OBJECTIVE: To explore the current status, evolution, hot topics, and future research trends in the field of burn-related sepsis research through a visual analysis of literature. METHODS: A bibliometric method was employed to retrieve articles related to burn-related sepsis from January 1, 1994, to May 16, 2024, in the China National Knowledge Infrastructure (CNKI) and the Web of Science database. The CiteSpace 6.3.R1 software was used to analyze the retrieved literature. The number of publications, authors, countries, and institutions in both Chinese and English literature was statistically analyzed. Co-occurrence analysis, clustering analysis, and co-citation analysis of keywords were performed. RESULTS: A total of 1 090 articles from the CNKI database and 1 143 articles from the Web of Science database were retrieved. Over the past 20 years, the volume of Chinese publications has remained stable, although there has been a slight decline in the past two years. In contrast, the number of English publications, after a period of growth, showed a sharp decline over the past three years. In Chinese literature, 1 457 authors published articles on burn-related sepsis as first authors, with 14 core authors publishing four or more articles. In English literature, 98 authors published articles on burn-related sepsis as first authors. Research on burn-related sepsis was conducted by 76 countries, with the United States having the most collaborations and publications. Globally, 1 349 institutions published articles on burn-related sepsis, with the top institutions being the First Affiliated Hospital of the PLA General Hospital (8 articles) for Chinese literature and the University of Texas Medical Branch (57 articles) for English literature. In the co-occurrence analysis, 208 Chinese keywords and 211 English keywords were included. Excluding keywords related to search terms, the top five most frequent keywords in Chinese literature were burn, sepsis, infection, severe burn, and procalcitonin; the top five most frequent keywords in English literature were sepsis, septic shock, mortality, injury, and burn injury. Chinese keyword analysis identified six clusters, with the largest being sepsis, followed by procalcitonin, infection, and severe burn. English keyword analysis identified seven clusters, with the largest being expression, followed by epidemiology, inhalation injury, and acute kidney injury. The persistent clusters in Chinese literature were procalcitonin, with recent emerging nodes being severe burn, inflammatory response, platelets, and predictive value. In English literature, the persistent clusters were inhalation injury and nitric oxide, with recent emerging nodes being continuous renal replacement therapy, hemorrhagic shock, and early enteral nutrition. The longest-lasting emergent keyword in Chinese literature was delayed resuscitation (2003-2010), with the highest emergent strength being severe burn. In English literature, the longest-lasting emergent keywords, each lasting five years, were nitric oxide (2007-2012), management (2019-2024), and impact (2019-2024), with the highest emergent strength being thermal injury. CONCLUSIONS Research on burn-related sepsis has shifted from focusing on early studies on pathogenesis and mortality to focus on prevention, treatment, and early diagnosis. Future research is expected to focus on early diagnosis and risk factors of burn-related sepsis.
Burns/complications* ; Sepsis/etiology* ; Humans ; Bibliometrics ; China

Objective To analyze the risk factors for acute kidney injury(AKI)in patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB)and establish a prediction model.Methods A total of 286 ANVUGIB patients admitted to our hospital from August 2021 to August 2024 were enrolled.Patients were divided into an observation group(with AKI,n=43)and a control group(without AKI,n=243).The influencing factors for AKI in ANVUGIB patients were analyzed,and a nomogram prediction model was con-structed to evaluate its predictive efficacy.Results Among 286 ANVUGIB patients,43 cases(15.03%)de-veloped AKI.Logistic regression analysis showed that platelet count had no significant effect on AKI compli-cation in ANVUGIB(P>0.05).Hemoglobin,albumin,and sodium were independent protective factors for AKI complication(P<0.05),while comorbid coronary heart disease,bleeding volume,blood transfusion,and risk grade were independent risk factors(P<0.05).The nomogram prediction model for AKI complication in ANVUGIB demonstrated good fit in the Hosmer-Lemeshow test.ROC curve analysis revealed an AUC of 0.908(95%CI:0.868 to 0.939),with a sensitivity of 83.72%and specificity of 84.77%.The calibration curve showed a Brier score of 0.075 and calibration slope of 0.808,indicating good calibration.Conclusion Comorbid coro-nary heart disease,bleeding volume,blood transfusion,risk grade,hemoglobin,albumin,and sodium are signif-icant influencing factors for AKI complication in ANVUGIB.The nomogram model based on these factors shows favorable predictive performance and serves as a reliable tool for AKI risk stratification in ANVUGIB patients,supporting early clinical intervention decisions.

