A study on the safety and efficacy of endoscopic thyroidectomy via axillary approach for the treatment of thyroid cancer.

This study aims to evaluate the safety and efficacy of endoscopic thyroid cancer treatment using an axillary approach. Participants were allocated into 2 groups: one undergoing transaxillary endoscopic surgery and the other, traditional open surgery. We compared intraoperative and postoperative conditions, focusing on parameters such as intraoperative blood loss, duration of surgery, length of postoperative hospitalization, volume of postoperative drainage, number of lymph nodes cleared in the central region, neck pain scores, neck injury indices, cosmetic satisfaction, postoperative complications, and total hospitalization duration. Patients in the endoscopic treatment (ET) group experienced longer surgical times, less intraoperative bleeding, and increased postoperative drainage. These indicators showed significant differences between the groups (P < .05). For the group undergoing endoscopic surgery via the axillary approach, there was a lower neck pain score on the third postoperative day and higher cosmetic satisfaction at 3 months. However, there were no significant differences between the groups in terms of the number of lymph nodes cleared in the central area, and the incidence of complications such as difficulty breathing, difficulty swallowing, hoarseness, and subcutaneous hematoma (P > .05). The axillary approach endoscopic surgery group also showed significantly prolonged surgery times and postoperative hospital stays, with a significant increase in postoperative drainage fluid (P < .05). Concurrently, this technique involved smaller surgical incisions and effectively concealed scars in the armpit, leading to better outcomes in terms of intraoperative bleeding, neck pain scores, and postoperative cosmetic satisfaction. Non-inflatable ET via the axillary approach for treating thyroid cancer demonstrates promising efficacy and safety. It offers additional benefits of minimal pain and enhanced cosmetic outcomes, making it a viable option for clinical adoption and application.

The Hippo-YAP Signaling Pathway in Osteoarthritis and Rheumatoid Arthritis.

Arthritis is the most prevalent joint disease and is characterized by articular cartilage degradation, synovial inflammation, and changes in periarticular and subchondral bone. Recent studies have reported that Yes-associated protein (YAP) and the transcriptional coactivator with PDZ-binding motif (TAZ) have significant effects on the proliferation, migration, and survival of chondrocytes and fibroblast-like synovial cells (FLSs). YAP/TAZ signaling pathway, as well as the related Hippo-YAP signaling pathway, are responsible for the condition of cells and articular cartilage in joints. They are tightly regulated to maintain metabolism in chondrocytes and FLSs because abnormal expression may result in cartilage damage. However, the roles and mechanisms of the Hippo-YAP pathway in arthritis remain largely unknown. This review summarizes the roles and key functions of YAP/TAZ and the Hippo-YAP signaling pathway in FLSs and chondrocytes for the induction of proliferation, migration, survival, and differentiation in rheumatoid arthritis (RA) and osteoarthritis (OA) research. We also discuss the therapeutic strategies involving YAP/TAZ and the related Hippo-YAP signaling pathway involved in OA.

Efficacy of a modified needle grasper for single-port laparoscopic hernia repair in children: a propensity score-matched analysis.

PURPOSE: The advantage of using the single-port technique over the conventional two-port approach is uncertain. This study aimed to evaluate the outcomes of a single-port laparoscopic percutaneous extraperitoneal closure (SLPEC) using a modified needle grasper in children and compare the results to those of two-port laparoscopic percutaneous extraperitoneal closure (TLPEC). METHODS: A retrospective cohort analysis of SLPEC and TLPEC surgery from February 2016 to June 2021 was conducted at our institution. Pediatric patients underwent SLPEC using the modified needle grasper to complete the high ligation of the hernia sac, while operations in the conventional two-port group only used regular laparoscopic instruments. A 1:1 propensity score matching (PSM) analysis was used to reduce selection bias. RESULTS: Of 1320 patients, 1169 were included in the single-port/two-port crude evaluation, with 930 in the PSM cohort (465 patients/arm). Among 1:1 matched patients, the operation time for single-port patients vs. two-port patients were 11.28 ± 3.98 vs. 15.47 ± 4.54 min for unilateral repair and 16.86 ± 4.59 vs. 20.40 ± 4.29 min for bilateral repair (p < .05). Cosmetic results did not differ between the SLPEC and TLPEC groups (0% vs. 0.7%, p = 0.249). The recurrence rates were comparable between the two groups (0.6% vs. 1.1%, p = 0.725). Moreover, the differences in surgical site infection (SSI), testicular atrophy, open conversion and postoperative hydrocele occurrence were insignificant between the two groups. CONCLUSIONS: In this cohort study, the modified needle grasper is a safe and feasible instrument for SLPEC, and SLPEC using the needle grasper has a shorter operation time than TLPEC.

miR-5581 Contributes to Osteoarthritis by Targeting NRF1 to Disturb the Proliferation and Functions of Chondrocytes.

