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

ObjectiveTo investigate the current status of emergency management for severe mental disorders in Shanghai, and to provide countermeasures and suggestions for the establishment of a sound emergency management system for severe mental disorders and the enhancement of emergency management capability. MethodsA questionnaire survey and qualitative interviews were used to conduct an investigation into the emergency management in 17 district-level mental illness prevention and control institutions in Shanghai, which includes the basic situation of emergency management for severe mental disorders, the construction of emergency response teams and personnel, emergency preparedness drills and training, emergency management plans and rules and regulations, and problems encountered in emergency management. ResultsIn terms of emergency management mechanism and basic situation, resources such as personnel allocation, security funds and green channel were well equipped in each district-level mental illness prevention and control institution in Shanghai. However, the equipment of some hardware facilities was still insufficient to some extent. Therefore, further improvement on the emergency management mechanism for severe mental disorders was needed. With regard to the construction of emergency team and personnel allocation, the majority were those aged between 35‒<45 years old, with a bachelor’s degree, and more than 10 years of working experience. For example, 90.27% staff in district-level mental illness prevention and control institution had a bachelor’s degree or above, which was higher than that among the staff in community-level (73.60%); staff majored in clinical medicine in district-level institution accounted for the proportion at 52.71%, higher than that among the staff in community-level (28.86%); 57.24% staff in district-level institution had an intermediate professional title, higher than that among the staff in community-level (42.28%); and 69.90% staff in district-level institution had more than 10 years of working experience, higher than that among the staff in community-level (43.62%). In the aspect of emergency drills and training, all district-level mental illness prevention and control institutions in Shanghai had a high demand for emergency training, and the weak aspects mainly focused on lack of emergency service protocols, skills of addressing technical challenges, and construction of effectiveness evaluation system. Moreover, the teaching methods were primarily centered on case analysis, simulation drills, interactive discussions, and so forth. Concerning emergency management plans and rules and regulations, all districts in Shanghai had relatively established well-developed systems for emergency response plans, emergency response leadership groups, and emergency response operational task forces for severe mental disorders. About half of the institutions had established other rules and regulations related to emergency management of severe mental disorders in addition to emergency plans. ConclusionShanghai has initially established an emergency management system for severe mental disorders, but it is still fragile in specialized training for emergency management of severe mental disorders, construction of emergency management mechanisms, and the building-up of grassroots emergency teams. Further priorities should include strengthening emergency management training, enhancing the construction of emergency management personnel teams, and gradually establishing a more comprehensive and integrated emergency management mechanism for severe mental disorders.

ObjectiveTo investigate the status of liver function abnormalities in patients with severe mental disorder (SMD) in Shanghai community, to explore the related factors to abnormal liver function in patients with SMD, and to analyze the effects of the types of mental disorders and medication status on liver function abnormalities. MethodsThe patients with SMD in Jinshan District, Minhang District, Hongkou District and Xuhui District of Shanghai were selected as the research subjects. Questionnaire survey, physical examination and laboratory tests were conducted to obtain their demographic characteristics and liver function indicators such as alanine aminotransferase (ALT) and total bilirubin (TBil). The types of mental disorders and medication status of patients in Jinshan District were also investigated. Abnormalities in liver function were determined by abnormalities in either ALT or TBil. Binary logistic regression analysis was used for multivariate analysis of the status of abnormal liver function, and the effects of mental disorder types and medication status on liver function were analyzed, simultaneously. ResultsA total of 7 251 patients with SMD were finally included into this study, and the rate of liver function abnormality was 22.7%, of which 694 cases (9.6%) had ALT abnormality and 1 084 cases (14.9%) had TBil abnormality. Univariate analysis showed that the rate of liver function abnormalities was higher in males than that in females (χ²=45.026, P<0.001), higher in suburbs than that in urban areas (χ²=25.317, P<0.001), higher in those with higher BMI than in those with lower BMI (χ²=63.748, P<0.001), higher in those with elevated blood pressure (BP) than in those without elevated BP (χ²=24.774, P<0.001), higher in those with elevated blood glucose than in those without elevated blood glucose (χ²=43.345, P<0.001), higher in those with abnormal triglyceride (TG) than in those with normal TG (χ²=15.551,P<0.001), and higher in those with abnormal total cholesterol (TC) than in those with normal TC (χ²=10.962, P=0.001). Multivariate analysis showed that the rate of abnormal liver function was higher in males than that in females (OR=1.53, 95%CI: 1.36‒1.73), higher in suburbs than that in urban areas (OR=1.43, 95%CI: 1.21‒1.70), higher in those with overweight than in those with normal BMI (OR=1.16, 95%CI: 1.01‒1.33), higher in those with obesity than in those with those with normal BMI (OR=1.61, 95%CI: 1.36‒1.91), higher in those with elevated blood glucose than in those without elevated blood glucose (OR=1.39, 95%CI: 1.23‒1.58), and higher in those with abnormal TC than in those with normal TC (OR=1.36, 95%CI: 1.13‒1.65).The difference in the rate of ALT abnormalities among the SMD patients in Jinshan District with different medication status was statistically significant (χ²=21.928, P<0.001). Whereas, the differences in the effects of the types of mental disorders and medication status on the status of liver function abnormalities were not statistically significant(P>0.05). ConclusionThe detection rate of liver function abnormalities in community-based SMD patients in Shanghai is high, and male, suburban, and accompanied by elevated BMI, BP, blood glucose, and TC are risk factors for liver function abnormalities in patients with SMD. Primary healthcare providers should pay more attention to the liver function of patients with SMD and initiate targeted and tailored prevention, detection and treatment measures.

