Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 5...Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.展开更多
BACKGROUND Mucormycosis is a rare,rapidly progressive and often fatal fungal infection.The rarity of the condition lends itself to unfamiliarity,delayed treatment,and poor outcomes.Diagnosis of fungal infections early...BACKGROUND Mucormycosis is a rare,rapidly progressive and often fatal fungal infection.The rarity of the condition lends itself to unfamiliarity,delayed treatment,and poor outcomes.Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients.CASE SUMMARY An 11-year-old girl with a history of 15%total body surface area scald burns involving both lower limbs progressed to develop angioinvasive mucormycosis.This further led to a thrombosis of the right external iliac artery and vein and rapidly progressive necrosis of surrounding soft tissues.She also had dextrocardia and patent foramen ovale.A right hip disarticulation and serial aggressive debridements were performed but she went on to develop systemic sepsis with multisystem involvement and succumbed to the infection.Pathology revealed mucor species with extensive vascular invasion.CONCLUSION This case highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are signs of fulminant wound infection.展开更多
Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on c...Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on corn leaf burn caused by foliar spray of undiluted UAN solution on corn canopy at Jackson, TN in 2018. Thirteen treatments of the mixtures of UAN and humic acid were evaluated at V6 of corn with different UAN application rates and different UAN/humic acid ratios. Leaf burn during 1 2, 3, 4, 5, 6, 7, and 14 days after UAN foliar spray significantly differed between with or without humic acid addition. The addition of humic acid to UAN significantly reduced leaf burn at each UAN application rate (15, 25, and 35 gal/acre). The reduction of leaf burn was enhanced as the humic acid/UAN ratio went up from 10% to 30%. Leaf burn due to foliar application of UAN became severer with higher UAN rates. The linear regression of leaf burn 14 days after application with humic acid/UAN ratio was highly significant and negative. However, the linear regression of leaf burn 14 days after application with the UAN application rate was highly significant and positive. In conclusion, adding humic acid to foliar-applied UAN is beneficial for reducing corn leaf burn during the early growing season.展开更多
In Côte d’Ivoire, the recurring and unregulated use of bushfires, which cause ecological damage, presents a pressing concern for the custodians of protected areas. This study aims to enhance our comprehension of...In Côte d’Ivoire, the recurring and unregulated use of bushfires, which cause ecological damage, presents a pressing concern for the custodians of protected areas. This study aims to enhance our comprehension of the dynamics of burnt areas within the Abokouamékro Wildlife Reserve (AWR) by employing the analysis of spectral indices derived from satellite imagery. The research methodology began with the calculation of mean indices and their corresponding spectral sub-indices, including NDVI, SAVI, NDWI, NDMI, BAI, NBR, TCW, TCG, and TCB, utilizing data from the Sentinel-2A satellite image dated January 17, 2022. Subsequently, a fuzzy classification model was applied to these various indices and sub-indices, guided by the degree of membership α, with the goal of effectively distinguishing between burned and unburned areas. Following the classification, the accuracies of the classified indices and sub-indices were validated using the coordinates of 100 data points collected within the AWR through GPS technology. The results revealed that the overall accuracy of all indices and sub-indices declines as the degree of membership α decreases from 1 to 0. Among the mean spectral indices, NDVI-mean, SAVI-mean, NDMI-mean exhibited the highest overall accuracies, achieving 97%, 95%, and 90%, respectively. These results closely mirrored those obtained by sub-indices using band 8 (NDVI-B8, SAVI-B8, and NDMI-B8), which yield respective overall accuracies of 93%, 92%, and 89%. At a degree of membership α = 1, the estimated burned areas for the most effective indices encompassed 2144.38 hectares for NDVI-mean, 1932.14 hectares for mean SAVI-mean, and 4947.13 hectares for mean NDMI-mean. A prospective approach involving the amalgamation of these three indices could have the potential to yield improved outcomes. This study could be a substantial contribution to the discrimination of bushfires in Côte d’Ivoire.展开更多
We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doub...We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doubt whether applying this strategy to every patient during a mass burn event could be realistic.Of note,while there is an undisputed consensus that early burn wound excision is the gold standard of burn care,what‘early’actually means is still debated.Depending on the authors,the corresponding time limit typically varies from 24 h to a few days[2,3].展开更多
As an innovative propulsion technique, laser augmented chemical propulsion(LACP) seems superior to the traditional ones. However, the corresponding combustion theories have still to be ascertained for LACP. Burning ra...As an innovative propulsion technique, laser augmented chemical propulsion(LACP) seems superior to the traditional ones. However, the corresponding combustion theories have still to be ascertained for LACP. Burning rate of 5-aminotetrazole(5-ATZ) propellant has been studied by testing pressed samples under different combustor pressures and laser powers. Based on micro computed tomography(Micro CT),an advanced thickness-over-time(TOT) method to characterize the regression of the produced nonplanar burning surface is established. Because of a shell structure covering the combustion surface,the burning rate of the implemented 5-ATZ propellant is not constant during laser ablation. Resorting to functional fitting, a new law of non-constant burning including the effect of the observed unique burning surface structures is proposed. Accordingly, applicable combustion conditions of 5-ATZ based propellants have been preliminarily speculated for future research activities.展开更多
