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Background Wound infections can lead to high risks of postoperative septic complications. To date, the efficacy of a closed suction irrigation method of wound closure on the rate of postoperative wound infection in patients is poorly understood. Therefore, comparing this new strategy with conventional primary wound closure on the incidence of postoperative wound infection can provide value for clinical treatment. Methods Our study focused on retrospective research for patients with open abdominal wounds. All patients were referred by tertiary hospitals and registered in our hospital from January 2009 to July 2019. According to wound types, patients were divided into two groups, namely patients with wounds primarily closed as the control group and patients with wounds sutured by closed suction irrigation after primary closure as the study group. Results A total of 159 patients were collected in our present research, with 86 as study subjects and 73 as control subjects. The wound infection rate was significantly lower in the study group than the control group (P=0.017). The time interval for diagnosing wound infection from the primary operation was 4.895±0.875 days for the study group and 4.509±0.697 days for the control group. The length of hospital stay and the time taken for the wound to heal completely was shorter in patients in the study group compared to patients in the control group (8.046±2.110 vs. 8.983±2.887 days and 8.092±3.258 vs. 10.328±6.074 days, respectively). Conclusions The closed suction irrigation method significantly reduced postoperative wound infection rates in patients with a high risk of postoperative septic complications. The discoveries of our investigation should be further validated in large scope randomized controlled trials.

Background: The competing endogenous RNA (ceRNA) network plays an important role in the occurrence and development of a variety of diseases. This study aimed to construct a ceRNA network related to exosomes in diabetic retinopathy (DR). Methods: We explored the Gene Expression Omnibus (GEO) database and then analyzed the RNAs of samples to obtain differentially expressed lncRNAs (DELs), miRNAs (DEMs) and mRNAs (DEGs) alongside the progress of DR. Next, Gene Set Enrichment Analysis (GSEA) analysis of DEGs, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of up-DEGs were performed. In addition, a ceRNA network related to exosomes in DR was constructed on the base of DELs, DEMs and DEGs. Finally, the function of the ceRNA network was explored by GO and KEGG enrichment analysis. Results: Through our analysis, 267 DELs (93 up and 174 down), 114 DEMs (64 up and 50 down) and 2368 DEGs (1252 up and 1116 down) were screened. The GSEA analysis results show that these genes were mainly related to cytokine-cytokine receptor interaction, hippo signaling pathway and JAK-STAT signaling pathway. The GO and KEGG results show that these up-DEGs were mainly enriched in viral gene expression, components of ribosomes, mineral absorption, Wntprotein binding, and TGF-β signaling pathway. Besides, a ceRNA network, including 15 lncRNAs (e.g., C1orf145, FGF14-IT1, and PRNT), 3 miRNAs (miR-10a-5p, miR-1297 and miR-507) and 11 mRNAs (NCOR2, CHAC1 and LIX1L, etc.) was constructed. Those 5 lncRNAs were up-regulated, 1 miRNA was down-regulated and 5 mRNAs were up-regulated in DR, while 10 lncRNAs were downregulated, 2 miRNAs were up-regulated and 6 mRNAs were down-regulated in DR. Conclusion: The novel ceRNA network that we constructed will provide new insights into the underlying molecular mechanisms of exosomes in DR.

Augmented renal clearance (ARC) can cause underexposure to vancomycin, thereby increasing the risk of treatment failure. Our objective was to evaluate population pharmacokinetics and optimize the dosing regimen of vancomycin in a pediatric population with ARC. Sparse pharmacokinetic sampling and therapeutic drug monitoring (TDM) data were collected from pediatric patients with ARC treated with vancomycin. A pharmacokinetic model was developed using NONMEM 7.2. The dosing regimen was optimized using Monte Carlo dose simulations. A total of 242 vancomycin serum concentrations from 113 patients (age range, 0.4 to 14.9 years; 49 females and 64 males) were available. The mean vancomycin dose was 58.8 mg/kg body weight/day (13.6 mg/kg/dose), and the mean vancomycin serum trough concentration was 6.5 mg/liter. A one-compartment pharmacokinetic model with first-order elimination was developed. Body weight and age were the most significant and positive covariates for clearance and volume of distribution. For the pediatric population with ARC, the current recommended vancomycin dose of 60 mg/kg/day was associated with a high risk of underdosing. To reach the target area under the concentration-time curve over 24 h in the steady state divided by the MIC (AUC/MIC) ratio of 400 to 700 in these pediatric patients, the vancomycin dose should be increased to 75 mg/kg/day for infants and children between 1 month and 12 years of age and 70 mg/kg/day for adolescents between 12 and 18 years of age. In conclusion, a one-compartment pharmacokinetic model with first-order elimination was established with body weight and age as significant covariates. An optimal dosing regimen was developed in pediatric patients with ARC aged 1 month to 18 years.

