Improving treatment plan and mental health in children with abdominal infection for broad-spectrum bacterial infections

BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.

Study on the correlation between abdominal infection and psychological stress in children based on nucleic acid detection

BACKGROUND Diagnosing and treating abdominal infection in children remains a challenge.Nucleic acid detection,as a rapid and accurate diagnosis tool,has great significance in this field.AIM To investigate the diagnosis and treatment of abdominal infection by nucleic acid detection and its possible correlation with psychological stress in children.METHODS A total of 50 pediatric patients diagnosed with abdominal infections between September 2020 and July 2021 were included in this study.Intra-abdominal pus samples were collected for pathogen culture,drug susceptibility testing,and broad-spectrum bacterial nucleic acid testing.Psychological stress,anxiety,depression,and coping styles were assessed using the coping with a disease(CODI)scale.RESULTS Based on susceptibility testing,a regimen of cefazoxime,piperacillin/tazobactam,and metronidazole or ornidazole achieved 100%effectiveness in treating appendicitis.Psychological assessments revealed a positive correlation between pressure level and both anxiety(r=0.324,P=0.001)and depressive disorders(r=0.325,P<0.001).Acceptance and distancing as coping strategies were negatively correlated with anxiety and depression,while negative emotional responses were strongly associated with increased anxiety(r=0.574,P<0.001)and depression(r=0.511,P=0.001).Coping strategies such as illusion and escape showed no significant correlation with emotional outcomes.CONCLUSION Nucleic acid testing helps in the diagnosis of abdominal infections in children,and also focuses on children's mental health.

Effect of Continuous Double-Lumen Irrigation Drainage at Constant Temperature on the Control of Abdominal Infection After Surgery

Objective:To investigate the effect of continuous double-lumen irrigation drainage at constant temperature on the control of abdominal infection after surgery,providing a reference for clinical treatment.Methods:From December 2022 to August 2023,100 patients with abdominal infections after surgery were selected from Wendeng People's Hospital in Weihai.They were randomly divided into a control group(50 cases,using conventional single-hole rubber irrigation drainage)and an observation group(50 cases,using continuous double-lumen irrigation drainage at constant temperature).The inflammatory and immune indicators of the two groups were compared after different interventions,and the specific conditions of abdominal infection were statistically analyzed.Results:There was no significant difference in inflammatory indicators between the two groups before intervention(P>0.05).After the intervention,the inflammatory indicators of the observation group were significantly lower(P<0.05).There was no significant difference in immune function indicators between the two groups before intervention(P>0.05).After intervention,the immune function indicators of the observation group showed significant improvement(P<0.05).The control of abdominal infection in the observation group was better than in the control group(P<0.05).Conclusion:Continuous double-lumen rrigation drainage at constant temperature has a better effect on controlling abdominal infection after surgery,improving the infection condition,and enhancing the immune function of patients.

Postoperative encapsulated hemoperitoneum in a patient with gastric stromal tumor treated by exposed endoscopic full-thickness resection: A case report

BACKGROUND Gastric stromal tumors,originating from mesenchymal tissues,are one of the most common tumors of the digestive tract.For stromal tumors originating from the muscularis propria,compared with conventional endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR)can remove deep lesions and digestive tract wall tumors completely.However,this technique has major limitations such as perforation,postoperative bleeding,and post-polypectomy syndrome.Herein,we report a case of postoperative serous surface bleeding which formed an encapsulated hemoperitoneum in a patient with gastric stromal tumor that was treated with exposed EFTR.Feasible treatment options to address this complication are described.CASE SUMMARY A 47-year-old male patient had a hemispherical protrusion found during gastric endoscopic ultrasonography,located at the upper gastric curvature adjacent to the stomach fundus,with a smooth surface mucosa and poor mobility.The lesion was 19.3 mm×16.1 mm in size and originated from the fourth ultrasound layer.Computed tomography(CT)revealed no significant evidence of lymph node enlargement or distant metastasis.Using conventional ESD technology for mucosal pre-resection,exposed EFTR was performed to resect the intact tumor in order to achieve a definitive histopathological diagnosis.Based on its morphology and immunohistochemical expression of CD117 and DOG-1,the lesion was proven to be consistent with a gastric stromal tumor.Six days after exposed EFTR,CT showed a large amount of encapsulated fluid and gas accumulation around the stomach.In addition,gastroscopy suggested intracavitary bleeding and abdominal puncture drainage indicated serosal bleeding.Based on these findings,the patient was diagnosed with serosal bleeding resulting in encapsulated abdominal hemorrhage after exposed EFTR for a gastric stromal tumor.The patient received combined treatments,such as hemostasis under gastroscopy,gastrointestinal decompression,and abdominal drainage.All examinations were normal within six months of follow-up.CONCLUSION This patient developed serous surface bleeding in the gastric cavity following exposed EFTR.Serosal bleeding resulting in an encapsulated hemoperitoneum is rare in clinical practice.The combined treatment may replace certain surgical techniques.