Gradiently denitrated gun propellant(GDGP)prepared by a“gradient denitration”strategy is obviously superior in progressive burning performance to the traditional deterred gun propellant.Currently,the preparation of ...Gradiently denitrated gun propellant(GDGP)prepared by a“gradient denitration”strategy is obviously superior in progressive burning performance to the traditional deterred gun propellant.Currently,the preparation of GDGP employed a tedious two-step method involving organic solvents,which hinders the large-scale preparation of GDGP.In this paper,GDGP was successfully prepared via a novelty and environmentally friendly one-step method.The obtained samples were characterized by FT-IR,Raman,SEM and XPS.The results showed that the content of nitrate groups gradiently increased from the surface to the core in the surface layer of GDGP and the surface layer of GDGP exhibited a higher compaction than that of raw gun propellant,with a well-preserved nitrocellulose structure.The denitration process enabled the propellant surface with regressive energy density and good progressive burning performance,as confirmed by oxygen bomb and closed bomb test.At the same time,the effects of different solvents on the component loss of propellant were compared.The result showed that water caused the least component loss.Finally,the stability of GDGP was confirmed by methyl-violet test.This work not only provided environmentally friendly,simple and economic preparation of GDGP,but also confirmed the stability of GDGP prepared by this method.展开更多
Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotil...Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.Methods:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,2020.Both 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation injury.GI dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ACS.Surgeries,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were recorded.Results:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive burns.The 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 d.GI dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness TBSA.Overall,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)over GI ulcer/haemorrhage(P<0.001).Conclusion:Patients with severe burns have an unfavourable prognosis,as nearly one-fifth died within 90 d.Half of our patients had comorbidities related to GI dysfunction,among which GI ulcers and haemorrhages were independently correlated with 90-day mortality.More attention should be given to severe burn patients with GI dysfunction.展开更多
Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a signifi...Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.展开更多
Prescribed burning can alter soil microbial activity and spatially redistribute soil nutrient elements.However,no systematic,in-depth studies have investigated the impact of prescribed burning on the spatial patterns ...Prescribed burning can alter soil microbial activity and spatially redistribute soil nutrient elements.However,no systematic,in-depth studies have investigated the impact of prescribed burning on the spatial patterns of soil microbial biomass in temperate forest ecosystems in Northeast China.The present study investigated the impacts of prescribed burning on the small-scale spatial heterogeneity of microbial biomass carbon(MBC)and microbial biomass nitrogen(MBN)in the upper(0–10 cm)and lower(10–20 cm)soil layers in Pinus koraiensis and Quercus mongolica forests and explored the factors that infl uence spatial variations of these variables after prescribed burning.Our results showed that,MBC declined by approximately 30%in the 10–20 cm soil layer in the Q.mongolica forest,where there were no signifi cant eff ects on the soil MBC and MBN contents of the P.koraiensis forest(p>0.05)after prescribed burning.Compared to the MBC of the Q.mongolica forest before the prescribed burn,MBC spatial dependence in the upper and lower soil layers was approximately 7%and 2%higher,respectively.After the prescribed burn,MBN spatial dependence in the upper and lower soil layers in the P.koraiensis forest was approximately 1%and 13%lower,respectively,than that before the burn,and the MBC spatial variability in the 0–10 cm soil layer in the two forest types was explained by the soil moisture content(SMC),whereas the MBN spatial variability in the 0–10 cm soil layer in the two forests was explained by the soil pH and nitrate nitrogen(NO_(3)^(–)-N),respectively.In the lower soil layer(10–20 cm)of the Q.mongolica forest,elevation and ammonium nitrogen(NH 4+-N)were the main factors aff ecting the spatial variability of MBC and MBN,respectively.In the 10–20 cm soil layer of the P.koraiensis forest,NO_(3)^(–)-N and slope were the main factors aff ecting the spatial variability of MBC and MBN,respectively,after the burn.The spatial distributions of MBC and MBN in the two forests were largely structured with higher spatial autocorrelation(relative structural variance C/[C 0+C]>0.75).However,the factors infl uencing the spatial variability of MBC and MBN in the two forest types were not consistent between the upper and lower soil layers with prescribed burning.These fi ndings have important implications for developing sustainable management and conservation policies for forest ecosystems.展开更多
Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,burns are classi...Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,burns are classifi ed as mild or severe.Mild burns usually refer to burns that encompass less than 10%of the total body surface area(TBSA),mainly superficial burns.Severe burns are defined as TBSA>10%in elderly patients,TBSA>20%in adults,and TBSA>30%in children.[2]Burn injuries,particularly severe burns,are accompanied by an immune and inflammatory response,metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.[3]Therefore,burn care providers face many challenges,including acute and critical care management,long-term care,and rehabilitation.Here,we report a 94-year-old patient with severe burns who recovered well and was discharged from the hospital in a wheelchair.展开更多
Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healin...Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healing and the associated mechanisms ofα-lactalbumin(ALA)based electrospun nanofibrous scaffolds(ENs)as compared to other regenerative protein scaffolds were established.Bovine serum albumin(BSA),collagen type I(COL),lysozyme(LZM)and ALA were separately blended with poly(ε-caprolactone)(PCL)to fabricate four different composite ENs(LZM/PCL,BSA/PCL,COL/PCL and ALA/PCL ENs).The hydrophilic composite scaffolds exhibited an enhancedwettability and variablemechanical properties.The ALA/PCL ENs demonstrated higher levels of fibroblast proliferation and adhesion than the other composite ENs.As compared to PCL ENs and other composite scaffolds,the ALA/PCL ENs also promoted a better maturity of the regenerative skin tissues and showed a comparable wound healing effect to Collagen sponge^(■)on third-degree burn model.The enhanced wound healing activity of ALA/PCL ENs compared to other ENs could be attributed to their ability to promote serotonin production at wound sites.Collectively,this investigation demonstrated that ALA is a unique protein with a greater potential for burn wound healing as compared to other regenerative proteins when loaded in the nanofibrous scaffolds.展开更多
Dear Editor,The aim of the letter is to stress the need of creating unified recommendations concerning early burn wound excision in cases of mass casualty burns exclusively.There are several triage methods,both for ci...Dear Editor,The aim of the letter is to stress the need of creating unified recommendations concerning early burn wound excision in cases of mass casualty burns exclusively.There are several triage methods,both for civilian and military circumstances,that govern burn casualty triage and evacuation from the incident site,as well as hospital referral up to 120 h from the disaster.展开更多
The laminar combustion characteristics of CH_(4)/air premixed flames with CO_(2) addition are systemically studied.Experimental measurements and numerical simulations of the laminar burning velocity(LBV)are performed ...The laminar combustion characteristics of CH_(4)/air premixed flames with CO_(2) addition are systemically studied.Experimental measurements and numerical simulations of the laminar burning velocity(LBV)are performed in CH_(4)/CO_(2)/Air flames with various CO_(2) doping ratio under equivalence ratios of 1.0–1.4.GRI 3.0 mech and Aramco mech are employed for predicting LBV,adiabatic flame temperature(AFT),important intermediate radicals(CH_(3),H,OH,O)and NO_(x) emissions(NO,NO_(2),N2O),as well as the sensitivity analysis is also conducted.The detail analysis of experiment and simulation reveals that as the CO_(2) addition increases from 0%to 40%,the LBVs and AFTs decrease monotonously.Under the same CO_(2) doping ratio,the LBVs and AFTs increase first and then decrease with the increase of equivalence ratio,and the maximum of LBV is reached at equivalence ratio of 1.05.The mole fraction tendency of important intermediates and NO_(x) with equivalence ratio and CO_(2) doping ratio are similar to the LBVs and AFTs.Reaction H+O_(2)⇔O+OH is found to be responsible for the promotion of the generation of important intermediates and NO_(x) under the equivalence ratios and CO_(2) addition through sensitivity analysis.The sensitivity coefficients of elementary reactions that the increasing of CO_(2) doping ratio promotes or inhibits formation of intermediate radicals and NO_(x) decreases.展开更多
As an innovative propulsion technique, combustion mechanism of laser-augmented chemical propulsion has still to be ascertained. Benefiting from high nitrogen content and thermal stability, 5-aminotetrazole is a suitab...As an innovative propulsion technique, combustion mechanism of laser-augmented chemical propulsion has still to be ascertained. Benefiting from high nitrogen content and thermal stability, 5-aminotetrazole is a suitable ingredient for LACP. Under a flowing nitrogen environment, two kinds of unique burning surfaces were observed to occur for 5-ATZ, used as a single reacting propellant ingredient with the addition of carbon, under laser ablation. Both surfaces are hollow structures and differ by the possible presence of edges. Using micro computed tomography, the 3D perspective structures of both surfaces were revealed. Resorting to various characterization methods, a unified formation mechanism for both surfaces is proposed. This mechanism specifically applies to laser ablation, but could be crucial to common burning mechanisms in LACP.展开更多
BACKGROUND Current evidence shows that human induced pluripotent stem cells(hiPSCs)can effectively differentiate into keratinocytes(KCs),but its effect on skin burn healing has not been reported.AIM To observe the eff...BACKGROUND Current evidence shows that human induced pluripotent stem cells(hiPSCs)can effectively differentiate into keratinocytes(KCs),but its effect on skin burn healing has not been reported.AIM To observe the effects of hiPSCs-derived KCs transplantation on skin burn healing in mice and to preliminarily reveal the underlying mechanisms.METHODS An analysis of differentially expressed genes in burn wounds based on GEO datasets GSE140926,and GSE27186 was established.A differentiation medium containing retinoic acid and bone morphogenetic protein 4 was applied to induce hiPSCs to differentiate into KCs.The expression of KCs marker proteins was detected using immunofluorescence staining.A model of a C57BL/6 mouse with deep cutaneous second-degree burn was created,and then phosphate buffered saline(PBS),hiPSCs-KCs,or hiPSCs-KCs with knockdown of COL7A1 were injected around the wound surface.The wound healing,re-epithelialization,engraftment of hiPSCs-KCs into wounds,proinflammatory factor level,and the NF-κB pathway proteins were assessed by hematoxylin-eosin staining,carboxifluorescein diacetate succinimidyl ester(CFSE)fluorescence staining,enzyme linked immunosorbent assay,and Western blotting on days 3,7,and 14 after the injection,respectively.Moreover,the effects of COL7A1 knockdown on the proliferation and migration of hiPSCs-KCs were confirmed by immunohistochemistry,EdU,Transwell,and damage repair assays.RESULTS HiPSCs-KCs could express the hallmark proteins of KCs.COL7A1 was down-regulated in burn wound tissues and highly expressed in hiPSCs-KCs.Transplantation of hiPSCs-KCs into mice with burn wounds resulted in a significant decrease in wound area,an increase in wound re-epithelialization,a decrease in proinflammatory factors content,and an inhibition of NF-κB pathway activation compared to the PBS group.The in vitro assay showed that COL7A1 knockdown could rescue the inhibition of hiPSCs-KCs proliferation and migration,providing further evidence that COL7A1 speeds up burn wound healing by limiting cell proliferation and migration.CONCLUSION In deep,second-degree burn wounds,COL7A1 can promote KC proliferation and migration while also suppressing the inflammatory response.展开更多
