Guidelines for the diagnosis, treatment, prevention and control of infections caused by carbapenem-resistant gram-negative bacilli.

The dissemination of carbapenem-resistant Gram-negative bacilli (CRGNB) is a global public health issue. CRGNB isolates are usually extensively drug-resistant or pandrug-resistant, resulting in limited antimicrobial treatment options and high mortality. A multidisciplinary guideline development group covering clinical infectious diseases, clinical microbiology, clinical pharmacology, infection control, and guideline methodology experts jointly developed the present clinical practice guidelines based on best available scientific evidence to address the clinical issues regarding laboratory testing, antimicrobial therapy, and prevention of CRGNB infections.

Extracellular matrix bioink boosts stemness and facilitates transplantation of intestinal organoids as a biosafe Matrigel alternative.

Organoids hold inestimable therapeutic potential in regenerative medicine and are increasingly serving as an in vitro research platform. Still, their expanding applications are critically restricted by the canonical culture matrix and system. Synthesis of a suitable bioink of bioactivity, biosecurity, tunable stiffness, and printability to replace conventional matrices and fabricate customized culture systems remains challenging.

Current knowledge on the multiform reconstitution of intestinal stem cell niche.

The development of "mini-guts" organoid originates from the identification of Lgr5 intestinal stem cells (ISCs) and circumambient signalings within their specific niche at the crypt bottom. These self-renewing "mini-guts", also named enteroids or colonoids, undergo perpetual proliferation and regulated differentiation, which results in a high-performance, self-assembling and physiological organoid platform in diverse areas of intestinal research and therapy. The triumphant reconstitution of ISC niche also relies on Matrigel, a heterogeneous sarcoma extract.

[The application progress of fluid de-escalation therapy in abdominal infection-induced septic shock].

After adequate fluid resuscitation in the early stage of septic shock, excessive accumulation of fluid in the body leads to organ dysfunction, which prolongs hospitalization, mechanical ventilation time, and renal replacement therapy time, and is associated with poor prognosis. The fluid de-escalation therapy is an important fluid management strategy performed in the late stage of septic shock. It aims to clear excess fluid by restricting fluid infusion, using diuretics and renal replacement therapy to achieve a negative fluid balance.

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression.

The management of enterocutaneous fistulas (ECF) can be challenging because of massive fluid loss, which can lead to electrolyte imbalance, severe dehydration, malnutrition and sepsis. Nutritional support plays a key role in the management and successful closure of ECF. The principle of nutritional support for patients with ECF should be giving enteral nutrition (EN) priority, supplemented by parenteral nutrition if necessary.

Current progress of source control in the management of intra-abdominal infections.

Intra-abdominal infection (IAI) is a deadly condition in which the outcome is associated with urgent diagnosis, assessment and management, including fluid resuscitation, antibiotic administration while obtaining further laboratory results, attaining precise measurements of hemodynamic status, and pursuing source control. This last item makes abdominal sepsis a unique treatment challenge. Delayed or inadequate source control is an independent predictor of poor outcomes and recognizing source control failure is often difficult or impossible.

[Predictive value of lung ultrasound score on weaning outcome in patients with intro-abdominal infection undergoing mechanical ventilation].

Objective: To evaluate the value of lung ultrasound score (LUS) on predicting weaning outcome in patients with intro-abdominal infection (IAI) undergoing mechanical ventilation.

Methods: Patients with IAI undergoing mechanical ventilation admitted to Research Institute of General Surgery of East War Zone Hospital and intensive care unit (ICU) of the First People's Hospital of Lianyungang from January to December in 2018 were included. The patients who satisfied weaning criteria were enrolled in the weaning process, which included spontaneous breathing trial (SBT) and extubation.

Application of a 3D-printed "fistula stent" in plugging enteroatmospheric fistula with open abdomen: A case report.

Background: Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula (EAF), which is one of the most common complications of OA therapy, remains a thorny challenge.

Case Summary: Our team applied thermoplastic polyurethane as a befitting material for producing a 3D-printed "fistula stent" in the management of an EAF patient, who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction.

Impaired Coagulation Status in the Crohn's Disease Patients Complicated with Intestinal Fistula.

Background: Intestinal fistula is one of the common complications of Crohn's disease (CD) that might require surgical treatment. The clinical characteristics and outcomes of CD with intestinal fistula are much different from CD alone. This study was to investigate whether the coagulation status of CD is changed by intestinal fistula.

[Susceptibility genes and serum markers of intestinal fibrosis in Crohn disease].

Crohn disease (CD) is a chronic inflammatory disease which progressively affects the digestive tract with unknown etiology. During the disease course, intestinal fibrosis will gradually develop in many CD patients and results in irreversible fibrosis stricture, causing refractory abdominal pain and even intestinal obstruction, and necessitating one or more surgical interventions. Thus far the exact etiology of CD remains unknown.

3D-printed "fistula stent" designed for management of enterocutaneous fistula: An advanced strategy.

Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as "fistula patch" and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage.

[Effect of postoperative hyperglycemia on clinical outcome of gastrointestinal fistula patients undergoing gastrointestinal reconstruction].

Objective: To investigate the effect of hyperglycemia within postoperative 48 hours on gastrointestinal (GI) fistula patients without preoperative diagnosis of diabetes undergoing selective GI reconstruction.

