Objective To evaluate the relationship between ceftazidime-avibactam(CAZ-AVI)blood concentrations and efficacy in critically ill patients and to investigate the factors influencing blood levels.Methods The CAZ-AVI trough concentrations(Cmin)were detected in 29 patients who received CAZ-AVI treatment for at least 48 hours.The clinical materials of the patients were collected together for retrospective analysis.Results The Cmin of ceftazidime(CAZ)and avibactam(AVI)were(50.95±5.17)and(7.52±0.96)mg·L-1 in the effective group and(31.16±7.03)and(5.37±1.32)mg·L-1 in the ineffective group,respectively.The Cmin of CAZ in the effective group was significantly higher than in the ineffective group(P<0.05),and there was no significant difference in AVI Cmin between the two groups(P>0.05).Spearman's correlation analysis showed that CAZ Cmin was positively correlated with clinical efficacy(P<0.05),and no correlation between AVI Cmin and clinical efficacy(P>0.05).The optimal CAZ Cmin threshold was 24.59 mg·L-1.Multiple linear regression analysis showed that age and creatinine clearance was significantly correlated with the Cmin of CAZ,and creatinine clearance was significantly correlated with AVI Cmin(P<0.05).Conclusions The Cmin of CAZ correlates with efficacy,and it may be more beneficial for clinical treatment to keep the concentration of CAZ-AVI always greater than the minimum inhibitory concentration during the dosing interval.The creatinine clearance should be fully considered when optimizing CAZ-AVI dosage in critically ill patients.

Objective The aim of this study was to investigate the effects of LncRNA OTUD6B-AS1 on the proliferation,mi-gration and invasion of lung adenocarcinoma A549 cells.Methods Lung adenocarcinoma A549 cell line was cultured in vitro,and transient transfection of OTUD6B-AS1 and empty plasmid group were used as the control group.Overexpression and control cell mod-els were constructed,and divided into OTUD6B-AS1 overexpression group and empty plasmid group(NC group).The cell model was divided into the empty plasmid group(NC group)and OTUD6B-AS1 overexpression group.The transfection efficiency of OTUD6B-AS1 mRNA was verified through qRT-PCR.The CCK-8 experiment was used to detect the effect of OTUD6B-AS1 on the prolifera-tion activity of lung adenocarcinoma cells,and the Transwell assay was used to detect the effect of OTUD6B-AS1 on the migration and invasion ability of lung adenocarcinoma cells.Results Compared to the NC group,the overexpression OTUD6B-AS1 group had a sig-nificant increase in the expression of OTUD6B-AS1(P<0.05).The CCK-8 assay results showed that the proliferation activity of A549 cells in the OTUD6B-AS1 overexpression group was significantly reduced compared to the NC group(P<0.05).The results of the Transwell assay showed that the OTUD6B-AS1 overexpression group had significantly lower cell migration and invasion abilities than the NC group(P<0.05).Conclusion Overexpression lncRNA OTUD6B-AS1 in lung adenocarcinoma A549 cells can signifi-cantly inhibit the proliferation,migration,and invasion ability of A549 cells.

Chronic obstructive pulmonary disease (COPD) can be prevented and treated through effective care, reducing exacerbations and hospitalizations. Early identification of individuals at high risk of COPD exacerbation is an opportunity for preventive measures. However, many patients struggle to follow their treatment plans because of a lack of knowledge about the disease, limited access to resources, and insufficient clinical support. The growth of digital health—which encompasses advancements in health information technology, artificial intelligence, telehealth, the Internet of Things, mobile health, wearable technology, and digital therapeutics—offers opportunities for improving the early diagnosis and management of COPD. This study reviewed the field of digital health in terms of COPD. The findings showed that despite significant advances in digital health, there are still obstacles impeding its effectiveness. Finally, we highlighted some of the major challenges and possibilities for developing and integrating digital health in COPD management.