Objectives: To investigate the appetite of COVID-19 patients treated in a makeshift hospital and to evaluate the effectiveness of abdominal massage and ST-36 (Zusanli) acupressure in improving their appetite.Design: Randomized controlled trial.Methods: This study was performed between February 15 and March 2, 2020, in a sports centre makeshift hospital in Wuhan, China. The appetite of 110 COVID-19 patients was assessed using a mobile app-based Simplified Nutritional Appetite Questionnaire (SNAQ). The experimental and control groups, 55 patients each, were randomized using a prepared randomization checklist. Through video guidance and on-the-spot instruction, patients in the experimental group mastered the methods of abdominal massage and ST-36 (Zusanli) acupressure and implemented the intervention for 7 days by themselves. The appetite of the patients was assessed again after intervention.Results: In a total of 110 participants, 43 (39.1%) patients suffered from a poor appetite. A positive correlation between poor appetite and older age as well as fever was observed (pp=0.0004), and the proportion of patients with a poor appetite was markedly reduced after the intervention (41.8% vs 10.9%, p=0.0002). Compared with the control group, the rate of poor appetite in the experimental group was significantly decreased postintervention (27.3% vs 10.9%, p=0.029).Conclusion: In COVID-19 patients, a poor appetite may be correlated with older age and fever. Abdominal massage and ST-36 (Zusanli) acupressure are applicable and effective in improving the appetite of COVID-19 patients during isolation treatment.Trial registration: Chinese clinical trial registry (ChiCTR2000033261), the trial was registered retrospectively.

This research presents the general design of a three-tower, self-anchored suspension bridge with a concrete stiffening girder based on practical engineering. The finite-element method is adopted to explore the structural behaviour of a bridge affected by shrinkage and creep of the concrete stiffening girder. The results show that shrinkage and creep of the concrete stiffening girder have a major effect on the mechanical behaviour of the side towers and stiffening girder. A new main cable system consisting of a prefabricated parallel wire strand (PPWS) cable with a polyethylene jacket and cold-cast anchorage is proposed to allow the main cables to be tensioned and the bridge cable force to be adjusted at any time. The experimental results of the PPWS cable show that the design and manufacture of the largest cable in China are safe and reliable. Moreover, the numerical simulation results for a new cable clamp connecting two main cables to a single hanger indicate that its design is reasonable. Furthermore, the anti-corrosive properties of the special cable system are investigated. The behaviour results as well as some key design technologies of this bridge style in the study provide valuable knowledge for its future application.

Location is a basic property of an object. In the last decades, much attention has been paid to the precise localization and performance evaluation in wireless sensor networks. Time-of-arrival (TOA) and inertial measurement unit (IMU) based localization methods have been drawing attentions due to their advantageous performance. However, TOA suffers from the multipath effect and IMU from error accumulation problem, which have limited their application prospects. Thus, the fusion of these two methods becomes necessary. Besides, in existing literatures, when estimating the positioning accuracy, it is generally assumed that the position of base station is error-free, which is not so consistent with reality. Thus, for the purpose of achieving high precision positioning in practical conditions, we modeled the anchor position error, IMU error, and TOA error, respectively. Based on these models, CRLB and PCRLB in 3-D environment are deduced to evaluate positioning accuracy in both spatial and temporal level. Finally, CRLB and PCRLB are considered when different base station topologies are used, as well as compared with commonly used localization algorithms. Experimental results show that the impacts of anchor position error on positioning results cannot be ignored. CRLB and PCRLB can be used as benchmarks based on IMU/TOA fusion positioning systems and as reference lower bounds for performance improvement of localization algorithms.