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Zhao RY, Liu MD, Lin YX, Huang L. Severe Jarisch-Herxheimer Reaction (JHR) in a leptospirosis patient: A case report. Heliyon 2024; 10:e24538. [PMID: 38314303 PMCID: PMC10837501 DOI: 10.1016/j.heliyon.2024.e24538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Leptospirosis is a zoonosis that is related to potential respiratory, renal, neurological, and cardiovascular failure. At present, antibiotics are the recommended treatment, but due to the underlying cause of the disease, they may induce the Jarisch-Herxheimer reaction (JHR) within 24 hours. At the same time, we speculate that JHR may aggravate the natural course of leptospirosis. Considering that there are few available reports on this event, we will share a case of pulmonary hemorrhagic leptospirosis, where antibiotic treatment is suspected to have triggered the JHR. This report is expected to improve clinical attention to the relationship between leptospirosis and JHR.
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Affiliation(s)
- Ruo-Yan Zhao
- Hubei University of Medicine, Shiyan, 442000, Hubei Province, China
- Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Meng-Die Liu
- Shenzhen University, Shenzhen, 518000, Guangdong Province, China
- Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Ying-Xin Lin
- Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Lei Huang
- Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, 518000, Guangdong Province, China
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Yang XK, Zhang DL, He T, Zhang Y, Xu ZG, Wei JT, Li J, Liu MD. [Clinical experience of free superficial temporal fascia flap/anterolateral femoral fascial flap combined with skin grafting in repairing deep tissue defects of special parts of extremities]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:507-511. [PMID: 37805764 DOI: 10.3760/cma.j.cn501225-20220915-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
The deep tissue defects of extremities are prone to cause the exposure of tendons, blood vessels, nerves, and bones, which are commonly repaired with free flaps in clinical practice. However, for special parts such as fingers, toes, posterior ankles, anterior tibias, and dorsum of feet, the appearances are usually bulky after being repaired with free flaps and need lipectomy operations, which bring great physiological, psychological, and economic burden to patients. As the fascia flap is soft and thin with reliable blood supply and strong anti-infection ability, the free fascia flap combined with skin grafting offers some advantages in repairing the above-mentioned wounds. However, its clinical application is severely limited due to the complexity of surgical operation and the difficulty in observing blood supply after operation. In recent years, our team has carried out a lot of work and accumulated rich experience in repairing deep tissue defects of special parts of extremities with free superficial temporal fascia flap/anterolateral femoral fascial flap combined with skin grafting. From the clinical perspective, this paper mainly introduces the anatomy and harvesting method of free superficial temporal fascia flap/anterolateral femoral fascial flap, as well as the advantages, difficulties, and precautions of clinical application, for reference of peers.
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Affiliation(s)
- X K Yang
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - D L Zhang
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - T He
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - Y Zhang
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - Z G Xu
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - J T Wei
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - J Li
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
| | - M D Liu
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital, Air Force Medical University, Xi'an 710032, China
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Yang GH, Liu MD, Hu XL, Wang H, Li XG. [Research progress on proactive healthy lifestyle and disease immunoprevention]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:78-85. [PMID: 36655262 DOI: 10.3760/cma.j.cn112150-20220323-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The paradox of increasing health needs and limited health resources prompted a change in the traditional concept of disease prevention and control, and the concept of proactive health has emerged. Proactive health aimed to prevent and control disease and improve the body's immunity by using controlled methods and means to activate the body's self-healing ability and to identify foreign harmful substances as well as damage factors and tumor cells that the body itself may produce while giving full play to individual initiative. With the continuous development of science, people could maintain and improve their immune system from many aspects, which could be roughly divided into nonpharmaceutical interventions and pharmaceutical interventions. Nonpharmacological interventions included changing lifestyles and habits, adjusting the nutritional structure and intake of food, regulating mindsets and emotions, and improving the living and working environment, etc. This review systematically elaborated on the functions and molecular mechanisms of nutrition, exercise, sleep, and emotion in regulating immunity, to provide some scientific evidence and theoretical support for proactive health.