Methods: Clinical data of GI fistula patients with age of 18 to 70 years and without diffuse peritonitis and systemic infection undergoing definitive GI reconstruction at Intestinal Fistula Center of Jinling Hospital from September 2012 to December 2015 were retrospectively analyzed. According to the highest blood glucose (BG) value detected within postoperative 48 hours, patients were divided into normoglycemia (BG<6.

[Overview of diet-related study in Crohn's disease].

Crohn's disease (CD) is a chronic inflammatory disorder affecting any part of the digestive tract which relapses and remits throughout the disease course. It occurs in individuals with genetic susceptibility and involves an abnormal response of the immune system to the external environment. Besides, improved hygiene, abuse of antibiotics, westernization of diet with high sugar and fat are thought to be associated with rapidly increasing incidence of CD.

Cordyceps sinensis preserves intestinal mucosal barrier and may be an adjunct therapy in endotoxin-induced sepsis rat model: a pilot study.

Background: Cordyceps sinensis (C. sinensis), a traditional Chinese medicine, exhibits various pharmacological activities such as reparative, antioxidant, and apoptosis inhibitory effects. Intestinal barrier dysfunction plays a vital role in the progression of sepsis.

[Risk factors of surgical site infection in definitive surgery of intestinal fistulas].

Objective: To investigate the risk factors of surgical site infection (SSI) in definitive surgery of intestinal fistulas.

Methods: Patients with gastrointestinal fistula undergoing definitive operation during November 2011 to November 2013 in Jinling Hospital were prospectively enrolled in the study. Risk factors of SSI were analyzed.

Fistula output microorganism-susceptible antimicrobial prophylaxis is associated with a lower risk of surgical site infection in gastrointestinal fistula patients undergoing one-stage definitive surgery.

Background: Empiric broad-spectrum antimicrobial prophylaxis (AMP) may not be sufficient to minimize the risk of surgical site infections (SSIs) after definitive surgical treatment of gastrointestinal (GI) fistula. This study investigates whether AMP targeted toward fistula microbiology is associated with a lower risk of SSIs in GI fistula patients undergoing one-stage definitive surgery.

Methods: Fistula output was sampled from the abdominal fistula opening for microbial growth and drug sensitivity prior to surgery.

Polymorphism of heat shock protein 70-2 and enterocutaneous fistula in Chinese population.

Aim: To investigate whether the heat shock protein 70-2 (HSP70-2) polymorphism is associated with enterocutaneous fistulas in a Chinese population.

Methods: This study included 131 patients with enterocutaneous/enteroatmospheric fistulas. Patients with inflammatory bowel disease or other autoimmune diseases were excluded from this study.

[Pathogenesis, diagnosis and treatment of anemia in inflammatory bowel disease].

Anemia is a common and severe complication in inflammatory bowel disease. Anemia can induce impaired cardiovascular and renal functions, and lead to a significantly decreased quality of life. This review is dedicated to explain the underlying mechanism, diagnosis and management of anemia in inflammatory bowel disease.

Clinical characteristics of non-perianal fistulating Crohn's disease in China: a single-center experience of 184 cases.

Background: There is little information of non-perianal fistulating Crohn's disease in the consensus published by the European Crohn's and Colitis Organization in 2006 and 2010. This study was designed to demonstrate the clinical characteristics of non-perianal fistulating Crohn's disease among homogenous Chinese population.

Methods: One-hundred-and-eighty-four patients were retrospectively collected.

[Research progress of anemia associated with inflammatory bowel diseases].

Anemia is a frequent and serious complication in patients with inflammatory bowel disease (IBD). One third of patients with inflammatory bowel disease suffers from recurrent anemia. Anemia is associated with a decrease in the quality of life and an increased rate of hospitalization.

[Current practice in the prevention and management of surgical site infections in gastrointestinal surgery].

Surgical site infection(SSI) is one of post-operative complications in gastrointestinal surgery. SSI may increase the morbidity and mortality of surgical patients and increase their hospital stay and expense. The risk factors can come from patients, physicians and hospital environments.

[Outcomes of chronic radiation intestinal injury treated with surgical interventions].

Objective: To explore the surgical approaches and clinical outcomes of chronic radiation intestinal injury (CRII).

Methods: From January 1, 2001 to December 31, 2010, at Department of Surgery, Nanjing General Hospital of Nanjing Command a consecutive series of 206 CRII patients undergoing surgical interventions was reviewed retrospectively. There were 64 males and 142 females with an age range of (50 ± 11) years old.

Risk factors for leukopenia in patients with gastrointestinal fistula.

Background: White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated.

[Experimental study of liver injury in rats of abdominal infection with abdominal compartment syndrome].

Objective: To evaluate the liver injury in rats of abdominal infection complicated with abdominal compartment syndrome(ACS).

Methods: SD rats were divided into four groups, including the sham group, the abdominal infection group, the ACS group, and the abdominal infection plus ACS group (combination group). Rats were sacrificed at 1 h, 6 h, 12 h, 24 h after operation with 6 rats at each time point.

[Placement of double cannula using trocar puncture for abdominal abscess drainage].

Objective: To study the effects of placement of double cannula using trocar puncture for intra-abdominal abscess drainage.

Methods: A retrospective study was performed to investigate the clinical data of 32 patients undergoing intra-abdominal abscess drainage with double cannula placed using trocar puncture between June 2010 and December 2010.

Techniques: the location and size of the abscess was evaluated by ultrasound and CT.