Objective: To investigate the characteristics of schizophrenic patients using long-acting antipsychotic medications, so as to provide the basis for applicable population of long-acting antipsychotic medications. Methods: Data of schizophrenic patients using long-acting antipsychotic medications in Shanghai City from June 2020 to June 2022 were collected through Shanghai Mental Health Information Management System, and demographic characteristics, illness and medication use of patients were descriptively analyzed. Results: A total of 2 684 schizophrenic patients using long-acting antipsychotic medications were included in the study, had a mean age of (46.92±12.39) years, with 1 246 males (46.42%) and 1 438 females (53.58%). There were 1 397 unemployed cases, accounting for 52.05%; 1 429 cases with an educational level in junior high school or below, accounting for 53.24%; 1 301 unmarried cases, accounting for 48.47%; 832 cases in poverty, accounting for 31.00%. The caregivers of patients were mainly their parents, with 1 507 cases accounting for 56.15%. The courses of illness were mainly ≤10 years and >10-20 years, with 860 cases each, both accounting for 32.04%; 1 963 cases with incomplete self-awareness, accounting for 73.14%; 1 570 cases hospitalized at least once, accounting for 58.49%. There were 2 486 cases with continuous medication, accounting for 92.62%. The main method of taking medication was given by others, with 1 947 cases accounting for 72.54%. The medication adherence was mainly taking medication on time and in the right amount, with 2 437 cases accounting for 90.80%. Conclusion The main characteristics of schizophrenic patients using long-acting antipsychotic medications are young, unmarried, and unemployed adults, with incomplete self-awareness, continuous medication and medication given by others.

Objective To explore the correlations between self-esteem,social support and mental health status of patients with deep bums at special sites at different stages of the disease course.Methods A total of 36 inpatients who were admitted to Department of Burn Surgery of The First Affiliated Hospital of Naval Medical University(Second Military Medical University)between Jan.2020 and Sep.2023 were enrolled.The patients were assessed with self-rating anxiety scale(SAS),self-rating depression scale(SDS),post-traumatic stress disorder(PTSD)checklist-civilian version(PCL-C),Rosenberg self-esteem scale(RSES),and perceived social support scale(PSSS)within 7 d of burns(early stage of disease),at wound closure(early rehabilitation stage),and 3 months after wound closure(late rehabilitation stage).The data were collected and invalid data were excluded for statistical analysis.Results A total of 36 patients effectively completed all the scales.There were anxiety,depression and PTSD in patients with deep bums at special sites at different stages of the disease course,and the number of burn patients with anxiety,depression and PTSD showed a downward trend with the course of disease.The RSES score at the early rehabilitation stage was positively correlated with SAS score(rs=0.412,P=0.013),SDS score(rs=0.347,P=0.038)and PCL-C score(rs=0.447,P=0.006)at the early stage of disease,but not with SAS,SDS,or PCL-C scores at the early and late rehabilitation stages(all P＞0.05).There were no correlations between PSSS score at the early rehabilitation stage and SAS,SDS,or PCL-C scores at the early stage of disease or SAS or PCL-C scores at the early stage of rehabilitation(all P＞0.05),but there were negative correlations between PSSS score at the early rehabilitation stage and SDS score at the early stage of rehabilitation(r=-0.430,P=0.009)and SAS score(r=-0.467,P=0.004),SDS score(r=-0.483,P=0.003),and PCL-C score(rs=-0.351,P=0.036)at the late stage of rehabilitation.Conclusion Anxiety,depression,and PTSD are observed in patients with deep burns in special areas at different stages of the disease.A high level of self-esteem is associated with an increased risk of mental problems at early stage of burns.Conversely,a high level of social support is associated with a reduced likelihood of mental problems at late stage of rehabilitation.

