OBJECTIVE: To explore the clinical features of patients with necrotizing soft tissue infection (NSTI) and the related factors for sepsis, so as to provide a basis for early intervention and improvement of patients' prognosis. METHODS: A retrospective case series study was conducted to analyze the clinical data of NSTI patients admitted to the department of burns and wound repair surgery of Guangdong Provincial People's Hospital from October 2021 to December 2024. Demographic information, underlying diseases, infection characteristics, laboratory test results and etiological findings at admission, treatment status, occurrence of complications (including sepsis) and prognosis were collected. Univariate and multivariate Logistic regression analyses were used to identify the associated factors for sepsis in NSTI patients. Receiver operator characteristic curves (ROC curves) were plotted to evaluate the predictive value of individual and combined factors for sepsis. RESULTS: A total of 159 NSTI patients were enrolled, mainly middle-aged and elderly males. Most patients had comorbidities, including diabetes mellitus (110 cases, 69.2%) and hypertension (67 cases, 42.1%). The main infection site was the lower extremities (104 cases, 65.4%). Common symptoms included redness (96 cases, 60.4%), swelling (129 cases, 81.1%), local heat (60 cases, 37.7%), pain (100 cases, 62.9%), and skin ulceration or necrosis (9 cases, 5.7%). Imaging findings included soft tissue swelling (66 cases, 57.9%), gas accumulation (41 cases, 36.0%), and abnormal signal/density shadows (50 cases, 43.9%). Staphylococcus aureus was the main pathogenic bacterium [12.0% (31/259)], and drug-resistant Escherichia coli had the highest detection rate among drug-resistant bacteria [35.1% (13/37)]. Regarding debridement and repair, most patients (80 cases, 50.3%) underwent debridement ≥ 72 hours after admission, while only 10.1% (16 cases) received debridement within 6 hours. Most patients underwent multiple debridements, with 2 times of debridements being the most common (68 cases, 42.8%), and the maximum times of debridements reached 6. The largest number of patients received secondary suture (44 cases, 27.7%). In terms of complications, sepsis was the most common (66 cases, 41.51%), followed by acute kidney injury, respiratory failure requiring mechanical ventilation, and multiple organ dysfunction syndrome (MODS), while disseminated intravascular coagulation (DIC) was the least common. During the follow-up period, 9 patients (5.66%) were readmitted within 90 days, and 11 patients died, with a mortality rate of 6.92%. Univariate analysis showed that diabetes, coronary heart disease, gout, body temperature, heart rate, C-reactive protein, platelet count, total bilirubin, albumin, creatinine, out-of-hospital treatment, and out-of-hospital use of antimicrobial agents were significantly associated with sepsis in NSTI patients (all P < 0.05). Multivariate Logistic regression analysis showed that coronary heart disease [odds ratio (OR) = 30.085, 95% confidence interval (95%CI) was 2.105-956.935], C-reactive protein (OR = 1.026, 95%CI was 1.009-1.054), and total bilirubin (OR = 1.436, 95%CI was 1.188-1.948) were independent associated factors for sepsis in NSTI patients (all P < 0.05). ROC curve analysis revealed that the combination of the three predictors yielded the highest AUC for predicting sepsis in NSTI patients compared to any individual predictor [area under the curve (AUC) = 0.799 (95%CI was 0.721-0.878)]. CONCLUSIONS The clinical features of NSTI patients show certain regularity. Coronary heart disease, C-reactive protein, and total bilirubin are independent associated factors for sepsis in NSTI patients.
Humans ; Retrospective Studies ; Male ; Sepsis ; Soft Tissue Infections/microbiology* ; Female ; Middle Aged ; Aged ; Adult ; Prognosis ; Risk Factors ; Necrosis ; Logistic Models ; Fasciitis, Necrotizing

Objective To investigate the effect of different strand lengths of 125I seeds with the same activity on the dose of different reference points around the seeds.Methods The scanned images were transferred to the three-dimensional treatment planning system(3D-TPS)according to DICOM format.The target volume was delineated at 5 mm and 10 mm above and below the center of the phantom,and a 0.8 mCi seeds strand was simulated.The 1-20 seeds were arranged with an equal spacing of 5 mm(5 mm-100 mm).The 5 mm points above and below the center of the seeds strand were defined as point A and point A',and the 10 mm points above and below the center were defined as point B and point B'.5 mm above and below the edge of the seeds strand on the left side were defined as AL points and AL'points,and 5 mm above and below the edge of the seeds strand on the right side were defined as AR points and AR'points.Similarly,points 10 mm above the above mentioned positions were defined as BL points,BL'points,BR points,BR'points.The average dose symmetry points were measured at AL,AL',AR,and 5 mm,10 mm,15 mm and 20 mm inside AR' of the 45 mm-100 mm seeds strand.The dose at the center was compared with the dose at the end points.The dose at the center point A was compared with the average dose at the symmetry points of 5 mm,10 mm,15 mm and 20 mm inside of the end points AL,AL',AR and AR',and the dose at each point was curve fitting.The correlation between each point and seeds strands of different lengths was analyzed.Results There was a positive correlation between the dose and the length of each point.There was no statistically significant difference between the center point and the end point.There was a statistically significant difference in dosage at points 5 mm and 10 mm inside from point A,while there was no statistically significant difference in dosage at points 15 mm and 20 mm inside from point A.The dose of A,A',B and B' point increased steadily with the increase of seed chain length,and the fitting curves were obtained respectively:y=e(-0.620/x+5.28)(R2=0.992),y=e(-0.640/x+5.34)(R2=0.987),y=e(-0.82/x+4.80)(R2=0.984),y=e(-0.82/x+4.83)(R2=0.9g1).Conclusion The doses at points A,A',B,and B'are positively correlated with seeds strand length and have a high degree of stability.Point A can be used as a reference point for the target area dose of the seeds strand,and point B can be used as a reference point for the dose to critical organs.The dose at other positions is more variable and thus has a certain degree of uncertainty as a reference point for the seeds strand dose.