Background:Damage to the skin and underlying tissues due to thermal burns is relevant.Despite the success of modern medicine,repairing thermal damage to the skin is a difficult task in reconstructive plastic surgery b...Background:Damage to the skin and underlying tissues due to thermal burns is relevant.Despite the success of modern medicine,repairing thermal damage to the skin is a difficult task in reconstructive plastic surgery because of the nature of the damage and the regenerative features.Characteristic post-burn changes are associated with different depths of damage when areas of deep damage are combined with more superficial areas.Methods:We described a clinical case of the staged surgical treatment of a cicatricial deformity of the buccalperiorbital-perioral region resulting from a childhood burn injury from a hot object.The 44-year-old patient complained of an aesthetic and functional deformity of the buccal-periorbital-perioral region and had previously undergone repeated nonsurgical corrections.Results:A comprehensive approach to the surgical treatment of a patient with post-burn deformities using a diplene adhesive membrane directly affected the stage of the surgical treatment and contributed to improved functional and aesthetic results.Conclusion:The positive treatment results with preserved contraction and relaxation processes of the facial muscles as well as satisfactory aesthetic results allow us to recommend the use of a biodegradable diplene film during facial reconstructive operations.展开更多
Objective:To discuss the main active components and potential mechanisms of moist burn ointment in the treat-ment of diabetic ulcer were discussed by network pharmacology and molecular docking technology.Methods:Based...Objective:To discuss the main active components and potential mechanisms of moist burn ointment in the treat-ment of diabetic ulcer were discussed by network pharmacology and molecular docking technology.Methods:Based on the TC-MSP database,the main active components and targets of MEBO were screened.The targets related to diabetic ulcers were searched from GeneCards,OMIM,PharmGkb,TTD,and DrugBank databases.The STRING 11.5 database was used to con-struct a protein-protein interaction(PPI)network to screen the core targets.The'drug-target-disease'network diagram was made in Cytoscape 3.8.2 software to screen the core active components.GO enrichment analysis and KEGG pathway enrichment analysis were performed using R language software.Finally,molecular docking was used to preliminarily verify the screening results.Results:A total of 37 active components of MEBO were screened to map 100 targets,5527 targets for diabetic ulcer dis-ease,and 77 intersection targets.PPI network topology analysis suggested that TP53,TNF,HSP90AA1 and other targets were key targets;the network diagram of ‘drug-target-disease’showed that acacetin,wogonin,quercetin,and rutaecarpine were the core active ingredients.GO function analysis mainly involved angiogenesis,ion transport,diameter regulation,cytokine receptor binding,and other processes.KEGG enrichment analysis mainly included PI3K-Akt,AGE-RAGE,and other signaling pathways.Molecular docking showed that the core active ingredients and key targets had good docking activity.Conclusion:The treatment of diabetic ulcer with MEBO is the result of multi-component,multi-target,and synergistic regulation,which provides a theoretical basis for the clinical application of MEBO and the treatment of diabetic ulcer.展开更多
Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural ho...Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(P<0.05)predicting the disfigurement.Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity.In addition,delayed presentation and delayed intervention led to a longer hospital stay,and more interventions than the early intervention cohort.Conclusions:Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures.This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.展开更多
The Sentinel-2 satellites are providing an unparalleled wealth of high-resolution remotely sensed information with a short revisit cycle, which is ideal for mapping burned areas both accurately and timely. This paper ...The Sentinel-2 satellites are providing an unparalleled wealth of high-resolution remotely sensed information with a short revisit cycle, which is ideal for mapping burned areas both accurately and timely. This paper proposes an automated methodology for mapping burn scars using pairs of Sentinel-2 imagery, exploiting the state-of-the-art eXtreme Gradient Boosting (XGB) machine learning framework. A large database of 64 reference wildfire perimeters in Greece from 2016 to 2019 is used to train the classifier. An empirical methodology for appropriately sampling the training patterns from this database is formulated, which guarantees the effectiveness of the approach and its computational efficiency. A difference (pre-fire minus post-fire) spectral index is used for this purpose, upon which we appropriately identify the clear and fuzzy value ranges. To reduce the data volume, a super-pixel segmentation of the images is also employed, implemented via the QuickShift algorithm. The cross-validation results showcase the effectiveness of the proposed algorithm, with the average commission and omission errors being 9% and 2%, respectively, and the average Matthews correlation coefficient (MCC) equal to 0.93.展开更多
文摘Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.
文摘BACKGROUND Mucormycosis is a rare,rapidly progressive and often fatal fungal infection.The rarity of the condition lends itself to unfamiliarity,delayed treatment,and poor outcomes.Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients.CASE SUMMARY An 11-year-old girl with a history of 15%total body surface area scald burns involving both lower limbs progressed to develop angioinvasive mucormycosis.This further led to a thrombosis of the right external iliac artery and vein and rapidly progressive necrosis of surrounding soft tissues.She also had dextrocardia and patent foramen ovale.A right hip disarticulation and serial aggressive debridements were performed but she went on to develop systemic sepsis with multisystem involvement and succumbed to the infection.Pathology revealed mucor species with extensive vascular invasion.CONCLUSION This case highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are signs of fulminant wound infection.