"Westward Migration Spirit" is the precious spiritual wealth of Chinese Communist Party and the Chinese nation. The course teaching team takes the undergraduate students of clinical medicine as the teaching object, tries to integrate the "Westward Migration Spirit" into the cultivation of medical students’ medical professionalism, so as to endow new connotation of medical professionalism and promote the improvement of medical students’ professionalism. Through literature review, expert consultation and questionnaire survey, the paper sorted out the context of "Westward Migration Spirit" of Chongqing Medical University, and typical examples with the spirit of medical science and humanity were selected and integrated into the teaching. A questionnaire was designed to investigate the evaluation of 425 clinical medicine undergraduates and 5 teachers on the medical professionalism course integrated with "Westward Migration Spirit" . The results show that the students and teachers have good feedback to the medical professionalism courses integrated with the "Westward Migration Spirit" , and the course has a significant positive effect on the cultivation of medical students’ medical professionalism.

Objective:To explore the epidemiological characteristics and treatment outcomes of patients with inhalation injuries combined with total burn area less than 30% total body surface area (TBSA).Methods:A retrospective observational study was performed on medical records of 266 patients with inhalation injuries combined with total burn area less than 30%TBSA who were admitted to the First Affiliated Hospital of Naval Medical University from January 2008 to December 2016 and met the inclusion criteria. The following statistical data of the patients were collected, including gender, age, injury site, injurious factors of inhalation injury, degree of inhalation injury, combined total burn area, tracheotomy, time of tracheotomy, mechanical ventilation, whether stayed in intensive care unit (ICU) or not, microbial culture results of bronchoalveolar lavage fluid, length of hospital stay, length of ICU stay, mechanical ventilation days, and respiratory tract infections. Single factor and multivariate linear regression analysis were used to screen out the risk factors impacting the length of hospital stay, length of ICU stay, and mechanical ventilation days of patients. Single factor and multivariate logistic regression analysis were used to screen out the risk factors impacting respiratory tract infections of patients.Results:The 266 patients included 190 males and 76 females, with the majority age of above or equal to 21 years and below 65 years (217 patients). The major injury site was confined space. The major factor causing inhalation injury was hot air. Mild and moderate inhalation injuries were more common in patients. The combined total burn area was 9.00% (3.25%, 18.00%) TBSA. In 111 patients who had tracheotomy, most of them received the procedures before being admitted to the First Affiliated Hospital of Naval Medical University. The length of hospital stay of patients was 27 (10, 55) days. The length of ICU stay of 160 patients who were hospitalized in ICU was 15.5 (6.0, 40.0) days. The mechanical ventilation days of 109 patients who were conducted with mechanical ventilation were 6.0 (1.3, 11.5) days. A total of 119 patients were diagnosed with respiratory tract infections, with 548 strains including 35 types of pathogens isolated, mainly Gram-negative bacteria. Single factor linear regression analysis showed that age, injurious factors of inhalation injury, combined total burn area, degree of inhalation injury (moderate and severe), tracheotomy, mechanical ventilation, and respiratory tract infections were the factors impacting the length of hospital stay of patients ( β=-0.198, -0.224, 0.021, 0.127, 0.164, -0.298, 0.357, 0.447, 95% confidence interval (CI)=-0.397--0.001, -0.395--0.053, 0.015-0.028, 0.009-0.263, 0.008-0.319, -0.419--0.176, 0.242-0.471, 0.340-0.555, P<0.1). Multivariate linear regression analysis showed that with mechanical ventilation and respiratory tract infections were the independent risk factors impacting the length of hospital stay of patients ( β=0.146, 0.383, 95% CI=0.022-0.271, 0.261-0.506, P<0.05 or P<0.01). Single factor linear regression analysis showed that injurious factors of inhalation injury, combined total burn area, degree of