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Affiliation(s)
- G H Yang
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - M D Liu
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - X L Hu
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - H Wang
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - X G Li
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
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Liu MD, Li CX, Huang Y, Dong YD, Nu W, Zhao TY. Spatial Distribution of Culex tritaeniorhynchus Giles, 1901 (Diptera: Culicidae) in Relation to Pigsties and Other Geo-environmental Features in Dao County, Hunan Province, China. J Med Entomol 2019; 56:241-246. [PMID: 30169709 DOI: 10.1093/jme/tjy135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Indexed: 06/08/2023]
Abstract
In this study, we investigated the spatial distribution of Culex tritaeniorhynchus Giles, 1901 (Diptera: Culicidae) (the vector of Japanese B Encephalitis) and geo-environmental features (rice fields, forests, watercourses, and highways) correlated with their abundance in pigsties of Dao County, Hunan Province, China. First, light trapping in pigsties was carried out to determine vector density. Second, based on Advanced Land Observing Satellite remote-sensing datasets, spatial datasets of mosquito density and various geo-environmental features were constructed using Geography Information System. Finally, spatial statistical analysis and general linear regression were used to analyze the spatial distribution of vectors in relation to the geo-environmental features correlating with the abundance of mosquitoes in pigsties. As the results show, the distribution of mosquitoes in pigsties was not spatially autocorrelated, and several geo-environmental features that were either positively or negatively correlated with mosquito abundance in pigsties were identified. The application of these results to improve the control of vectors of Japanese B Encephalitis is also discussed.
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Affiliation(s)
- M D Liu
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - C X Li
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - Y Huang
- Hunan Center for Disease Control and Prevention, Changsha, China
| | - Y D Dong
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - W Nu
- Hunan Center for Disease Control and Prevention, Changsha, China
| | - T Y Zhao
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
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Liu MD, Yang XK, Han F, Fang ZQ, Zhang Y, Hu DH, Tao K. [Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees]. Zhonghua Shao Shang Za Zhi 2018; 34:266-270. [PMID: 29804424 DOI: 10.3760/cma.j.issn.1009-2587.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. Methods: From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Wound debridement was operated on 1 to 3 days after admission. After debridement, the area of skin and soft tissue defect ranged from 10 cm×7 cm to 42 cm×18 cm. Vacuum sealing drainage (VSD) treatment was performed after debridement, and flap transplantation operation was performed after VSD treatment for 5 to 7 days. Defects of nine patients were treated with local rotation flaps. Seven patients with skin and soft tissue defects on knees and knee joint capsule defects of 5 cm×3 cm to 9 cm×7 cm were treated with free anterolateral femoral flaps combined with fascia lata. Ten patients with skin and soft tissue defects on knees and patellar ligament defects of 6 cm×3 cm to 12 cm×4 cm were treated with free anterolateral femoral flaps combined with iliotibial tract. The area of flaps ranged from 11 cm×9 cm to 22 cm×15 cm. After flap transplantation operation, functional reconstruction of knee joint was carried out according to early, continuous, and sequential systematic rehabilitation treatment strategy. The pain degree and function of knee joint of patients were scored by the International Knee Documentation Committee (IKDC) Knee Evaluation Form before operation and 12 months after operation. The knee joint flexion and extension degrees of patients were measured by joint protractor in 2 weeks and 12 months after operation. The color Doppler ultrasound was used to evaluate integrity of knee joint capsule and continuity of patellar ligament of patients in 6 and 12 months after operation. Results: All flaps of 26 patients survived well, and wounds healed completely after the operation. Distal parts of flaps of 2 patients treated with free anterolateral femoral flaps had local necrosis after the operation, and their wounds healed after debridement and transplantation of autologous intermediate split-thickness skin graft of thigh. The IKDC Knee Evaluation Form score of patients was (79±8) points in 12 months after operation, which was significantly higher than (64±7) points before operation (t=7.20, P<0.05). The flexion degree of knee joint of patients was (117±10)° in 12 months after operation, which was significantly larger than (35±8)° in 2 weeks after operation (t=32.65, P<0.05). The extension degree of knee joint of patients was (12±9)° in 12 months after operation, which was significantly smaller than (61±9)° in 2 weeks after operation (t=19.63, P<0.05). In 6 and 12 months after operation, 9 patients treated with local rotation flaps had good integrity of knee joint capsule and continuity of patellar ligament; 7 patients treated with free anterolateral femoral flaps and fascia lata had good integrity of knee joint capsule; 10 patients treated with free anterolateral femoral flaps and iliotibial tract had good continuity of patellar ligament. During follow-up of 12 months, all flaps survived well; knees of all patients had good appearance; knee joints functioned normally. Conclusions: Good appearance and function of knees can be achieved by repairing wound of skin and soft tissue defect on knees after severe burn or trauma with local rotation flaps or free anterolateral femoral flaps with fascia lata or iliotibial tract plus systematic rehabilitation treatment of knee joint in early stage after flap transplantation operation.