Objective:To provide warning information for early renal injury in pilots by investigating the relationship between serum cystatin C (Cys-C) level and renal blood flow parameters in healthy pilots.Methods:A total of 347 military pilots who underwent annual physical examination in the Air Service Department of the 960th Hospital of Joint Logistics Support Force from July of 2019 to December of 2021 were selected as the pilot group, and 347 healthy subjects who were in same age span and examined at same period were selected as the control group. Color Doppler flow imaging was used to qualitatively analyze renal artery blood flow parameters, including the peak systolic velocity (PSV), end-diastolic blood flow velocity (EDV) and resistance index (RI) of the main renal artery, segmental artery and interlobar arteries. The serum urea nitrogen, serum creatinine and uric acid of subjects were measured. Both pilot group and the control group were divided into 21-30 years old, 31-40 years old and 41-50 years old groups. According to the median level of serum Cys-C, the pilots were divided into high Cys-C group and low Cys-C group. The Cys-C level and renal blood flow parameters of each group were compared, and the correlation between Cys-C level and renal blood flow parameters of pilots was analyzed.Results:There were no significant differences on serum Cys-C level between the pilot group and the control group at all ages (all P>0.05). There was a significant difference on Cys-C levels among the pilots of different ages ( H=8.24, P=0.045). There was no significant difference in Cys-C levels among control groups at different ages ( P>0.05). The levels of endogenous creatinine clearance and uric acid in the high Cys-C group were higher than those in the low Cys-C group, and the differences were significant ( Z=-4.17, -2.98, P<0.001, =0.003). The EDV of main renal artery in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( t=4.82, P=0.021). The EDV of interlobar arteries in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( Z=-5.48, P=0.030). Correlation analysis showed that the Cys-C level of pilots was positively correlated with age, flying hours and uric acid level ( r=0.381, 0.165, 0.359, P=0.001, 0.002, 0.003). Cys-C level was negatively correlated with EDV of main renal artery and interlobar arteries ( r=-0.306, -0.321, P=0.048, 0.024), and positively correlated with RI of main renal artery ( r=0.417, P=0.029). Conclusions:The serum Cys-C of pilots could reflect certain basic data of renal function and is hopeful to provide warning for early renal injury due it correlated to the EDV of main renal artery and interlobar arteries and the RI of main renal artery.

Objective:To provide warning information for early renal injury in pilots by investigating the relationship between serum cystatin C (Cys-C) level and renal blood flow parameters in healthy pilots.Methods:A total of 347 military pilots who underwent annual physical examination in the Air Service Department of the 960th Hospital of Joint Logistics Support Force from July of 2019 to December of 2021 were selected as the pilot group, and 347 healthy subjects who were in same age span and examined at same period were selected as the control group. Color Doppler flow imaging was used to qualitatively analyze renal artery blood flow parameters, including the peak systolic velocity (PSV), end-diastolic blood flow velocity (EDV) and resistance index (RI) of the main renal artery, segmental artery and interlobar arteries. The serum urea nitrogen, serum creatinine and uric acid of subjects were measured. Both pilot group and the control group were divided into 21-30 years old, 31-40 years old and 41-50 years old groups. According to the median level of serum Cys-C, the pilots were divided into high Cys-C group and low Cys-C group. The Cys-C level and renal blood flow parameters of each group were compared, and the correlation between Cys-C level and renal blood flow parameters of pilots was analyzed.Results:There were no significant differences on serum Cys-C level between the pilot group and the control group at all ages (all P>0.05). There was a significant difference on Cys-C levels among the pilots of different ages ( H=8.24, P=0.045). There was no significant difference in Cys-C levels among control groups at different ages ( P>0.05). The levels of endogenous creatinine clearance and uric acid in the high Cys-C group were higher than those in the low Cys-C group, and the differences were significant ( Z=-4.17, -2.98, P<0.001, =0.003). The EDV of main renal artery in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( t=4.82, P=0.021). The EDV of interlobar arteries in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( Z=-5.48, P=0.030). Correlation analysis showed that the Cys-C level of pilots was positively correlated with age, flying hours and uric acid level ( r=0.381, 0.165, 0.359, P=0.001, 0.002, 0.003). Cys-C level was negatively correlated with EDV of main renal artery and interlobar arteries ( r=-0.306, -0.321, P=0.048, 0.024), and positively correlated with RI of main renal artery ( r=0.417, P=0.029). Conclusions:The serum Cys-C of pilots could reflect certain basic data of renal function and is hopeful to provide warning for early renal injury due it correlated to the EDV of main renal artery and interlobar arteries and the RI of main renal artery.