文摘Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on corn leaf burn caused by foliar spray of undiluted UAN solution on corn canopy at Jackson, TN in 2018. Thirteen treatments of the mixtures of UAN and humic acid were evaluated at V6 of corn with different UAN application rates and different UAN/humic acid ratios. Leaf burn during 1 2, 3, 4, 5, 6, 7, and 14 days after UAN foliar spray significantly differed between with or without humic acid addition. The addition of humic acid to UAN significantly reduced leaf burn at each UAN application rate (15, 25, and 35 gal/acre). The reduction of leaf burn was enhanced as the humic acid/UAN ratio went up from 10% to 30%. Leaf burn due to foliar application of UAN became severer with higher UAN rates. The linear regression of leaf burn 14 days after application with humic acid/UAN ratio was highly significant and negative. However, the linear regression of leaf burn 14 days after application with the UAN application rate was highly significant and positive. In conclusion, adding humic acid to foliar-applied UAN is beneficial for reducing corn leaf burn during the early growing season.
文摘In Côte d’Ivoire, the recurring and unregulated use of bushfires, which cause ecological damage, presents a pressing concern for the custodians of protected areas. This study aims to enhance our comprehension of the dynamics of burnt areas within the Abokouamékro Wildlife Reserve (AWR) by employing the analysis of spectral indices derived from satellite imagery. The research methodology began with the calculation of mean indices and their corresponding spectral sub-indices, including NDVI, SAVI, NDWI, NDMI, BAI, NBR, TCW, TCG, and TCB, utilizing data from the Sentinel-2A satellite image dated January 17, 2022. Subsequently, a fuzzy classification model was applied to these various indices and sub-indices, guided by the degree of membership α, with the goal of effectively distinguishing between burned and unburned areas. Following the classification, the accuracies of the classified indices and sub-indices were validated using the coordinates of 100 data points collected within the AWR through GPS technology. The results revealed that the overall accuracy of all indices and sub-indices declines as the degree of membership α decreases from 1 to 0. Among the mean spectral indices, NDVI-mean, SAVI-mean, NDMI-mean exhibited the highest overall accuracies, achieving 97%, 95%, and 90%, respectively. These results closely mirrored those obtained by sub-indices using band 8 (NDVI-B8, SAVI-B8, and NDMI-B8), which yield respective overall accuracies of 93%, 92%, and 89%. At a degree of membership α = 1, the estimated burned areas for the most effective indices encompassed 2144.38 hectares for NDVI-mean, 1932.14 hectares for mean SAVI-mean, and 4947.13 hectares for mean NDMI-mean. A prospective approach involving the amalgamation of these three indices could have the potential to yield improved outcomes. This study could be a substantial contribution to the discrimination of bushfires in Côte d’Ivoire.
文摘We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doubt whether applying this strategy to every patient during a mass burn event could be realistic.Of note,while there is an undisputed consensus that early burn wound excision is the gold standard of burn care,what‘early’actually means is still debated.Depending on the authors,the corresponding time limit typically varies from 24 h to a few days[2,3].
基金supported by the Shanghai Aerospace Science & Technology Innovation Fund (grant No. SAST201363)the Fundamental Research Funds for the Central Universities (grant No. 30919012102 in part)。
文摘As an innovative propulsion technique, laser augmented chemical propulsion(LACP) seems superior to the traditional ones. However, the corresponding combustion theories have still to be ascertained for LACP. Burning rate of 5-aminotetrazole(5-ATZ) propellant has been studied by testing pressed samples under different combustor pressures and laser powers. Based on micro computed tomography(Micro CT),an advanced thickness-over-time(TOT) method to characterize the regression of the produced nonplanar burning surface is established. Because of a shell structure covering the combustion surface,the burning rate of the implemented 5-ATZ propellant is not constant during laser ablation. Resorting to functional fitting, a new law of non-constant burning including the effect of the observed unique burning surface structures is proposed. Accordingly, applicable combustion conditions of 5-ATZ based propellants have been preliminarily speculated for future research activities.
文摘Gradiently denitrated gun propellant(GDGP)prepared by a“gradient denitration”strategy is obviously superior in progressive burning performance to the traditional deterred gun propellant.Currently,the preparation of GDGP employed a tedious two-step method involving organic solvents,which hinders the large-scale preparation of GDGP.In this paper,GDGP was successfully prepared via a novelty and environmentally friendly one-step method.The obtained samples were characterized by FT-IR,Raman,SEM and XPS.The results showed that the content of nitrate groups gradiently increased from the surface to the core in the surface layer of GDGP and the surface layer of GDGP exhibited a higher compaction than that of raw gun propellant,with a well-preserved nitrocellulose structure.The denitration process enabled the propellant surface with regressive energy density and good progressive burning performance,as confirmed by oxygen bomb and closed bomb test.At the same time,the effects of different solvents on the component loss of propellant were compared.The result showed that water caused the least component loss.Finally,the stability of GDGP was confirmed by methyl-violet test.This work not only provided environmentally friendly,simple and economic preparation of GDGP,but also confirmed the stability of GDGP prepared by this method.
