Research progress of heat stroke during 1989–2019: A bibliometric analysis

Background: Heat stroke(HS) is an acute physical disorder that is associated with a high risk of organ dysfunction and even death. HS patients are usually treated symptomatically and conservatively;however, there remains a lack of specific and effective drugs in clinical practice. An analysis of publication contributions from institutions, journals and authors in different countries/regions was used to study research progress and trends regarding HS.Methods: We extracted all relevant publications on HS between 1989 and 2019 from Web of Science. Using the Statistical Package for Social Science(SPSS, version 24) and the software GraphPad Prism 8, graphs were generated and statistical analyses were performed, while VOSviewer software was employed to visualize the research trends in HS from the perspectives of co-occurring keywords.Results: As of April 14, 2020, we identified 1443 publications with a citation frequency of 5216. The United States accounted for the largest number of publications(36.2%) and the highest number of citations(14,410), as well as the highest H-index at 74. Although the sum of publications from China ranked second, there was a contradiction between the quantity and quality of publications. Furthermore, Medicine & Science in Sports & Exercise published the most papers related to HS, with Lin MT publishing the most papers in this field(112), while the review by Knochel JP received the highest citation frequency at 969. The keyword heat-stress appeared most recently, with an average appearing year of 2015.5. In the clinical research cluster, exertional heat-stroke was determined to be the hotspot, while ambient-temperature and heat waves were the new trends in the epidemiological research cluster.Conclusions: Corresponding to this important field, while the contributions of the publications from the United States were significant, the mismatch between the quantity and quality of publications from China must be examined. Moreover, it is hypothesized that clinical and epidemiological studies may become hotspots in the near future.

Effect of preoperative limited fluid resuscitation to the patients with traumatic shock

Objective:To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock.Methods:Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital between January 2002 to October 2005 and were divided into 3 groups accord ing to the preoperative levels of systolic blood pressure(SBP).SBP of group A and group B were about 70 and 80 mmHg,respectively;and the SBP of group C was over 90 mmHg.Results:(1)There was no sig- nificant difference in age,gender,and injury severity score(ISS),initiated resuscitation time and initiated operation time among the 3 groups.Preoperatively,there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A,B and C(1687±96 ml,2096±87 ml. 2976±93 ml,P<0.05;and 294±110ml,404±113 ml,7984±230ml,P<0.05).(2)The hemoglobin level in group C(94±45 g/L)was lower than that in group A(110±22 g/L)and group B(103±24 g/L)(P<0.05).However,there was no significant difference in the level of hemoglobin between group A and B.(3)There was no significant difference in the incidence of acute renal failure(ARF)among the 3 groups.The incidence of acute respiratory distress syndrome(ARDS)of group C(31.2%)was higher than that of group A(16.7%)and group B(18.2%)(P<0.05).The mortality of group C(34.4%)was higher than that of group A(12.5%)and group B(12.1%)(P<0.05).Conclusion:Preoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss,incidence of ARDS and mor tality.

Long-term follow-up of endoscopic papillectomy and the value of preventive pancreatic stent placement(with videos)

Background:Early-stage ampullary adenomas have only been reported in a small case series on endoscopic management.Hence,this study aimed to evaluate the long-term outcomes of early ampullary adenoma with endoscopic management and identify the risk factors for acute pancreatitis after endoscopic papillectomy(EP).Methods:In this study,115 patients who underwent EP at Changhai Hospital(Shanghai,China)between January 2012 and December 2018 were retrospectively analysed.Endoscopy was performed at 1,3,6,and 12months after EP.Data were statistically analysed using the t-test or the Mann–Whitney U test.Results:A total of 107 patients were included in this study and the follow-up period was 75643 months.The average age of the 107 patients was 54.6 years and the average tumor size was 17mm.The average age of the patients(53.7610.7 years vs 55.2610.5 years,P=0.482),minimum tumor size(13 vs 19mm,P=0.063),and complete resection rate(84.78%vs 85.25%,P=0.947)did not differ significantly between the stent placement and non-stent placement groups.Post-EP acute pancreatitis rates in the non-stent placement and stent placement groups were 11.48%and 4.35%,respectively.The risk of post-EP acute pancreatitis was significantly associated with the preoperative carcinoembryonic antigen level in univariate analysis,but not in multivariate analysis.The risk of post-EP acute pancreatitis was not significantly associated with the placement of the pancreatic stent in either univariate or multivariate analysis.Moreover,delayed proximal pancreatic duct stenosis was not noted in either group during long-term follow-up.Conclusions:EP is a satisfactory option for treating adenomas of the ampulla of the duodenum.

Unplanned decannulation of tracheotomy tube in massive burn patients： a retrospective case series study

Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.