Chondrocyte survival is critical for the preservation of a healthy cartilage matrix. Limited chondrocyte function and survival can result in articular cartilage failure, thereby contributing to osteoarthritis (OA). In this study, miR-5581 was significantly up-regulated in OA samples, and miR-5581-associated genes were enriched in Kras signaling. miR-5581 up-regulation was observed in clinical OA samples and IL-1ß-stimulated chondrocytes. miR-5581 inhibition attenuated IL-1ß-induced chondrocyte proliferation suppression, extracellular matrix (ECM) synthesis suppression and degradation, and IL-1ß-suppressed Kras signaling activation. miR-5581 was targeted to inhibit NRF1. In IL-1ß-treated chondrocytes, NRF1 overexpression attenuated IL-1ß-induced cellular damage and partially abolished the effects of miR-5581 overexpression on IL-1ß-stimulated chondrocytes. NRF1 was down-regulated in knee joint cartilage of OA mice. In conclusion, miR-5581, which was up-regulated in OA samples and IL-1ß-stimulated chondrocytes, inhibited chondrocyte proliferation and ECM synthesis, and promoted ECM degradation through targeting NRF1, whereby Kras signaling might be involved.

An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review.

Acute septic arthritis is on the rise among all patients. Acute septic arthritis must be extensively assessed, identified, and treated to prevent fatal consequences. Antimicrobial therapy administered intravenously has long been considered the gold standard for treating acute osteoarticular infections. According to clinical research, parenteral antibiotics for a few days, followed by oral antibiotics, are safe and effective for treating infections without complications. This article focuses on bringing physicians up-to-date on the most recent findings and discussions about the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis. In recent years, the emergence of antibiotic-resistant, particularly aggressive bacterial species has highlighted the need for more research to enhance treatment approaches and develop innovative diagnosis methods and drugs that might combat better in all patients. This article aims to furnish radiologists, orthopaedic surgeons, and other medical practitioners with contemporary insights on the subject matter and foster collaborative efforts to improve patient outcomes. This review represents the initial comprehensive update encompassing patients across all age groups.

The Expression of αvß3 and Osteopontin in Osteoarthritic Knee Cartilage and Their Correlations With Disease Severity and Chondrocyte Senescence.

Osteoarthritis (OA) is the main joint disease associated with aging. Previous studies have confirmed that both osteopontin (OPN) and αvß3 integrin are involved in the progression of knee OA. The purpose of this study was to determine the expression of OPN and αvß3 integrin and chondrocyte senescence levels in OA. Forty-six cartilage tissues from normal and knee OA patients were divided into 4 groups of normal, minor, moderate, and severe lesions based on the Mankin score. Immunohistochemistry and western blotting were used to determine the expression of αvß3, OPN, and senescent-associated-ß-galactosidase (SAß-gal) in articular cartilage. Then, Spearman's correlation was used to analyze the correlations between the Mankin scores and αvß3, OPN and SAß-gal. Pearson correlation analysis was used to analyze the correlations among αvß3, OPN, and SAß-gal. The expression of OPN, αvß3, and SAß-gal in articular cartilage was explored. αvß3, OPN, and SAß-gal proteins were all elevated in OA cartilage, and the correlation coefficient between the Mankin score and the average optical density value of αvß3, OPN, SAß-gal were r =0.60, r =0.75, and r =0.87, respectively, all P <0.001; the correlation between the average optical density value of αvß3 and OPN was r =0.3191, P <0.05; the correlation between αvß3 and SAß-gal was r =0.4955, P <0.001; and the correlation between OPN and SAß-gal was r =0.7821, P <0.001. The correlations among αvß3, OPN, and SAß-gal expression in articular cartilage might be important in OA progression and pathogenesis. Nonetheless, more research is needed to elucidate the exact contribution of αvß3, OPN, and SAß-gal to the degenerative process of OA.

An objective bone conduction verification tool using a piezoelectric thin-film force transducer.