inhalation injury (moderate and severe), tracheotomy (no tracheotomy and prophylactic tracheotomy), mechanical ventilation, and respiratory tract infections were the factors impacting the length of ICU stay of patients ( β=0.225, 0.008, 0.237, 0.203, -0.408, -0.334, 0.309, 0.523, 95% CI=0.053-0.502, 0.006-0.010, -0.018-0.457, -0.022-0.428, -0.575--0.241, -0.687--0.018, 0.132-0.486, 0.369-0.678, P<0.1). Multivariate linear regression analysis showed that with respiratory tract infections was the independent risk factor impacting the length of ICU stay of patients ( β=0.440, 95% CI=0.278-0.601, P<0.01). Single factor linear regression analysis showed that injury site, injurious factors of inhalation injury (smoke and chemical gas), combined total burn area, degree of inhalation injury (moderate and severe), tracheotomy (no tracheotomy and prophylactic tracheotomy), and respiratory tract infections were the factors impacting mechanical ventilation days of patients ( β=-0.300, 0.545, 0.163, 0.005, 0.487, 0.799, -0.791, -0.736, 0.300, 95% CI=-0.565--0.034, 0.145-0.946, 0.051-1.188, 0.001-0.009, 0.127-0.847, 0.436-1.162, -1.075--0.508, -1.243--0.229, 0.005-0.605, P<0.1). Multivariate linear regression analysis showed that smoke inhalation, severe inhalation injury, and respiratory tract infections were the independent risk factors impacting mechanical ventilation days of patients ( β=0.210, 0.495, 0.263, 95% CI=0.138-0.560, 0.143-0.848, 0.007-0.519, P<0.05 or P<0.01). Single factor logistic regression analysis showed that age, injury site, combined total burn area (10%-19%TBSA and 20%-29%TBSA), degree of inhalation injury (moderate and severe), tracheotomy (prophylactic tracheotomy and no tracheotomy), and mechanical ventilation were the factors impacting respiratory tract infections of patients (odds ratio=1.079, 0.815, 1.400, 1.331, 1.803, 1.958, 0.990, 0.320, 3.094, 95% CI=0.840-1.362, 0.641-1.044, 1.122-1.526, 1.028-1.661, 1.344-2.405, 1.460-2.612, 0.744-1.320, 0.241-0.424, 2.331-4.090, P<0.1). Multivariate logistic regression analysis showed that with mechanical ventilation was the independent risk factor impacting respiratory tract infections of patients (odds ratio=4.300, 95% CI=2.152-8.624, P<0.01). Conclusions:The patients with inhalation injuries combined with total burn area less than 30%TBSA are mainly young and middle-aged males. Smoke inhalation, degree of inhalation injury, with mechanical ventilation and respiratory tract infections are the factors that affect the outcomes of patients with inhalation injuries combined with total burn area less than 30%TBSA. Additionally, prophylactic tracheotomy shows its potential value in reducing respiratory tract infections in patients with moderate or severe inhalation injuries.

Sepsis is one of the critical illnesses caused by burns, trauma, shock, infection, and so on. In patients with sepsis, vascular permeability is prone to develop through various pathophysiological mechanisms and thus could result in accumulation of tissue fluid, insufficient intravascular fluid, and finally cause septic shock and multiple organ dysfunction syndrome. Recent studies have shown that various factors and mediators involved in the regulation of vascular permeability in sepsis are expected to become targets for clinical treatment of sepsis. In this paper, we have reviewed the research advances on some molecules which are significantly associated with vascular permeability in sepsis, such as vascular endothelial growth factor, angiopoietin, sphingosine-1-phosphate, heparin-binding protein, and Slit2.

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection, which is a global health crisis. The cytokines are a class of protein mediators secreted by cells with low molecular weights and biological activity. There are two types of cytokines, pro-inflammatory and anti-inflammatory cytokines, participating in regulation of immunity and inflammation in sepsis. Cytokines are also used as biomarkers for early warning, diagnosis, and prognostic assessment of sepsis and as therapeutic targets for prevention and treatment of sepsis. This paper briefly summarizes the research advance of some cytokines in sepsis and the related work carried out by author′s institute, and elaborates the roles of cytokines in sepsis and their clinical application value, helping to provide some ideas and reference for the future research of cytokines in sepsis.