ObjectiveTo explore the effect of paliperidone palmitate treatment on schizophrenic patients in the community. Methods446 schizophrenic patients who used paliperidone palmitate injection were selected in Shanghai. Before and after the treatment， the disease family burden scale， the concise evaluation scale of drug treatment compliance， the VAS100 score of treatment satisfaction， the short form of quality of life measurement scale， and the screening scale of social function defects were used to evaluate the effects of paliperidone palmitate injection. The data were statistically analyzed using SPSS 26.0 software. ResultsAfter using paliperidone palmitate injection， the total score of family burden （13.94±12.17）， the score of daily family activities （3.26±2.74）， the score of family entertainment activities （2.21±2.30）， and the score of family relationship （2.79±2.76） were significantly higher than those before the treatment （14.98±12.64， 3.51±2.88， 2.48±2.38， 3.11±2.87， respectively， all with P<0.05）. The scores of the World Health Organization on quality of life brief scale （62.89±11.94） and the medication compliance scale （28.11±5.64） were better than those before treatment （60.67±12.62 and 27.37±6.96， all with P<0.05）. Compared with the prior treatment without paliperidone palmitate injection， the number of readmissions after treatment was significantly reduced （P<0.01）. ConclusionThe treatment of paliperidone palmitate injection has significant effect， which can effectively reduce the disease family burden of Schizophrenic patients， improve their quality of life， enhance their drug compliance， reduce the readmission rate of patients， ensure long-term treatment effect and promote disease recovery.

ObjectiveTo explore the relapse status based on the positive and negative syndrome scale （PANSS Scale） and related factors of schizophrenics in Shanghai communities， and to analyze the association between socio demographic characteristics， lifestyles， clinical characteristics and relapse. MethodsA dynamic cohort prospective study design was used in this study. From March 2018 to February 2019， a total of 189 schizophrenics in Xuhui， Hongkou， Changning， Jiading， Songjiang and Baoshan districts were enrolled successively. Baseline questionnaires were conducted through face-to-face interviews at baseline， which contained social demographic information， lifestyle information and clinical information. A follow-up was conducted every 2 weeks for a measurement of PANSS Scale for a total of 6 months. Relapse was assessed by a PANSS score increase of ≥25% from baseline （or an increase of 10 points or more if the baseline score was ≤40 points）. Univariate and multivariate Cox regression models were used to analyze the associations between relapse status （assessed by PANSS Scale） and socio demographic characteristics， lifestyles， and clinical characteristics， respectively. ResultsA total of 165 community schizophrenics completed baseline and follow-up surveys， with a loss to follow-up rate of about 12.7%. After exclusion of sociodemographic and clinical information deficits， 132 patients were included in the analysis totally， with an average age of 48.18±12.67 years， among whom 41.67% were male. Totally 33 patients relapsed during the 6-month follow-up period， with a relapse rate of 25.0%. After adjusting for gender， family history， age， employment， education， marital status， smoking， drinking， exercise frequency， medication compliance， insight， social function， violence history， stress recent events， adverse drug reactions and baseline scores of PANSS Scale， risk factors of relapse included the following four factors： age below 40 years （HR=4.47， 95%CI： 1.15-17.40）， primary school or below （HR=7.11， 95%CI： 1.54-32.83）， unemployed （HR=8.34， 95%CI： 1.78-38.98）， and adverse drug reactions （HR=5.02， 95%CI： 1.75-14.37）. ConclusionWe should pay attention to the risk factors such as age， education， employment and adverse drug reactions， in order to identify high-risk patients and to conduct timely interventions during the relapse management of schizophrenics in Shanghai community.

Objective:To evaluate the value of conventional ultrasound, shear wave elastography and thyroglobulin antibody in the differential diagnosis of benign and malignant thyroid nodules in pilots by Logistic regression model.Methods:The cohort study was used. The clinical data of pilots with thyroid nodules who were admitted to the 960th Hospital of the Joint Logistics Support Force from January of 2010 to May of 2022 were collected, including thyroglobulin antibody results and ultrasound images. The pathological results were used as the gold standard to establish a binary Logistic regression model and evaluate its ability to predict benign and malignant nodules.Results:Seventy-two pilots were included, all were male, with 22-55 years old and 75-5 600 h flying hours. A total of 85 nodules were detected. Among them, 48 nodules were benign nodules, including 34 nodular goiters, 10 adenomas, and 4 thyroid cystic nodules. There were 37 malignant nodules, all of which were papillary carcinomas. A total of 4 statistically significant characteristic variables were screened out, including thyroid nodule morphology, microcalcification, serum thyroglobulin antibody, and maximum elastic modulus. The sensitivity, specificity and accuracy of Logistic regression model in predicting benign and malignant thyroid nodules was 83.9%, 79.6% and 81.5%, respectively. The area under the receiver operating characteristic curve was 0.908 (95% CI: 0.850-0.966). Conclusions:The Logistic regression model established by shear wave elastography combined with thyroglobulin antibody has high diagnostic value. It is helpful to the differential diagnosis of benign and malignant thyroid nodules in pilots.