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Affiliation(s)
- M D Liu
- Burn Center of PLA, Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
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Wu YW, Seah YS, Chung KT, Liu MD. Postoperative pain relief in primigravida caesarean section patients--combination of intrathecal morphine and epinephrine. Acta Anaesthesiol Sin 1999; 37:111-4. [PMID: 10609343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Uterine contraction is less severe in primigravida patients. Intrathecal coadministration of morphine and epinephrine may provide an easy way of postcaesarean pain control. METHODS Twenty-eight primigravida patients who requested postcaesarean pain control were studied for the effectiveness of coadministration of intrathecal morphine and epinephrine. The solution for spinal anesthesia which contained 0.2 mg morphine, 0.1 mg epinephrine and 10 mg hyperbaric bupivacaine was injected intrathecally. Another 30 primigravida patients were collected randomly as control. In the control group, normal saline and 0.1 mg epinephrine were used with bupivacaine. Side effects from intrathecal morphine and the need of analgesia were recorded within 48 h. RESULTS In the study group, 89.3% (25/28) of patients did not need further narcotics for pain relief during their hospitalization after caesarean section. 96.4% (27/28) of patients needed only one dose of 50 mg intramuscular meperidine (Demerol) or no narcotic at all for pain relief within 48 h. No respiratory depression occurred. In the control group, each patient received in the average 6-7 doses of 50 mg Demerol for pain control within 48 h. CONCLUSIONS Our results showed that 0.2 mg morphine and 0.1 mg epinephrine in combination with 10 mg hyperbaric bupivacaine given intrathecally could provide a simple way of pain control in primigravida patients undergoing caesarean section.
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Affiliation(s)
- Y W Wu
- Department of Anesthesiology, Li Shin Hospital, Tao Yuan, Taiwan, R.O.C
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Ma EP, Liu XZ, Liu MD, Han Y, Lui X, Wu ZZ. The effect of superoxide dismutase on the recovery of human bone marrow hemopoietic stem cells stored at 4 degreesC. Cryobiology 1998; 37:372-5. [PMID: 9917354 DOI: 10.1006/cryo.1998.2132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of superoxide dismutase (SOD) on the recovery of human hemopoietic stem cells stored at 4 degreesC has been studied. Human bone marrow cells from cancer patients without hemopoietic diseases were stored at 4 degreesC for 1-7 days in RPMI 1640 medium containing 10% human AB serum with or without 6 U/ml of SOD. The recovery of colony-forming units of the following types were counted: granulocyte and macrophage type; megakaryocyte type; mixed granulocyte, erythrocyte, megakaryocyte, and macrophage type; and burst-forming units of erythrocytic type. The SOD groups recovered, respectively, 5.6, 5.3, 4.6, and 4.4 times as many colonies as the control group. This study demonstrates that the addition of SOD to hypothermic storage media may increase the recovery of hemopoietic stem cells.
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Affiliation(s)
- E P Ma
- Institute of Blood Transfusion, Beijing, Beijing, 100850, China
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Liu MD, Cheng P. [Analysis of nosocomial infection in hospitalized critical and serious patients]. Zhonghua Liu Xing Bing Xue Za Zhi 1995; 16:231-3. [PMID: 7585905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An investigation was made on 298 hospitalized critical and serious patients in Chongqing. the results showed that the nosocomial infection rate was 43.3% (129/298). The higher infection rate was found in the departments of brain surgery and hematopathy. The lower respiratory tract was found to be the most commonly seen infection sites (65.1%). Of 46 strains of the pathogenic organisms causing the nosocomial infection, gram-negative becilli were accounted for 52.2% and fungi 28.3%. The case fatality rate of infected patients (37.9%) was significantly higher than that of non-infected patient's (10.7%).
