ObjectiveTo clarify the application value of nutritional scoring in patients with sepsis and explore the impact of the modified Nutritional Risk in Critically Ill （mNUTRIC） score on the in-hospital fatality of sepsis patients in the emergency intensive care unit （EICU）. MethodsA retrospective analysis was conducted on the clinical data and laboratory examination results of 436 sepsis patients treated in the EICU of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2021 to May 2024. The patients were divided into survival group （298 cases） and death group （138 cases） according to whether they died or not during hospital treatment， and then compared the two groups’ data. Logistic multi-factor regression analysis was used to analyze the risk factors for in-hospital death and the ROC curve to evaluate the predictive value of each risk factor for the prognosis of sepsis patients. ResultsThe death group exhibited higher Acute Physiology and Chronic Health EvaluationⅡ（APACHE Ⅱ） score， Nutritional Risk Screening 2002 （NRS 2002） score， mNUTRIC score， Sequential Organ Failure Assessment （SOFA） score， Padua Prediction Score for Venous Thromboembolism， the proportions of chronic kidney failure and pneumonia patients， C-reactive protein （CRP） level， lactate concentration and neutrophil count， but lower prognostic nutritional index， cholinesterase level， cholinesterase-albumin ratio and lymphocyte count than the survival group， with statistical significance （all P<0.05）. Logistic regression analysis revealed that the mNUTRIC score ［OR=1.254， 95%CI （1.109，1.417）］， CRP ［OR=1.004， 95%CI （1，1.007）］， and pneumonia ［OR=1.82， 95%CI （1.017， 3.257）］ were independent risk factors for in-hospital death in sepsis patients. ROC curve analysis showed that the area under the curve （AUC） of the mNUTRIC score for predicting in-hospital death in sepsis patients was 0.683 ［95%CI （0.623，0.742）］， with a sensitivity of 83% and a specificity of 49.3%. The AUC for CRP and pneumonia were 0.602 ［95%CI （0.533， 0.671）］， and 0.582 ［95%CI （0.516，0.647）］. ConclusionThe mNUTRIC score is an independent predictive indicator for in-hospital death in sepsis patients in the EICU.

Objective To explore the effectiveness of FOCUS-PDCA(find,organise,clarify,understand,select,plan,do,check and act)mode in prevention and treatment of incontinence-associated dermatitis(IAD)in emergency intensive care unit(EICU),and to reduce the incidence of IAD.Methods A pre-post control study design was employed in this study.Inpatients admitted to the EICU of the hospital between 1st January and 31st December 2022 were enrolled as study subjects.A total of 169 patients in EICU between January and June 2022 were assigned as a control group,while 197 patients in EICU between July and December 2022 as an trial group.Patients in the control group received conventional quality management,while those in the trial group were treated with the FOCUS-PDCA mode.The two groups were compared in terms of incidence of IAD,the knowledge,trust and behaviour scores of the nurses,and satisfaction from the communications with nurses before and after implementation of the FOCUS-PDCA mode.Results All patients in the two groups had completed the study.Following the implementation of FOCUS-PDCA mode,patients in the trial group exhibited a significantly decrease in incidence of IAD from 10.06%(trial group)to 1.52%(control group),significant increase of scores on the IAD knowledge,behaviour and satisfaction from communications with the nurses,from(36.07±3.98),(16.56±2.15)and(25.15±5.21),to(38.59±3.72),(18.07±1.66),and(30.67±5.84),respectively(all P<0.05).Conclusion FOCUS-PDCA mode can effectively decrease the incidence of IAD,enhance the IAD knowledge and behaviour of nurses and gain satisfactions from communication with nursing staff and clinical quality,thereby improving therapeutic outcomes.

