Bacterial Infections in Acute-on-chronic Liver Failure:Epidemiology,Diagnosis,Pathogenesis,and Management

Acute-on-chronic liver failure(ACLF)is a distinct condition characterized by the abrupt exacerbation of pre-existing chronic liver disease,often leading to multi-organ failures and significant short-term mortalities.Bacterial infection is one of the most frequent triggers for ACLF and a common complication following its onset.The impact of bacterial infections on the clinical course and outcome of ACLF underscores their critical role in the pathogenesis of systemic inflammation and organ failures.In addition,the evolving epidemiology and increasing prevalence of multidrug-resistant bacteria in cirrhosis and ACLF highlight the importance of appropriate empirical antibiotic use,as well as accurate and prompt microbiological diagnosis.This review provided an update on recent advances in the epidemiology,diagnosis,pathogenesis,and management of bacterial infections in ACLF.

Fibrin sealant for the prevention of anastomotic leakage after esophagectomy for esophageal or esophagogastric junction cancer:interim report of a prospective,phase III,randomized controlled study

Purpose Anastomotic leakage(AL)is one of the most pernicious complications after esophagectomy for patients with esophageal or esophagogastric junction cancer(EC or EJC).The application of fibrin sealant(FS)may be advantageous for reducing the incidence of AL.This study aims to evaluate the safety and effectiveness of FS in preventing AL in patients undergoing McKeown esophagectomy.Methods In this multicenter,prospective,randomized controlled trial,we planned to recruit 360 patients aged 18–75 years with resectable EC or EJC and the interim analysis was performed when the number of participants reaches 180.Patients assigned to the FS group received McKeown esophagectomy with 2.5ml FS applied to the cervical anastomosis,while patients in the control group received surgery alone.The primary endpoint was the incidence of cervical AL within the first 3 months postoperatively.Result From February 2019 to November 2021,180 patients were recruited,with 89 in the FS group and 91 in the control group.There was no statistically difference between the incidence of AL between the two groups[6.7%(6/89)in the FS vs.14.3%(13/91)in the control group,P=0.16].Complications was comparable(P=0.76)between the FS group(42 of 89,47.2%)and the control group(45 of 91,49.5%).No adverse events related to FS or deaths occurred postoperatively.Conclusion The application of FS intraoperatively is feasible and does not increase the risk of complications,and its effectiveness for the prevention of AL needs to be revalidated after the completion of patient enrollment.Trial registration This trial was registered at ClinicalTrials.gov(NCT03847857)on February 19th,2019.

Autonomous battery-changing system for UAV's lifelong flight

Unmanned aerial vehicles(UAVs)lifelong flight is essential to accomplish various tasks,e.g.,aerial patrol,aerial rescue,etc.However,traditional UAVs have limited power to sustain their flight and need skilled operators manually control their charging process.Manufacturers and users are eagerly seeking a reliable autonomous battery-changing solution.To address this need,we propose and design an autonomous battery-changing system for UAVs using the theory of inventive problem solving(TRIZ)and user-centered design(UCD)methods.For practical application,we employ UCD to thoroughly analyze user requirements,identify multiple pairs of technical contradictions,and solve these inconsistencies using TRIZ theory.Furthermore,we design an autonomous battery-changing hardware system that meets user requirements and realizes the battery change process after the automatic landing of UAVs.Finally,we conduct experiments to validate our system’s effectiveness.The experimental results show that our battery-changing system can implement the autonomous battery-changing task,and our system has high efficiency and robustness in the real environment.