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Affiliation(s)
- M D Liu
- Department of Infection Control, Daping Hospital, Third Military Medical College, Chongqing
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Pidgeon C, Markovich RJ, Liu MD, Holzer TJ, Novak RM, Keyer KA. Antiviral phospholipids. Anti-HIV drugs conjugated to the glycerobackbone of phospholipids. J Biol Chem 1993; 268:7773-8. [PMID: 7681828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Heteroatom fatty acid analogs of myristic acid containing oxygen or sulfur substituted for the alkyl methylene groups inhibit replication of the human immunodeficiency virus (HIV) in infected cells by acting as alternative substrates during the viral protein myristoylation event. In this class of compounds, 12-methoxydodecanoic acid is the most potent compound but is approximately 10(3)-fold less active than azidothymidine. The antiviral activity of 12-methoxydodecanoic acid can be enhanced > 40-fold by preparing L-alpha-phosphatidylethanolamine containing 12-methoxydodecanoic acid in both alkyl chains. In addition, the diacylated L-alpha-phosphatidylcholine analog containing 12-methoxydodecanoic acid in both alkyl chains (i) has a 15-fold better antiviral selectivity, (ii) is 7-fold more potent, and (iii) is 10-100-fold more synergistic with azidothymidine than 12-methoxydodecanoic acid. Because of potent synergism, the antiviral selectivity of the diacylated L-alpha-phosphatidylcholine analog is > 10(4) when coadministered with azidothymidine. Phospholipid conjugates are chiral at the C-2 carbon of the glycerol backbone and most interesting is the observation that both the D- and L-isomers of phosphatidylcholine, phosphatidylglycerol, phosphatidic acid, and phosphatidylserine have approximately equal antiviral activity. Phospholipase A2 stereospecifically hydrolyzes only the L isomer of phospholipids and similar activity for both the D- and L- phospholipid isomers suggests that phospholipase A2 is not the rate-limiting enzyme for release of the drugs in vivo.
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Affiliation(s)
- C Pidgeon
- Department of Medicinal Chemistry and Pharmacognosy, School of Pharmacy, Purdue University, West Lafayette, Indiana 47907
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Abstract
Reversal of opioid effects by naloxone (NX) can lead to significant cardiovascular problems. We have reported previously that hypercapnic dogs develop greater increases in blood pressure and plasma catecholamine (CA) levels than hypocapnic ones when reversed with naloxone. We have also demonstrated differences between NX and nalbuphine (NBPH) in producing excitatory adrenergic responses when administered during normocapnia. The present study was designed to investigate possible dissimilarities in cardiovascular and sympathetic events after administration of either NX or NBPH in dogs made hypercapnic following fentanyl administration. After induction of anaesthesia with thiopentone and intubation, two groups of dogs were maintained with controlled ventilation on enflurane in oxygen anaesthesia and given 50 micrograms.kg-1 fentanyl IV. This caused a significant decrease in heart rate (HR) (P less than 0.001), mean arterial blood pressure (MAP) (P less than 0.001), and plasma concentrations of norepinephrine (NE) (P less than 0.002). Then, ventilation was decreased to produce a PaCO2 of 60 mmHg; this was accompanied by a significant elevation in plasma level of both epinephrine (EPI) (P less than 0.02) and NE (P less than 0.001). Administration of 20 micrograms.kg-1 NX to six dogs resulted in immediate increases in HR (P less than 0.01) and MAP (P less than 0.01), and a further rise in CA levels to greater than pre-fentanyl baseline values. In six other dogs, NBPH (0.3 mg.kg-1) caused increases in HR (P less than 0.001) and MAP (P less than 0.001) only, and the MAP rise was significantly less than that seen in the NX group (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C A Mills
- Department of Anesthesiology, University of California, Los Angeles
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Liu MD. [Nearly total excision of skin graft over the brain surface and repair of the skull defect]. Zhonghua Wai Ke Za Zhi 1982; 20:488. [PMID: 6759074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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