Chronic obstructive pulmonary disease (COPD) can be prevented and treated through effective care, reducing exacerbations and hospitalizations. Early identification of individuals at high risk of COPD exacerbation is an opportunity for preventive measures. However, many patients struggle to follow their treatment plans because of a lack of knowledge about the disease, limited access to resources, and insufficient clinical support. The growth of digital health—which encompasses advancements in health information technology, artificial intelligence, telehealth, the Internet of Things, mobile health, wearable technology, and digital therapeutics—offers opportunities for improving the early diagnosis and management of COPD. This study reviewed the field of digital health in terms of COPD. The findings showed that despite significant advances in digital health, there are still obstacles impeding its effectiveness. Finally, we highlighted some of the major challenges and possibilities for developing and integrating digital health in COPD management.

BACKGROUND: Cicatricial alopecia always occurs following the scalp trauma, and the optimal repairing method is scalp soft tissue expansion. OBJECTIVE: To verify the repairing effect of scalp soft tissue expansion therapy on the large-scale cicatricial alopecia. DESIGN, TIME AND SETTING: A case report was carried out in the Department of Burn and Plastic Surgery at the 180 Hospital of Chinese PLA (Quangzhou, Fujian, China) between January 1996 and April 2008. PARTICIPANTS: Thirty-six patients of cicatricial alopecia were adopted, with the size arranging 15 cm?9 cm to 24 cm?14 cm. METHODS: Scalp soft tissue expansion was performed in 36 cases of cicatricial alopecia. In later stage, the residual alopecia with small area was removed by scar excision plus suture for several times, treated with transposition repair of local flap and autologous hair transplant carrying hair follicle. The largest area to repair alopecia reached 336 cm2. MAIN OUTCOME MEASURES: Postoperative complications, repairing effect and cicatrix restitution were observed after operation; The elimination of alopecia area, hair density and appearance were detected during follow-ups. RESULTS: Psilotic scar eliminated in all cases, but 11 cases underwent scalp scar excision, transposition of local flap and autologous hair transplant because of wide incisional scar or residual small alopecia. No obvious complications occurred. It was found by a postoperative follow-up of 1-3 years that hair growth was good. CONCLUSION: Skin soft tissue expansion is an ideal method to repair cicatricial alopecia with large area. In later stage, the combination of simple repair methods can obtain better curative effect.

OBJECTIVETo investigate the blood vascular distribution of supra-genicular flap and to apply the retrograded supra-genicular flap for reconstructive surgery.

METHODSEight fresh adult cadavers with 16 lower extremities were used for the study, by means of injecting the media of red latex into the main artery of the limb. The skin vascular architecture on the lower two thirds of each thigh was observed to decide the blood supply of this region. Fifty-two patients were also used to treat the scarring contraction of the popiteal fossa with 56 of the retrograded supra-genicular flaps, and long-term follow-ups were carried out.

RESULTSFrom this study, it was found that there are rich blood vascular networks of the skin above the knee anteriorally, laterally and medially. The abundant vascular anastomoses were also found around the knee. The clinical application of the retrograded supra-genicular flap was successfully carried out for the treatment of the scarring contraction of the popiteal fossa. All of the flaps were survived well. Long-term results were satisfactory.

CONCLUSIONThe above mentioned flap is a safe and effective flap for repair the defect of the popiteal fossa.

Adolescent ; Adult ; Burns ; complications ; Cadaver ; Child ; Child, Preschool ; Cicatrix ; etiology ; surgery ; Humans ; Knee ; blood supply ; Male ; Surgery, Plastic ; methods ; Surgical Flaps ; blood supply ; Thigh ; blood supply ; Treatment Outcome

Modern wars result in a significant increase in the incidence of burn injury,and a lot of soldiers with extensive deep burn will occur intensively in a short time.At present,allogeneic skin graft is a principal method to treat extensive burn,but allogeneic skin source is in extremely short supply.Therefore,this review concentrates on the source of allogeneic skin,the necessity to establish allogeneic skin bank for preparedness against war,the present existing problems and main solutions to related problems.