aeruginosa strains showed downward trends from 2014 to 2023,the isolation rates of carbapenem-resistant Klebsiella pneumoniae and the third generation cephalo-sporins-resistant Escherichia coli showed upward trends,however,there were no significant differences.CONCLUSIONS The patients with no less than 60 years of age,no lower than grade Ⅲ of burn wound depth and burn wounds in limbs are more likely to have burn wound infections.S.aureus is the predominant species of pathogens causing the infections.The isolation rates of carbapenem-resistant K.pneumoniae strains and the third generation cephalosporins-resistant E.coli strains show upward trends.It is necessary to take targeted prevention and treatment measures for the burn wound infections.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Vector flow imaging(VFI)is an innovative ultrasound flow measurement technology.Compared with the traditional color Doppler and spectral Doppler,VFI has the advantages of independence of angle correction and direct acquisition of real-time amplitude and direction of flow.Transverse oscillation(TO)method is one of the effective methods for vector flow imaging.However,a complete and detailed algorithm validation process based on commercial ultrasound machines is still lacking due to more complex convex probes.This study starts with introducing the imaging process and principle of transverse oscillation vector flow technique,and calculates the error between the set velocity value and the measured velocity value through the simulation experiment,and verifies the error between the set velocity value and the measured velocity value through the Doppler flow phantom experiment.Among them,the velocity value measured by the TO vector flow technique in the simulation experiment is 0.48 m/s and the preset value is 0.50 m/s,the error between them is-4％.The velocity values are 8.33,11.14,14.44 and 16.67 cm/s measured by the Doppler flow phantom experiment,the actual velocity values are 7.97,10.78,14.06 and 17.34 cm/s,the errors between them are all within±5％.Both experiments verify the feasibility of using vector flow technique on abdominal convex probe.

Objective:To analyze the clinical characteristics of asymptomatic infection of brucellosis, in order to provide reference for prevention and treatment of brucellosis.Methods:Retrospective analysis was used to collect the clinical data of patients with brucellosis asymptomatic infection and confirmed cases admitted to the 940th Hospital of Joint Logistics Support Force of Chinese PLA from 2017 to 2021, and the demography characteristics, clinical manifestations and laboratory test results were analyzed.Results:The results showed that a total of 18 cases of asymptomatic infection and 85 confirmed cases of brucellosis were included, and there was no statistically significant difference in age, gender, occupation and ethnicity distribution between the two groups ( F = 7.09, χ 2 = 0.74, 4.02, 0.55, P = 0.295, 0.785, 0.327, 1.000). The 18 cases of asymptomatic infection of brucellosis were found through screening in key populations, and no clinical symptoms or abnormal imaging signs were observed. The clinical symptoms of 85 confirmed cases were mainly muscle and joint pain, fever, sweating, fatigue, and low back pain; and the imaging manifestations were mainly arthritis, splenomegaly, and spondylitis. The median percentage of eosinophils (0.70%, 1.40%), percentage of basophils (3.05%, 0.40%), C-reactive protein (1.62, 4.62 mg/L), erythrocyte sedimentation rate (1.00, 11.00 mm/h), and antibody titer of serum agglutination test (1 ∶ 100, 1 ∶ 200) showed statistically significant differences between asymptomatic infection and confirmed cases of brucellosis ( Z = - 2.97, - 5.11, - 3.49, - 3.21, - 3.50, P = 0.003, 0.001, 0.001, 0.001, 0.007). Conclusions:There is a difference in the composition of granulocytes between asymptomatic infection and confirmed cases of brucellosis, and the level of inflammatory response indicators is lower than that of confirmed cases. Regular seroepidemiological surveys among key populations can help screen for asymptomatic infection of brucellosis.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Echocardiogram is vital for the diagnosis of cardiac disease. The heart has complex hemodynamics requiring an advanced ultrasound imaging mode. Cardiac ultrasound vector flow imaging is capable of measuring the actual magnitude and direction of the blood flow velocity, obtaining the quantitative parameters of hemodynamics, and then providing more information for clinical research and diagnosis. This study mainly reviewed several different vector flow imaging techniques for cardiac flow and presented the implementation difficulties, and proposed a diverging wave based high frame rate cardiac ultrasound vector flow imaging. The study discussed the limitation of current ultrasound technology used in the cardiac flow measurement, analyzed and demonstrated the specific reasons for these implementation difficulties and the potential future development.
Blood Flow Velocity ; Heart/physiology* ; Hemodynamics ; Ultrasonography

The gut microbiota of intensive care unit (ICU) patients displays extreme dysbiosis asso-ciated with increased susceptibility to organ failure, sepsis, and septic shock. However, such dysbio-sis is difficult to characterize owing to the high dimensional complexity of the gut microbiota. We tested whether the concept of enterotype can be applied to the gut microbiota of ICU patients to describe the dysbiosis. We collected 131 fecal samples from 64 ICU patients diagnosed with sepsis or septic shock and performed 16S rRNA gene sequencing to dissect their gut microbiota compo-sitions. During the development of sepsis or septic shock and during various medical treatments, the ICU patients always exhibited two dysbiotic microbiota patterns, or ICU-enterotypes, which could not be explained by host properties such as age, sex, and body mass index, or external stressors such as infection site and antibiotic use. ICU-enterotype I (ICU E1) comprised predominantly Bac-teroides and an unclassified genus of Enterobacteriaceae, while ICU-enterotype Ⅱ(ICU E2) com-prised predominantly Enterococcus. Among more critically ill patients with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores > 18, septic shock was more likely to occur with ICU E1 (P = 0.041). Additionally, ICU E1 was correlated with high serum lactate levels (P = 0.007). Therefore, different patterns of dysbiosis were correlated with different clinicaloutcomes, suggesting that ICU-enterotypes should be diagnosed as independent clinical indices. Thus, the microbial-based human index classifier we propose is precise and effective for timely mon-itoring of ICU-enterotypes of individual patients. This work is a first step toward precision medicine for septic patients based on their gut microbiota profiles.

The paper described the hemodynamics of blood flow based on fluid mechanics and its corresponding formulas, and revealed the limitation of blood flow velocity measurement for non-laminar flow when using the conventional pulse wave Doppler. The paper demonstrated the calculation of turbulence for blood flow based on velocity directions and quantified the turbulence according to the presented formulas. Two methods were introduced and the simulated results were analyzed. An example using real data based on ultrasound vector flow imaging for calculating the turbulence of blood flow was presented in the end.
Blood Flow Velocity ; Ultrasonography