基金study was approved respectively by the Ethics Committee for Clinical Research and Animal Trials of the First Affiliated Hospital of Sun Yat-sen University([2021]014)Zhongshan People's Hospital(K2021-049)and Dongguan People's Hospital(DRYA2021-054-A1).
文摘Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.Methods:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,2020.Both 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation injury.GI dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ACS.Surgeries,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were recorded.Results:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive burns.The 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 d.GI dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness TBSA.Overall,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)over GI ulcer/haemorrhage(P<0.001).Conclusion:Patients with severe burns have an unfavourable prognosis,as nearly one-fifth died within 90 d.Half of our patients had comorbidities related to GI dysfunction,among which GI ulcers and haemorrhages were independently correlated with 90-day mortality.More attention should be given to severe burn patients with GI dysfunction.
基金the National Key R&D Program of China(Grant No.2020YFA0908100)the National Nature Science Foundation(Grant Nos.12274356,82070931,and 82271045)+1 种基金Fundamental Research Funds for the Central Universities(20720220022)the 111 Project(B16029)。
文摘Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.
基金supported by the National Natural Science Foundation of China(Grant No.32001324,32071777)Youth Lift Project of China Association for Science and Technology(Grant No.YESS20210370)Heilongjiang Province Outstanding Youth Joint Guidance Project(No.LH2021C012).
文摘Prescribed burning can alter soil microbial activity and spatially redistribute soil nutrient elements.However,no systematic,in-depth studies have investigated the impact of prescribed burning on the spatial patterns of soil microbial biomass in temperate forest ecosystems in Northeast China.The present study investigated the impacts of prescribed burning on the small-scale spatial heterogeneity of microbial biomass carbon(MBC)and microbial biomass nitrogen(MBN)in the upper(0–10 cm)and lower(10–20 cm)soil layers in Pinus koraiensis and Quercus mongolica forests and explored the factors that infl uence spatial variations of these variables after prescribed burning.Our results showed that,MBC declined by approximately 30%in the 10–20 cm soil layer in the Q.mongolica forest,where there were no signifi cant eff ects on the soil MBC and MBN contents of the P.koraiensis forest(p>0.05)after prescribed burning.Compared to the MBC of the Q.mongolica forest before the prescribed burn,MBC spatial dependence in the upper and lower soil layers was approximately 7%and 2%higher,respectively.After the prescribed burn,MBN spatial dependence in the upper and lower soil layers in the P.koraiensis forest was approximately 1%and 13%lower,respectively,than that before the burn,and the MBC spatial variability in the 0–10 cm soil layer in the two forest types was explained by the soil moisture content(SMC),whereas the MBN spatial variability in the 0–10 cm soil layer in the two forests was explained by the soil pH and nitrate nitrogen(NO_(3)^(–)-N),respectively.In the lower soil layer(10–20 cm)of the Q.mongolica forest,elevation and ammonium nitrogen(NH 4+-N)were the main factors aff ecting the spatial variability of MBC and MBN,respectively.In the 10–20 cm soil layer of the P.koraiensis forest,NO_(3)^(–)-N and slope were the main factors aff ecting the spatial variability of MBC and MBN,respectively,after the burn.The spatial distributions of MBC and MBN in the two forests were largely structured with higher spatial autocorrelation(relative structural variance C/[C 0+C]>0.75).However,the factors infl uencing the spatial variability of MBC and MBN in the two forest types were not consistent between the upper and lower soil layers with prescribed burning.These fi ndings have important implications for developing sustainable management and conservation policies for forest ecosystems.
基金supported by a Major Science and Technology Project on Health of Zhejiang Province(WKJ-ZJ-2123).
文摘Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,burns are classifi ed as mild or severe.Mild burns usually refer to burns that encompass less than 10%of the total body surface area(TBSA),mainly superficial burns.Severe burns are defined as TBSA>10%in elderly patients,TBSA>20%in adults,and TBSA>30%in children.[2]Burn injuries,particularly severe burns,are accompanied by an immune and inflammatory response,metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.[3]Therefore,burn care providers face many challenges,including acute and critical care management,long-term care,and rehabilitation.Here,we report a 94-year-old patient with severe burns who recovered well and was discharged from the hospital in a wheelchair.
基金supported by the Liaoning Pan Deng Xue Zhe Scholar(No.XLYC2002061)the Overseas Expertise Introduction Project for Discipline Innovation(“111 Project”)(No.D20029)+5 种基金X.G.acknowledges the Educational Department of Liaoning Province(grant No.LJKZ0925),(Youth Project,grant No.LJKQZ2021035)the international postdoctoral exchange fellowship program(grant No.PC2021047)H.B.thanks the financial support from National Natural Science Foundation of China(grant No.82050410448)Fellowship of China Postdoctoral Science Foundation(grant No.2021MD703857)D.Cun acknowledges financial support from Ministry of Education Chunhui Program(2020)VF acknowledges VILLUM FONDEN for supporting the project via the Villum Young Investigator Grant(grant No.19175).