All hearing aid fittings should be validated with appropriate outcome measurements, whereas there is a lack of well-designed objective verification methods for bone conduction (BC) hearing aids, compared to the real-ear measurement for air conduction hearing aids. This study aims to develop a new objective verification method for BC hearing aids by placing a piezoelectric thin-film force transducer between the BC transducer and the stimulation position. The newly proposed method was compared with the ear canal method and the artificial mastoid method through audibility estimation. The audibility estimation adopted the responses from the transducers that correspond to the individual BC hearing thresholds and three different input levels of pink noise. Twenty hearing-impaired (HI) subjects without prior experience with hearing aids were recruited for this study. The measurement and analysis results showed that the force transducer and ear canal methods almost yielded consistent results, while the artificial mastoid method exhibited significant differences from these two methods. The proposed force transducer method showed a lower noise level and was less affected by the sound field signal when compared with other methods. This indicates that it is promising to utilize a piezoelectric thin-film force transducer as an in-situ objective measurement method of BC stimulation.

Interpretable Machine Learning to Optimize Early In-Hospital Mortality Prediction for Elderly Patients with Sepsis: A Discovery Study.

Sepsis-related mortality rates are high among elderly patients, especially those in intensive care units (ICUs). Early prediction of the prognosis of sepsis is critical, as prompt and effective treatment can improve prognosis. Researchers have predicted mortality and the development of sepsis using machine learning algorithms; however, few studies specifically focus on elderly patients with sepsis. This paper proposes a viable model for early prediction of in-hospital mortality among elderly patients diagnosed with sepsis. We extracted patient information from the Medical Information Mart for Intensive Care IV database. We employed several machine learning algorithms to predict the in-hospital mortality of elderly ICU patients with sepsis. The performance of the model was evaluated by using the AUROC and F1 score. Furthermore, the SHAP algorithm was used to explain the model, analyze how the individual features affect the model output, and visualize the Shapley value for a single individual. Our study included 18522 elderly patients, with a mortality of 15.4%. After screening, 59 clinical variables were extracted to develop models. Feature importance analysis showed that age, PO2, RDW, SPO2, WBC, and urine output were significantly related to the in-hospital mortality. According to the results of AUROC (0.871 (95% CI: 0.854-0.888)) and F1 score (0.547 (95% CI: 0.539-0.661)) analyses, the extreme gradient boosting (XGBoost) model outperformed the other models (i.e., LGBM, LR, RF, DT, and KNN). Furthermore, SHAP force analysis illustrated how the constructed model visualized the individualized prediction of death. XGBoost machine learning framework gives good in-hospital mortality prediction of elderly patients with sepsis and can maximize prediction model accuracy. The XGBoost model could be an effective tool to assist doctors in identifying high-risk cases of in-hospital mortality among elderly patients with sepsis. This could be used to create a clinical decision support system in the future.

Osteopontin, a bridge links osteoarthritis and osteoporosis.

Osteoarthritis (OA) is the most prevalent joint disease characterized by degradation of articular cartilage, inflammation, and changes in periarticular and subchondral bone of joints. Osteoporosis (OP) is another systemic skeletal disease characterized by low bone mass and bone mineral density (BMD) accompanied by microarchitectural deterioration in bone tissue and increased bone fragility and fracture risk. Both OA and OP are mainly affected on the elderly people. Recent studies have shown that osteopontin (OPN) plays a vital role in bone metabolism and homeostasis. OPN involves these biological activities through participating in the proliferation, migration, differentiation, and adhesion of several bone-related cells, including chondrocytes, synoviocytes, osteoclasts, osteoblasts, and marrow mesenchymal stem cells (MSCs). OPN has been demonstrated to be closely related to the occurrence and development of many bone-related diseases, such as OA and OP. This review summarizes the role of OPN in regulating inflammation activity and bone metabolism in OA and OP. Furthermore, some drugs that targeted OPN to treat OA and OP are also summarized in the review. However, the complex mechanism of OPN in regulating OA and OP is not fully elucidated, which drives us to explore the depth effect of OPN on these two bone diseases.

Clinical Features of Aortic Dissection in the Emergency Department: A Single-center Experience from South China.