Clinically,pancreatic cancer is a highly aggressive tumor,and neurotropic growth is an important biological feature of pancreatic cancer.Nerve invasion brings great pain burden to patients,and it seriously affects the quality of life and the will to survive of patients.The"three-step analgesia principle"for the management of cancer pain proposed by World Health Organization(WHO)is a traditional therapeutic regimen for cancer pain.However,because of its obvious toxic side effects,poor efficacy,easy addiction,easy drug resistance,non-standard medication of clinical physicians,etc.,the"three-step analgesia principle"is unable to meet the needs of the patient's condition..In recent years,with the development of interventional technology and the development of extensive clinical trials,the interventional means,which is regarded as the"fourth step"of cancer pain management,has achieved great clinical effect,it includes various therapeutic methods and imaging-guided techniques such as neural destruction(denervation),125I particle implantation,patient-controlled analgesic pump technology,implantation of intrathecal drug infusion system,etc.,and clinical practice has proved that these techniques have significant clinical efficacy and they can provide a convenient,safe and effective treatment method for HCC patients.

The stimulator of interferon genes(STING),an integral adaptor protein in the DNA-sensing pathway,plays a pivotal role in the innate immune response against infections.Additionally,it presents a valuable therapeutic target for infectious diseases and cancer.We observed that fangchinoline(Fan),a bis-benzylisoquinoline alkaloid(BBA),effectively impedes the replication of vesicular stomatitis virus(VSV),encephalomyocarditis virus(EMCV),influenza A virus(H1 N1),and herpes simplex virus-1(HSV-1)in vitro.Fan treatment significantly reduced the viral load,attenuated tissue inflammation,and improved survival in a viral sepsis mouse model.Mechanistically,Fan activates the antiviral response in a STING-dependent manner,leading to increased expression of interferon(1FN)and interferon-stimulated genes(ISGs)for potent antiviral effects in vivo and in vitro.Notably,Fan interacts with STING,preventing its degradation and thereby extending the activation of IFN-based antiviral responses.Collectively,our findings highlight the potential of Fan,which elicits antiviral immunity by suppressing STING degra-dation,as a promising candidate for antiviral therapy.

Identifying the compound formulae-related xenobiotics in bio-samples is full of challenges.Conventional strategies always exhibit the insufficiencies in overall coverage,analytical efficiency,and degree of automation,and the results highly rely on the personal knowledge and experience.The goal of this work was to establish a software-aided approach,by integrating ultra-high performance liquid chromatography/ion-mobility quadrupole time-of-flight mass spectrometry(UHPLC/IM-QTOF-MS)and in-house high-definition MS2 library,to enhance the identification of prototypes and metabolites of the compound formulae in vivo,taking Sishen formula(SSF)as a template.Seven different MS2 acquisition methods were compared,which demonstrated the potency of a hybrid scan approach(namely high-definition data-independent/data-dependent acquisition(HDDIDDA))in the identification precision,MS1 coverage,and MS2 spectra quality.The HDDIDDA data for 55 reference compounds,four component drugs,and SSF,together with the rat bio-samples(e.g.,plasma,urine,feces,liver,and kidney),were acquired.Based on the UNIFI? platform(Waters),the efficient data processing workflows were estab-lished by combining mass defect filtering(MDF)-induced classification,diagnostic product ions(DPIs),and neutral loss filtering(NLF)-dominated structural confirmation.The high-definition MS2 spectral li-braries,dubbed in vitro-SSF and in vivo-SSF,were elaborated,enabling the efficient and automatic identification of SSF-associated xenobiotics in diverse rat bio-samples.Consequently,118 prototypes and 206 metabolites of SSF were identified,with the identification rate reaching 80.51％and 79.61％,respectively.The metabolic pathways mainly involved the oxidation,reduction,hydrolysis,sulfation,methylation,demethylation,acetylation,glucuronidation,and the combined reactions.Conclusively,the proposed strategy can drive the identification of compound formulae-related xenobiotics in vivo in an intelligent manner.

Patients with breast hypertrophy often have breast and nipple-areolar complex (NAC) skin paresthesia, shoulder or back pain, eczema, reduced mobility, and other problems, which seriously decline the quality of life. With the improvement of patients’ requirements for life quality, researchers have gradually paid attention to the importance of breast and NAC sensation. This paper introduced Semmes-Weinstein monofilaments examination (SWME), pressure-specified sensory device (PSSD), and the hypotheses of breast and NAC sensory change in patients with mammary hypertrophy. The main factors causing sensory change after breast reduction surgery were also summarized. In these patients, the sensory change of the nipple and areola are not necessarily consistent. Pedicle selection could probably affect postoperative breast and NAC sensation. Notably, the superior pedicle and superolateral pedicle could bring some risks to the innervation of NAC, which might cause a significant decrease in postoperative skin sensitivity within a certain period. In addition, patients with larger breasts probably could benefit more from surgery, and the resection volume was not significantly associated with sensory change.