Effect of lactobacillus on the gut microflora and barrier function of the rats with abdominal infection

AIM:To investigate the effect of probiotics supplemented by gut on the tight junctions of epithelial cells, barrier function and the microflora of rats with abdominal infection. METHODS: After the model of cecal ligation and perforation established, SD rats were divided into two groups: parenteral nutrition (PN) group and PIM+probiotics (probiotics) group, PN solution was supplemented by neck vein and probiotics was delivered via the jejunostomy tube for five days. Vena cava blood and the homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine the bacterial translocation rate (BTR). The ultra-structure of epithelial tight junctions and microvilli of the gut were observed by electron microscopy; occluding expression was measured by indirect-immune fluorescence method; anaerobic bacterial growth by anaerobic culture and DNA fingerprint of bacterial colonies of the feces by PCR. RESULTS: The quantity of lactobacteria and bifydobacteria in probiotics group was higher than that of PN group. The profiles of DNA fingerprint expression in probiotics group were similar to that in the normal group, a new 16S rDNA sequence appeared in the profile in PN group. The occludin expression, the integrality of the gut epithelial tight junction and microvilli in probiotics group were improved as compared with PN group. The BTR and endotoxin in blood were reduced more significantly in probiotics group as compared with PN group. CONCLUSION: The probiotics could improve the gut microflora disturbance, increase occludin expression, maintain the gut epithelial tight junction and decrease the bacterial translocations rate.

Risk factors and strategy for surgical incision infection in department of abdominal surgery

Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The diagnosis standard was based on Diagnosis Standard of Hospital Infection published by Ministry of Health.

Analysis of prognostic factors in patients with emergency sepsis

BACKGROUND Emergency sepsis is a common and serious infectious disease,and its prognosis is influenced by a number of factors.AIM To analyse the factors influencing the prognosis of patients with emergency sepsis in order to provide a basis for individualised patient treatment and care.By retrospectively analysing the clinical data collected,we conducted a comprehensive analysis of factors such as age,gender,underlying disease,etiology and site of infection,inflammatory indicators,multi-organ failure,cardiovascular function,therapeutic measures,immune status and severity of infection.METHODS Data collection:Clinical data were collected from patients diagnosed with acute sepsis,including basic information,laboratory findings,medical history and treatment options.Variable selection:Variables associated with prognosis were selected,including age,gender,underlying disease,etiology and site of infection,inflammatory indicators,multi-organ failure,cardiovascular function,treatment measures,immune status and severity of infection.Data analysis:The data collected are analysed using appropriate statistical methods such as multiple regression analysis and survival analysis.The impact of each factor on prognosis was assessed according to prognostic indicators,such as survival,length of stay and complication rates.RESULTS Descriptive statistics:Descriptive statistics were performed on the data collected from the patients,including their basic characteristics and clinical presentation.CONCLUSION Type 2 diabetes mellitus were independent factors affecting the prognosis of patients with sepsis.

Pylephlebitis—a rare complication of a fish bone migration mimicking metastatic pancreatic cancer:A case report

BACKGROUND Pylephlebitis is a rare condition,poorly recognized by clinicians and with few references.In this case,the clinical appearance resembled the clinical course of a pancreatic cancer and was originated by the ingestion of a fish bone,making the case more interesting and rare.CASE SUMMARY A 79-year-old female presented to the emergency department with fever,loss of appetite and jaundice.Tenderness in the right upper quadrant was present.Inflammation marker were high.A computed tomography(CT)scan revealed gallstones and aspects compatible with acute pancreatitis.The patient was admitted to surgery ward and has her condition aggravated.A magnetic resonance revealed multifocal liver lesions.Later,a cholangiopancreatography and an endoscopic ultrasound(US)were able to diagnose the condition.Specific treatment was implemented and the patient made a complete recovery.CONCLUSION In conclusion,this case report demonstrates for the first time the diagnosis of an unusual case of pylephlebitis complicated by the migration of a fish bone,mimicking metastatic pancreatic cancer.Clinical presentation and traditional imaging studies,such as transabdominal US and CT,remain the standard for diagnosing this condition.

Effect of retension sutures on abdominal pressure after abdominal surgery

To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients. Methods： This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the ＂U＂ type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure （IVP） was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded. Results： During the operation, the IVP decreased and then increased; it was at its lowest I h after the start of the operation （5.3 mmHg _＋ 3.2 mmHg） and peaked after tension-reducing （8.8 mmHg _＋ 4.0 mmHg）. The IVP values in the ＂U＂ type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation （p 〈 0.005）. The Visual Analogue Scale （VAS） pain scores were 3.9 ~ 2.2, 3.8 ~ 2.0, and 3.0 _＋ 1,0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the ＂U＂ type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group （p 〈 0,005）. Conclusion： Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.