Recently point-of-care testing (POCT) for cardiovascular biomarkers is sharply increasing among subdivision field of POCT,however the relevant quality control is not matched.In this paper,the present situation and problems about selecting biomarkers,managing quality and reporting results during clinical application were expounded.The difference between POCT for cardiovascular biomarkers and routine biomarkers was elaborated.The domestic and international rules and standards about POCT for cardiovascular biomarkers were summarized.Finally,this paper included some rationalization proposal to solve the noticeable problems of quality control in POCT for cardiovascular biomarkers.

OBJECTIVETo screen for mutations of NTRK1 gene in a Chinese family affected with congenital insensitivity to pain with anhidrosis (CIPA).

METHODSGenomic DNA was extracted from the proband and her family members. All of the 17 exons and intron-exon boundaries of the NTRK1 gene were analyzed by direct Sanger sequencing. For the deletional mutation, the PCR products were subjected to T-A cloning and sequencing to verify the mutation.

RESULTSNTRK1 gene analysis revealed that proband has carried a c.1786C>T (p.Arg596*) nonsense mutation inherited from her mother and a novel deletional mutation c.1928-2028+23del from her father. Her elder brother only carried the deletional mutation.

CONCLUSIONThe diagnosis of CIPA relied on typical clinical symptoms of no pain, anhidrosis and intellectual disability and detection of the biallelic NTRK1 mutations. The novel deletional mutation has enriched the spectrum of NTRK1 mutations.

Child, Preschool ; DNA Mutational Analysis ; Exons ; Female ; Hereditary Sensory and Autonomic Neuropathies ; diagnosis ; genetics ; Humans ; Mutation ; Receptor, trkA ; genetics

Objective To observe the clinical efficacy of infrared thermal therapy against pseudomonas ae-ruginosa infection on deep partial-thickness burn wound. Methods Forty-three patients in our hospital with main-ly deep partial-thickness burn wound from January 2015 to October 2016 were randomly enrolled to the treatment group(TG,treated with sulfadiazine silver + infrared thermal therapy)and the control group(CG,treated with sulfadiazine silver only). Scores of wound exudation,positive rate of pseudomonas aeruginosa on wound,wound healing rate,wound healing time and overall evaluation of wound healing on the day of 0,3,7,14,21,28 after treatment were conventionally recorded. Adverse effects in TG and CG were also observed. Results (1)Age,sex and burn surface area of patients were found no statistically significant difference between the two groups(P>0.05). (2)On the day of 3,7 and 14,wound exudation score of TG was significantly lower than that of CG(P<0.05);On the day of0,21 and 28,wound exudation score of the two groups were almost same.(3)Positive rate of pseudomonas aeruginosa between the two groups on the day of 7,14 and 21,TG was significantly lower than CG(P < 0.05). (4)Wound healing rate of TG on the day of 7,14 and 21 was higher than CG,which was statistically significant difference in the 2 groups(P<0.05);Wound healing time of TG patients[(21.1 ± 6.5)day]was significantly shorter than that of CG patients[(26.2 ± 6.5)day](P<0.05).(5)Overall evaluation of wound healing of TG was better than that of CG on the day 14 and 21(P<0.05). Conclusions Infrared thermal therapy could reduce the secretion of deep partial-thickness burn wound and effectively control pseudomonas aeruginosa infection. Furthermore,infrared thermal therapy finally improved wound healing rate and shortenedwound healing time of burn wound.

Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy. Excision of scars, release of muscle, joints or bones, and soft tissue transplantation are the core of surgery. Laser treatment has a bright future but still needs to be further studied. Additionally, some novel treatments such as molecular targeted therapy, cell therapy, fat injection, and botulinum toxin injection will play important roles in prevention and treatment of postburn contractures in the future. The purpose of this article is to review the literature concerning postburn contractures of the hand, and summarize the present situation of prevention and treatment of such disease comprehensively.