文摘Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healing and the associated mechanisms ofα-lactalbumin(ALA)based electrospun nanofibrous scaffolds(ENs)as compared to other regenerative protein scaffolds were established.Bovine serum albumin(BSA),collagen type I(COL),lysozyme(LZM)and ALA were separately blended with poly(ε-caprolactone)(PCL)to fabricate four different composite ENs(LZM/PCL,BSA/PCL,COL/PCL and ALA/PCL ENs).The hydrophilic composite scaffolds exhibited an enhancedwettability and variablemechanical properties.The ALA/PCL ENs demonstrated higher levels of fibroblast proliferation and adhesion than the other composite ENs.As compared to PCL ENs and other composite scaffolds,the ALA/PCL ENs also promoted a better maturity of the regenerative skin tissues and showed a comparable wound healing effect to Collagen sponge^(■)on third-degree burn model.The enhanced wound healing activity of ALA/PCL ENs compared to other ENs could be attributed to their ability to promote serotonin production at wound sites.Collectively,this investigation demonstrated that ALA is a unique protein with a greater potential for burn wound healing as compared to other regenerative proteins when loaded in the nanofibrous scaffolds.
文摘Dear Editor,The aim of the letter is to stress the need of creating unified recommendations concerning early burn wound excision in cases of mass casualty burns exclusively.There are several triage methods,both for civilian and military circumstances,that govern burn casualty triage and evacuation from the incident site,as well as hospital referral up to 120 h from the disaster.
基金The authors would like to thank the National Natural Science Foundation of China(52176095)Anhui Provincial Natural Science Foundation(2008085J25)the Project of support program for outstanding young people in Colleges and Universities(gxyqZD201830)for their financial support of this study.
文摘The laminar combustion characteristics of CH_(4)/air premixed flames with CO_(2) addition are systemically studied.Experimental measurements and numerical simulations of the laminar burning velocity(LBV)are performed in CH_(4)/CO_(2)/Air flames with various CO_(2) doping ratio under equivalence ratios of 1.0–1.4.GRI 3.0 mech and Aramco mech are employed for predicting LBV,adiabatic flame temperature(AFT),important intermediate radicals(CH_(3),H,OH,O)and NO_(x) emissions(NO,NO_(2),N2O),as well as the sensitivity analysis is also conducted.The detail analysis of experiment and simulation reveals that as the CO_(2) addition increases from 0%to 40%,the LBVs and AFTs decrease monotonously.Under the same CO_(2) doping ratio,the LBVs and AFTs increase first and then decrease with the increase of equivalence ratio,and the maximum of LBV is reached at equivalence ratio of 1.05.The mole fraction tendency of important intermediates and NO_(x) with equivalence ratio and CO_(2) doping ratio are similar to the LBVs and AFTs.Reaction H+O_(2)⇔O+OH is found to be responsible for the promotion of the generation of important intermediates and NO_(x) under the equivalence ratios and CO_(2) addition through sensitivity analysis.The sensitivity coefficients of elementary reactions that the increasing of CO_(2) doping ratio promotes or inhibits formation of intermediate radicals and NO_(x) decreases.
基金supported by the Shanghai Aerospace Science & Technology Innovation Fund (Grant No. SAST201363)the Fundamental Research Funds for the Central Universities (Grant No. 30919012102 in part)。
文摘As an innovative propulsion technique, combustion mechanism of laser-augmented chemical propulsion has still to be ascertained. Benefiting from high nitrogen content and thermal stability, 5-aminotetrazole is a suitable ingredient for LACP. Under a flowing nitrogen environment, two kinds of unique burning surfaces were observed to occur for 5-ATZ, used as a single reacting propellant ingredient with the addition of carbon, under laser ablation. Both surfaces are hollow structures and differ by the possible presence of edges. Using micro computed tomography, the 3D perspective structures of both surfaces were revealed. Resorting to various characterization methods, a unified formation mechanism for both surfaces is proposed. This mechanism specifically applies to laser ablation, but could be crucial to common burning mechanisms in LACP.
基金Supported by the Hospital Research Fund,No.SDFEYBS1805,No.SDFEYGJ2013 and No.XKTJ-HRC20210015Suzhou Science and Technology Development Project,No.SYS2020105,No.SKJY2021078 and No.2022SS43+2 种基金the Special Project of“Technological Innovation”Project of CNNC Medical Industry Co.Ltd,No.ZHYLZD2021002CNNC Elite Talent Program2022 State Key Laboratory of Radiological Medicine and Radiation Protection jointly built by Province and Ministry,No.GZK1202244.
