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Extensive analysis of risk factors associated with surgical site infections post‐cardiothoracic open surgery

Abstract

Surgical site infections (SSIs) post-cardiothoracic surgery represent a significant challenge in patient care. Understanding the risk factors contributing to SSIs is essential for improving surgical outcomes and patient safety. A comprehensive retrospective analysis was conducted at our institution from January 2021 to December 2022. This study included 30 patients with SSIs and 60 without, following cardiothoracic open surgery. Data were collected on various variables, including hypertension, anaemia, operation time, hospital stay, alcohol consumption, smoking habits, Body Mass Index, age, and drainage tube placement. Univariate and multivariate logistic regression analyses were employed using SPSS software to identify significant predictors of SSIs. Univariate analysis indicated a strong correlation between SSIs and factors like smoking, diabetes mellitus, drainage tube placement, anaemia, and significant intraoperative blood loss (≥800 mL). These factors were statistically significant with p-values < 0.05. Multivariate logistic regression further confirmed the impact of these factors, with high odds ratios indicating a substantial increase in SSI risk associated with these conditions. This study highlights intraoperative blood loss, anaemia, drainage tube placement, smoking, and diabetes mellitus as key risk factors for SSIs post-cardiothoracic surgery. Recognising and addressing these factors through targeted preventive measures is crucial in clinical practice to reduce the incidence of SSIs and improve postoperative care in cardiothoracic surgery.

Visualizing the global trends of peptides in wound healing through an in‐depth bibliometric analysis

Abstract

Wound healing is a complicated and multistage biological process for the repair of damaged/injured tissues, which requires intelligent designs to provide comprehensive and convenient treatment. Peptide-based wound dressings have received extensive attention for further development and application due to their excellent biocompatibility and multifunctionality. However, the current lack of intuitive analysis of the development trend and research hotspots of peptides applied in wound healing, as well as detailed elaboration of possible research hotspots, restricted obtaining a comprehensive understanding and development in this field. The present study analysed publications from the Web of Science (WOS) Core Collection database and visualized the hotspots and current trends of peptide research in wound healing. Data between January 1st, 2003, and December 31st, 2022, were collected and subjected to a bibliometric analysis. The countries, institutions, co-authorship, co-citation reference, and co-occurrence of keywords in this subject were examined using VOSviewer and CiteSpace. We provided an intuitive, timely, and logical overview of the development prospects and challenges of peptide application in wound healing and some solutions to the major obstacles, which will help researchers gain insights into the investigation of this promising field.

Effect of rapid rehabilitation care on surgical site wound infection and pain in patients with intertrochanteric femoral fractures: A meta‐analysis

Abstract

This study examines the effects of rapid rehabilitation on surgical site wound infections and pain in patients with intertrochanteric femoral fractures. A computerised search was conducted for randomised controlled trials (RCTs) on rapid rehabilitation care in patients undergoing surgery for intertrochanteric femoral fractures published in the China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Database, VIP, PubMed, Embase, Cochrane Library and Web of Science. The search was conducted from the time of the database construction to August 2023. Two investigators independently performed literature screening, data extraction and quality assessment based on predefined inclusion and exclusion criteria. Meta-analysis was performed via RevMan 5.4 software. Encompassing 21 studies involving 2004 patients, with 1007 patients receiving rapid rehabilitation care and 997 receiving routine care, our analysis revealed that rapid rehabilitation care significantly reduced postoperative complications (odds ratio [OR] = 0.24, 95% confidence interval [CI]: 0.17–0.33, p < 0.001), wound infections (OR = 0.30, 95% CI: 0.14–0.65, p = 0.002) and hospital stay (mean difference [MD] = −5.23, 95% CI: −6.03 to −4.43, p < 0.001). Moreover, compared with routine care, it notably improved wound pain (MD = −1.51, 95% CI: −1.98 to −1.05, p < 0.001) in patients undergoing surgery for intertrochanteric femoral fractures. Our findings underscore the effectiveness of rapid rehabilitation care in reducing wound pain, postoperative complications and wound infections among patients with intertrochanteric femoral fractures.

Prime editing-mediated correction of the <i>CFTR</i> W1282X mutation in iPSCs and derived airway epithelial cells

by Chao Li, Zhong Liu, Justin Anderson, Zhongyu Liu, Liping Tang, Yao Li, Ning Peng, Jianguo Chen, Xueming Liu, Lianwu Fu, Tim M. Townes, Steven M. Rowe, David M. Bedwell, Jennifer Guimbellot, Rui Zhao

A major unmet need in the cystic fibrosis (CF) therapeutic landscape is the lack of effective treatments for nonsense CFTR mutations, which affect approximately 10% of CF patients. Correction of nonsense CFTR mutations via genomic editing represents a promising therapeutic approach. In this study, we tested whether prime editing, a novel CRISPR-based genomic editing method, can be a potential therapeutic modality to correct nonsense CFTR mutations. We generated iPSCs from a CF patient homozygous for the CFTR W1282X mutation. We demonstrated that prime editing corrected one mutant allele in iPSCs, which effectively restored CFTR function in iPSC-derived airway epithelial cells and organoids. We further demonstrated that prime editing may directly repair mutations in iPSC-derived airway epithelial cells when the prime editing machinery is efficiently delivered by helper-dependent adenovirus (HDAd). Together, our data demonstrated that prime editing may potentially be applied to correct CFTR mutations such as W1282X.