Objective To investigate the impact of different 125I seeds strand radian on the dose of different reference points around the seeds.Methods CT scan of self-developed radioactive particle radiation dose measurement phantom was performed,the scanned images were transferred to the three-dimensional treatment planning system(TPS).The target area at the middle level of the model was drawn.The target volume was delineated at 5 mm and 10 mm above and below the center of the phantom.125I seeds strand plans were designed with different radians,with a total length of 8 cm,seed spacing of 0 cm,activity of 0.8 mCi,and a total of 16 particles,with radians ranging from 30°to 170°,increasing by 10° increment.The point 5 mm vertically away from the center of the seeds strand towards the center was named A',and the point away from the center was named A.The point 10 mm vertically away from the center of the seeds strand towards the center was named B',and the point away from the center was named B.The doses at different radians were recorded,and the actual absorbed dose at 1-2 months after operation was calculated based on the particle activity decay formula.Results The doses at points A'and A were(218.3±23.1)and(201.5±16.0)Gy respectively(P=0.001).The actual absorbed doses at 1 month after operation were(65.5±6.9)and(60.5±4.8)Gy respectively(P=0.001),and the actual absorbed doses at 2 months after operation were(109.2±11.5)Gy and(100±7.9)Gy respectively(P=0.001).The doses at points B'and B were(95.9±11.0)Gy and(81.7±4.9)Gy respectively(P＜0.001),and the actual absorbed doses at 1 month after operation were(28.8±3.3)Gy and(24.5±1.5)Gy respectively(P＜0.001).The actual absorbed doses at 2 month after operation were(48.0±5.5)Gy and(41.0±2.4)Gy respectively(P＜0.001).The doses at points A'and A gradually decreased with the increase of the radians,reaching the minimum value at 100 degrees,and then increased gradually,showing a cubic function change.The actual absorbed dose showed the same trend.The doses at points B'and B increased gradually with the increase of the radians,showing a cubic function change.Conclusion At different radians,the point doses and absorbed doses on the centrifugal side of the seeds strand are both less than those on the centripetal side.There is a cubic function relationship between the dose at the reference points and the radian of the seeds strand.

Gastrointestinal stromal tumor(GIST),with a certain malignant potential,are currently the most common subepithelial tumors of the gastrointestinal tract.Early diagnosis and prediction of malignant potential are very important for the formulation of a treatment plan and determining the prognosis of GIST.Deep learning technology has made significant progress in the diagnosis of digestive tract diseases,and it can also effectively assist physicians in diagnosing GIST and predicting their malignant potential,preoperatively.The application of deep learning technology in the diagnosis of GIST includes CT,gastrointestinal endoscopy and endoscopic ultrasound.This paper aims to review the application of deep learning technology in the diagnosis and prediction of malignant potential of GIST.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.

Objective:To analyze the operational efficiency and its changes of traditional Chinese medicine(TCM)hospitals in Guangdong province,and to provide empirical evidence for improving the operational efficiency of TCM hospitals in Guangdong Province.Methods:The three-stage DEA model was used to conduct a static analysis of the operating efficiency of TCM hospitals in Guangdong Province in 2022,and the Malmquist index was used to conduct a dynamic analysis of the changes in the operating efficiency of TCM hospitals in Guangdong Province from 2018 to 2022.Results:After eliminating the influences of environmental variables and random interference,the average values of comprehensive efficiency,pure technical efficiency and average scale efficiency of the TCM hospitals in Guangdong Province in 2022 were 0.970,0.982 and 0.988,respectively.From 2018 to 2022,the total factor productivity index of Guangdong's TCM Hospitals was 1.008.Conclusion:The overall operation efficiency of TCM hospitals in Guangdong is high,but there are obvious regional differences.Further improvement of operation efficiency is mainly restricted by pure technical efficiency.Operational efficiency needs to be further improved through measures such as coordinating the layout of resources in various places,improving the external environment,sounding the internal management system of hospitals,and fine-tuning operational management.