文摘BACKGROUND Current evidence shows that human induced pluripotent stem cells(hiPSCs)can effectively differentiate into keratinocytes(KCs),but its effect on skin burn healing has not been reported.AIM To observe the effects of hiPSCs-derived KCs transplantation on skin burn healing in mice and to preliminarily reveal the underlying mechanisms.METHODS An analysis of differentially expressed genes in burn wounds based on GEO datasets GSE140926,and GSE27186 was established.A differentiation medium containing retinoic acid and bone morphogenetic protein 4 was applied to induce hiPSCs to differentiate into KCs.The expression of KCs marker proteins was detected using immunofluorescence staining.A model of a C57BL/6 mouse with deep cutaneous second-degree burn was created,and then phosphate buffered saline(PBS),hiPSCs-KCs,or hiPSCs-KCs with knockdown of COL7A1 were injected around the wound surface.The wound healing,re-epithelialization,engraftment of hiPSCs-KCs into wounds,proinflammatory factor level,and the NF-κB pathway proteins were assessed by hematoxylin-eosin staining,carboxifluorescein diacetate succinimidyl ester(CFSE)fluorescence staining,enzyme linked immunosorbent assay,and Western blotting on days 3,7,and 14 after the injection,respectively.Moreover,the effects of COL7A1 knockdown on the proliferation and migration of hiPSCs-KCs were confirmed by immunohistochemistry,EdU,Transwell,and damage repair assays.RESULTS HiPSCs-KCs could express the hallmark proteins of KCs.COL7A1 was down-regulated in burn wound tissues and highly expressed in hiPSCs-KCs.Transplantation of hiPSCs-KCs into mice with burn wounds resulted in a significant decrease in wound area,an increase in wound re-epithelialization,a decrease in proinflammatory factors content,and an inhibition of NF-κB pathway activation compared to the PBS group.The in vitro assay showed that COL7A1 knockdown could rescue the inhibition of hiPSCs-KCs proliferation and migration,providing further evidence that COL7A1 speeds up burn wound healing by limiting cell proliferation and migration.CONCLUSION In deep,second-degree burn wounds,COL7A1 can promote KC proliferation and migration while also suppressing the inflammatory response.
文摘Background:Damage to the skin and underlying tissues due to thermal burns is relevant.Despite the success of modern medicine,repairing thermal damage to the skin is a difficult task in reconstructive plastic surgery because of the nature of the damage and the regenerative features.Characteristic post-burn changes are associated with different depths of damage when areas of deep damage are combined with more superficial areas.Methods:We described a clinical case of the staged surgical treatment of a cicatricial deformity of the buccalperiorbital-perioral region resulting from a childhood burn injury from a hot object.The 44-year-old patient complained of an aesthetic and functional deformity of the buccal-periorbital-perioral region and had previously undergone repeated nonsurgical corrections.Results:A comprehensive approach to the surgical treatment of a patient with post-burn deformities using a diplene adhesive membrane directly affected the stage of the surgical treatment and contributed to improved functional and aesthetic results.Conclusion:The positive treatment results with preserved contraction and relaxation processes of the facial muscles as well as satisfactory aesthetic results allow us to recommend the use of a biodegradable diplene film during facial reconstructive operations.
基金National Natural Science Foundation Project (No.81774327)Guangxi Graduate Education Innovation Program Project (No.YCSW2023496)+1 种基金The"139"Plan for Senior and Secondary Backbone Talents in Guangxi Medicine (No.Gui Wei Ke Jiao Fa[2018]No.22)Graduate Innovation Program Project of Youjiang Ethnic Medical College (No.YXCXJH2022004)。
文摘Objective:To discuss the main active components and potential mechanisms of moist burn ointment in the treat-ment of diabetic ulcer were discussed by network pharmacology and molecular docking technology.Methods:Based on the TC-MSP database,the main active components and targets of MEBO were screened.The targets related to diabetic ulcers were searched from GeneCards,OMIM,PharmGkb,TTD,and DrugBank databases.The STRING 11.5 database was used to con-struct a protein-protein interaction(PPI)network to screen the core targets.The'drug-target-disease'network diagram was made in Cytoscape 3.8.2 software to screen the core active components.GO enrichment analysis and KEGG pathway enrichment analysis were performed using R language software.Finally,molecular docking was used to preliminarily verify the screening results.Results:A total of 37 active components of MEBO were screened to map 100 targets,5527 targets for diabetic ulcer dis-ease,and 77 intersection targets.PPI network topology analysis suggested that TP53,TNF,HSP90AA1 and other targets were key targets;the network diagram of ‘drug-target-disease’showed that acacetin,wogonin,quercetin,and rutaecarpine were the core active ingredients.GO function analysis mainly involved angiogenesis,ion transport,diameter regulation,cytokine receptor binding,and other processes.KEGG enrichment analysis mainly included PI3K-Akt,AGE-RAGE,and other signaling pathways.Molecular docking showed that the core active ingredients and key targets had good docking activity.Conclusion:The treatment of diabetic ulcer with MEBO is the result of multi-component,multi-target,and synergistic regulation,which provides a theoretical basis for the clinical application of MEBO and the treatment of diabetic ulcer.
文摘Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(P<0.05)predicting the disfigurement.Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity.In addition,delayed presentation and delayed intervention led to a longer hospital stay,and more interventions than the early intervention cohort.Conclusions:Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures.This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.
文摘The Sentinel-2 satellites are providing an unparalleled wealth of high-resolution remotely sensed information with a short revisit cycle, which is ideal for mapping burned areas both accurately and timely. This paper proposes an automated methodology for mapping burn scars using pairs of Sentinel-2 imagery, exploiting the state-of-the-art eXtreme Gradient Boosting (XGB) machine learning framework. A large database of 64 reference wildfire perimeters in Greece from 2016 to 2019 is used to train the classifier. An empirical methodology for appropriately sampling the training patterns from this database is formulated, which guarantees the effectiveness of the approach and its computational efficiency. A difference (pre-fire minus post-fire) spectral index is used for this purpose, upon which we appropriately identify the clear and fuzzy value ranges. To reduce the data volume, a super-pixel segmentation of the images is also employed, implemented via the QuickShift algorithm. The cross-validation results showcase the effectiveness of the proposed algorithm, with the average commission and omission errors being 9% and 2%, respectively, and the average Matthews correlation coefficient (MCC) equal to 0.93.