Effect of incisional negative pressure therapy and conventional treatment on wound complications after orthopaedic trauma surgery: A meta‐analysis of randomized controlled studies

Abstract

The results of this meta-analysis were applied to analyse the effects of Negative Pressure Wound Therapy (NPWT) and conventional dressings on post-surgical outcomes after trauma in orthopaedics. Through June 2023, a full review of the literature has been carried out with the help of 4 databases, PubMed, Embase, Cochrane Library, and the Web of Science. The quality of the literature was evaluated according to the classification and exclusion criteria established for this trial, which led to an analysis of 9 related trials. The results included the injury was deeply and superficially infected, and the wound was dehiscence. The 95% confidence interval (CI) and odds ratios (OR) were computed by means of a fixed-effect and a random-effect model. Meta-analyses were conducted with RevMan 5.3. There is no statistical significance between NPWT and routine therapy for deep wound infection (OR, 1.37; 95% CI, 0.82–2.27, p = 0.23); There was no difference in the incidence of inflammation in the wound than with conventional dressings (OR, 1.10; 95% CI, 0.84–1.45, p = 0.49); But NPWT was obviously superior to that of routine therapy in superficial wound infection (OR, 2.07; 95% CI, 1.32–3.25, p = 0.002) and wound dehiscence (OR, 2.44; 95% CI, 1.31–4.57, p = 0.005); But not with respect to wound exudate. therapy group, but no statistically significant difference was found with respect to wound exudation. (OR, 1.16; 95% CI, 0.86–1.57, p = 0.34). Given that some of the chosen trials are too small for this meta-analysis, caution should be exercised when treating their values. More high-quality research with a large sample is required in order to confirm the findings.

Vitamin K2 (MK-7) attenuates LPS-induced acute lung injury via inhibiting inflammation, apoptosis, and ferroptosis

by Yulian Wang, Weidong Yang, Lulu Liu, Lihong Liu, Jiepeng Chen, Lili Duan, Yuyuan Li, Shuzhuang Li

Acute lung injury (ALI) is a life-threatening disease that has received considerable critical attention in the field of intensive care. This study aimed to explore the role and mechanism of vitamin K2 (VK2) in ALI. Intraperitoneal injection of 7 mg/kg LPS was used to induce ALI in mice, and VK2 injection was intragastrically administered with the dose of 0.2 and 15 mg/kg. We found that VK2 improved the pulmonary pathology, reduced myeloperoxidase (MPO) activity and levels of TNF-α and IL-6, and boosted the level of IL-10 of mice with ALI. Moreover, VK2 played a significant part in apoptosis by downregulating and upregulating Caspase-3 and Bcl-2 expressions, respectively. As for further mechanism exploration, we found that VK2 inhibited P38 MAPK signaling. Our results also showed that VK2 inhibited ferroptosis, which manifested by reducing malondialdehyde (MDA) and iron levels, increasing glutathione (GSH) level, and upregulated and downregulated glutathione peroxidase 4 (GPX4) and heme oxygenase-1 (HO-1) expressions, respectively. In addition, VK2 also inhibited elastin degradation by reducing levels of uncarboxylated matrix Gla protein (uc-MGP) and desmosine (DES). Overall, VK2 robustly alleviated ALI by inhibiting LPS-induced inflammation, apoptosis, ferroptosis, and elastin degradation, making it a potential novel therapeutic candidate for ALI.

Evaluation of risk factors for surgical site infections in osteoarthritis patients undergoing total knee arthroplasty