Patients with breast hypertrophy often have breast and nipple-areolar complex (NAC) skin paresthesia, shoulder or back pain, eczema, reduced mobility, and other problems, which seriously decline the quality of life. With the improvement of patients’ requirements for life quality, researchers have gradually paid attention to the importance of breast and NAC sensation. This paper introduced Semmes-Weinstein monofilaments examination (SWME), pressure-specified sensory device (PSSD), and the hypotheses of breast and NAC sensory change in patients with mammary hypertrophy. The main factors causing sensory change after breast reduction surgery were also summarized. In these patients, the sensory change of the nipple and areola are not necessarily consistent. Pedicle selection could probably affect postoperative breast and NAC sensation. Notably, the superior pedicle and superolateral pedicle could bring some risks to the innervation of NAC, which might cause a significant decrease in postoperative skin sensitivity within a certain period. In addition, patients with larger breasts probably could benefit more from surgery, and the resection volume was not significantly associated with sensory change.

Pilonidal sinus disease (PSD) is mostly located beneath the skin of the sacrococcygeal region, which is usually present as the sinus or cyst with inflammation. It is prevalent in Europe and North American except Asia. With the high misdiagnosis and recurrence rates, and postoperative complications, more and more attention has been drawn to the diagnosis and treatment. However, the gold standard for PSD treatment has not yet been established. Compared with the non-surgical procedures, there is a consensus that operative treatment is an efficient method. Moreover, surgical flaps such as Limberg flap, Dufourmentel flap, and Karydakis flap play a crucial part in therapy. This review introduced the features of PSD, therapeutic principles and methods, mainly reviewed the current status and progress of surgical treatments, summarized the recent research achievements to give clinicians thoughtful and practical advice.

Objective:To establish the connection between the superficial inferior epigastric artery (SIEA) system and patients’ body mass index (BMI) statistics. It could provide a reference for the tendentious choice of preoperative reconstruction scheme.Methods:Female patients with unilateral breast cancer after radical mastectomy were included in this study from August 2008 to June 2018 in the Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The computed tomography angiography data before reconstruction were analyzed by Onis 2.5 software, and the SIEA diameter was measured. Pearson correlation analysis was performed for the correlation between the SIEA diameter and BMI.Results:A total of 19 patients, aged (43.0±8.1) years, ranging from 30 to 60 years old, with height of (1.61±0.05) m, body mass of (62.9±8.6) kg and BMI of (24.4±3.3) kg/m 2 were included. There were 20 sides of abdominal wall in 19 patients identified with SIEA, of which 18 cases were unilateral and one case was bilateral. The diameter of SIEA was (1.75±0.54) mm, which was high linear correlation with BMI ( r=0.85, P<0.001); when BMI ≥24 kg/m 2, SIEA≥1.5 mm could be satisfied. Conclusions:Preoperative CTA data of the patients with no previous potential factors affecting the diameter of SIEA indicated that there was SIEA on the donor side. When BMI was no less than 24 kg/m 2, the application of the SIEA flap in breast reconstruction could be a theoretical option worthy of trying.

Pilonidal sinus disease (PSD) is mostly located beneath the skin of the sacrococcygeal region, which is usually present as the sinus or cyst with inflammation. It is prevalent in Europe and North American except Asia. With the high misdiagnosis and recurrence rates, and postoperative complications, more and more attention has been drawn to the diagnosis and treatment. However, the gold standard for PSD treatment has not yet been established. Compared with the non-surgical procedures, there is a consensus that operative treatment is an efficient method. Moreover, surgical flaps such as Limberg flap, Dufourmentel flap, and Karydakis flap play a crucial part in therapy. This review introduced the features of PSD, therapeutic principles and methods, mainly reviewed the current status and progress of surgical treatments, summarized the recent research achievements to give clinicians thoughtful and practical advice.