In situ synthesis of graphene oxide/gold nanorods theranostic hybrids for efficient tumor computed tomography imaging and photothermal therapy

Graphene oxide/gold nanorod （GO/GNR） nanohybrids were synthesized with a GO- and gold-seed-mediated in situ growth method at room temperature by mixing polystyrene sulfonate （PSS） functionalized GO, secondary growth solution, and gold seeds. Compared with ex situ preparation methods of GO/GNRs or graphene （G）/GNRs, the in situ synthesis of GO/GNRs addressed the issue of the aggregation of the GNRs before their attachment onto the GO. The method is straightforward and environment-friendly; The GO/GNRs showed a remarkable photothermal effect in vitro. The temperature of the GO/GNR nanohybrids increased from 25 to 49.9 ℃ at a concentration of 50 μg/mL after irradiation with an 808-nm laser （0.4 W/cm2） for 6 min. Additionally; the GO/GNRs exhibited good optical and morphological stability and photothermal properties after six cycles of laser irradiation. Upon injection of the GO/GNRs into xenograft tumors, excellent computed tomography （CT） imaging properties and photothermal effect were obtained. The preclinical CT agent iohexol was combined with the GO/GNRs and further enhanced CT imaging. Therefore, the GO/GNR nanohybrids have great potential for predse CT-image-guided tumor photothermal treatment.

Prognostic factors associated with rebleeding in cirrhotic inpatients complicated with esophageal variceal bleeding

Background Esophageal variceal bleeding is a frequent and severe complication in patients with cirrhosis. The aim of this study was to identify prognostic factors of esophageal variceal rebleeding in cirrhotic inpatients.Methods Consecutive cirrhotic patients who were admitted to Changhai Hospital because of esophageal variceal bleeding were retrospectively analyzed. To assess the independent factors for recurrent hemorrhage after esophageal variceal bleeding, medical assessment was completed at the time of their initial hospital admission, including documentation of clinical, biochemical, and treatment methods that might contribute to variceal rebleeding. Univariate and multivariate analyses were retrospectively performed.Results Totally 186 patients （35.8%） were assigned to a rebleeding group and the other 334 patients （64.2%） to a non-rebleeding group. Multivariate stepwise regression analysis showed that four variables were positively correlated with rebleeding： Child-pugh grade B （OR=2.664, 95% CI 1.680-4.223） （compared with Child-pugh grade A）, total bilirubin （Tbil） （OR=1.0006, 95% CI 1.002-1.0107）, creatinine （OR=1.008, 95% CI 1.002-1.015） and the cumulative volume of blood transfusion （OR=1.519, 95% CI 1.345-1.716）. The presence of ascites （OR=0.270, 95% CI 0.136-0.536） and prophylactic antibiotics （OR=0.504, 95% CI 0.325-0.780） were negatively correlated with rebleeding of the cirrhotic inpatients. According to standardized coefficient, the importance of rebleeding predictors ranked from the most to the least was as follows： the cumulative volume of blood transfusion, Child-pugh grade B, Tbil and creatinine.Conclusion Rebleeding in cirrhotic inpatients was associated with more blood transfusions, Child-pugh grade B, higher Tbil and creatinine

Calcium silicate bioactive ceramics induce osteogenesis through oncostatin M

Immune reactions are a key factor in determining the destiny of bone substitute materials after implantation.Macrophages,the most vital factor in the immune response affecting implants,are critical in bone formation,as well as bone biomaterial-mediated bone repair.Therefore,it is critical to design materials with osteoimmunomodulatory properties to reduce host-to-material inflammatory responses by inducing macrophage polarization.Our previous study showed that calcium silicate(CS)bioceramics could significantly promote osteogenesis.Herein,we further investigated the effects of CS on the behavior of macrophages and how macrophages regulated osteogenesis.Under CS extract stimulation,the macrophage phenotype was converted to the M2 extreme.Stimulation by a macrophage-conditioned medium that was pretreated by CS extracts resulted in a significant enhancement of osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs),indicating the important role of macrophage polarization in biomaterial-induced osteogenesis.Mechanistically,oncostatin M(OSM)in the macrophage-conditioned medium promoted osteogenic differentiation of BMSCs through the ERK1/2 and JAK3 pathways.This in vivo study further demonstrated that CS bioceramics could stimulate osteogenesis better thanβ-TCP implants by accelerating new bone formation at defective sites in the femur.These findings improve our understanding of immune modulation of CS bioactive ceramics and facilitate strategies to improve the in vitro osteogenesis capability of bone substitute materials.

Pediatric burns due to hot water from water dispenser： a neglected issue that should be highly concerned

Background More and more Chinese drink hot water from water dispensers while many children were scalded due to this change. The present study aimed to propose a feasible strategy for prevention. Methods A retrospective study was conducted for all water dispensers related pediatric burns admitted to Changhai Hospital from January 2005 to December 2009. Results The number of new cases and incidences of pediatric burns due to hot water from water dispensers was significantly increasing year after year. In the total 238 involved cases, 175 cases happened on males and 78.9% were at the age of 1-4 years. The burn areas were mainly located in upper extremities. All water dispensers in the surveyed families had no isolate protection devices and 85.2% of their locations were easy for children to reach. Nearly half of the children were in the same room with their guardians when injured. Total 196 burned children were playing the taps of water dispensers before injured, unfortunately, 80.6% of them have not been stopped until burned. Conclusion As the kind of burns is quite serious and with bad outcome, some recommendations should be followed, such as buying water dispensers with protection devices, keeping children from touching them and so on.