Abstract

This research sought to delineate risk factors associated with surgical site infections (SSIs) post-total knee arthroplasty (post-TKA) in elderly osteoarthritis patients, aiming to enhance post-surgical outcomes. A retrospective examination was conducted on a cohort of 650 elderly patients who underwent unilateral TKA between January 2018 and August 2022. Data procurement was from the hospital's Electronic Health Record, and a comprehensive statistical evaluation was performed using IBM SPSS Statistics version 24.0. Both univariate and multivariate techniques assessed a spectrum of risk determinants such as age, body mass index (BMI), coexisting medical conditions and surgical variables. The univariate examination spotlighted age, BMI, diabetes prevalence, chronic corticosteroid consumption and American Society of Anesthesiologists (ASA) physical status classification as notable predictors of SSIs. The multivariate logistic regression pinpointed age, BMI, history of smoking and diabetes diagnosis as salient risk attributors for post-TKA infections. Concurrently, parameters like ASA classification, surgical duration and intraoperative haemorrhage further enriched the risk landscape. Geriatric patients undergoing TKA for knee osteoarthritis manifest a tangible infection susceptibility post-surgery. Precision interventions concentrating on amendable risk components, including meticulous preoperative evaluations and strategic postoperative care, are imperative to attenuate SSI incidence, thereby amplifying surgical efficacy and optimizing patient recuperation trajectories.

Long non-coding RNA SNHG17 may function as a competitive endogenous RNA in diffuse large B-cell lymphoma progression by sponging miR-34a-5p

by Shengjuan Lu, Lin Zeng, Guojun Mo, Danqing Lei, Yuanhong Li, Guodi Ou, Hailian Wu, Jie Sun, Chao Rong, Sha He, Dani Zhong, Qing Ke, Qingmei Zhang, Xiaohong Tan, Hong Cen, Xiaoxun Xie, Chengcheng Liao

We investigated the functional mechanism of long non-coding small nucleolar host gene 17 (SNHG17) in diffuse large B-cell lymphoma (DLBCL). lncRNAs related to the prognosis of patients with DLBCL were screened to analyze long non-coding small nucleolar host gene 17 (SNHG17) expression in DLBCL and normal tissues, and a nomogram established for predicting DLBCL prognosis. SNHG17 expression in B-cell lymphoma cells was detected using qPCR. The effects of SNHG17 with/without doxorubicin on the proliferation and apoptosis of DoHH2 and Daudi were detected. The effects of combined SNHG17 and doxorubicin were analyzed. The regulatory function of SNHG17 in DLBCL was investigated using a mouse tumor xenotransplantation model. RNA sequencing was used to analyze the signaling pathways involved in SNHG17 knockdown in B-cell lymphoma cell lines. The target relationships among SNHG17, microRNA, and downstream mRNA biomolecules were detected. A higher SNHG17 level predicted a lower survival rate. SNHG17 was highly expressed in DLBCL patient tissues and cell lines. We established a prognostic model containing SNHG17 expression, which could effectively predict the overall survival rate of DLBCL patients. SNHG17 knockdown inhibited the proliferation and induced the apoptosis of B-cell lymphoma cells, and the combination of SNHG17 and doxorubicin had a synergistic effect. SNHG17, miR-34a-5p, and ZESTE gene enhancer homolog 2 (EZH2) had common hypothetical binding sites, and the luciferase reporter assay verified that miR-34a-5p was the direct target of SNHG17, and EZH2 was the direct target of miR-34a-5p. The carcinogenic function of SNHG17 in the proliferation and apoptosis of DLBCL cells was partially reversed by a miR-34a-5p inhibitor. SNHG17 increases EZH2 levels by inhibiting miR-34a-5p. Our findings indicate SNHG17 as critical for promoting DLBCL progression by regulating the EZH2 signaling pathway and sponging miR-34a-5p. These findings provide a new prognostic marker and therapeutic target for the prognosis and treatment of DLBCL.

Effect of “micromovement” in preventing intraoperative acquired pressure injuries among patients undergoing surgery in supine position

Abstract

To explore the clinical effect of “micromovement” in preventing intraoperative acquired pressure injures (IAPIs) among patients experiencing surgery in supine position. A total of 200 patients accepting elective surgery in supine position from 10 May 2023 to 4 July 2023 at Shulan (Hangzhou) Hospital were selected and randomized into two groups (experimental group, n = 100; control group, n = 100). For control group patients, soft silicone foam dressing was applied to the sacrococcygeal region. On the basis of the treatment for control group patients, “micromovement” was implemented among experimental group patients. During this process, the operating table was tilted for 15° leftwards and rightwards alternately every 1 h, and the tilt angle was maintained for 5 min to prevent IAPIs. Finally, comparisons between the two groups were made in terms of the sacrococcygeal IAPI incidence, relative temperature differences (ΔT) on sacrococcygeal skin, and job satisfaction of nurses. Compared with control group patients, patients from the experimental group exhibited lower IAPI incidence (2% vs. 10%), reduced ΔT between the sacrococcygeal skin and surrounding normal skin [0 (−0.1, 0.1) vs. 0.2 (−0.2, 0.4)], and elevated job satisfaction of nurses (80% vs. 66%). All the differences were statistically significant (p < 0.05). “Micromovement” implemented intraoperatively among patients receiving surgery in supine position is able to lower the IAPI incidence by five times and elevate job satisfaction of nurses.

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