OBJECTIVES: Our goal in this study was to determine 1) whether there are any differences in clinical characteristics between Chinese and Western patients with aortic dissection (AD), and 2) the mortality rate of AD patients in the emergency department (ED) and identify the risk predictors for death. METHODS: We retrospectively analyzed patients who were diagnosed with AD and admitted to our ED between September 1, 2017-August 31, 2020. Data on age, gender, clinical manifestation, medical history, routine blood tests, liver and kidney function, coagulation, myocardial enzymology, and mortality were collected. RESULTS: We enrolled 535 AD patients (422 men and 113 women) with a mean age of 54.7±14.1 years. Type A AD constituted 40% of the total number of AD cases, while type B AD constituted 60%. The proportion of those who were females, 10-92 years, with type A AD, and hypertension in the Chinese population was lower than that in the Western population (P <0.05 for all). Type A AD patients had a higher proportion of acute AD clinical manifestations than did patients with type B AD (P = 0.0084, P <0.05). The mortality rate of type A AD patients (10.75%) was higher than that of type B AD patients (1.87%) (P <0.0001) in the ED. Higher values of white blood cells, neutrophils, high-density lipoprotein, activated partial thromboplastin time, and D-dimer level with worsened hepatic and renal function were found in the deceased group, and multivariate logistic regression revealed that blood urea nitrogen (BUN) levels (P = 0.0031, P <0.05) were significantly associated with death. CONCLUSION: In South China, patients with AD had a mean age of 54.7 years, with 78.88% prevalence in males and 66.92% hypertension rate. Type A AD accounted for 40% of all AD cases, and 10.70% of patients with type A AD died in the ED. Elevated BUN levels may be a risk predictor for death in patients with type A AD.

OPN inhibits autophagy through CD44, integrin and the MAPK pathway in osteoarthritic chondrocytes.

Background: To investigate whether osteopontin (OPN) affects autophagy in human osteoarthritic chondrocytes and determine the roles of CD44, αvß3 integrin and the Mitogen-activated protein kinase (MAPK) pathway in this progress. Methods: First, we compared the autophagy levels in the human osteoarthritis (OA) and normal cartilage, then, we cultured human OA chondrocytes in vitro and treated cells with recombinant human OPN (rhOPN) to determine autophagy changes. Next, the anti-CD44 and anti-CD51/61 monoclonal antibodies (Abs) or isotype IgG were used to determine the possible role of CD44 and αvß3 integrin; subsequently, an inhibitor of the ERK MAPK pathway was used to investigate the role of ERK MAPK. Western blotting was used to measure the Beclin1, LC3 II and MAPK proteins expressions, mRFP-GFP-LC3 confocal imaging and transmission electron microscopy were also used to detect the autophagy levels. Cell Counting Kit-8 (CCK-8) was used to assay the proliferation and activity of chondrocytes. Results: The LC3 protein was greatly decreased in OA cartilage compared to normal cartilage, and OPN suppressed the autophagy activity in chondrocytes in vitro. Blocking experiments with anti-CD44 and anti-CD51/61 Abs indicated that OPN could suppress the expression of LC3II and Beclin1 through αvß3 integrin and CD44. Our results also indicated that the ratio of p-ERK/ERK but not p-P38/P38 and p-JNK/JNK was increased after the rhOPN treatment. The ERK inhibitor inhibited the activity of OPN in the suppression of autophagy, and the CCK-8 results showed that rhOPN could promote chondrocyte proliferation. Conclusion: OPN inhibited chondrocyte autophagy through CD44 and αvß3 integrin receptors and via the ERK MAPK signaling pathway.

Caffeine alleviates acute liver injury by inducing the expression of NEDD4L and deceasing GRP78 level via ubiquitination.

BACKGROUND: Acute liver injury is liver cell injury that occurs rapidly in a short period of time. Caffeine has been shown to maintain hepatoprotective effect with an unclear mechanism. Endoplasmic reticulum stress (ERS) has significant effects in acute liver injury. Induction of GRP78 is a hallmark of ERS. Whether or not caffeine's function is related to GRP78 remains to be explored. METHODS: Acute liver injury model was established by LPS-treated L02 cells and in vivo administration of LPS/D-Gal in mice. Caffeine was pre-treated in L02 cells or mice. Gene levels was determined by real-time PCR and western blot. Cell viability was tested by CCK-8 assay and cell apoptosis was tested by flow cytometry. The interaction of GRP78 and NEDD4L was determined by Pull-down and co-immunoprecipitation (Co-IP) assay. The ubiquitination by NEDD4L on GRP78 was validated by in vitro ubiquitination assay. RESULTS: Caffeine protected liver cells against acute injury induced cell apoptosis and ERS both in vitro and in vivo. Suppression of GRP78 could block the LPS-induced cell apoptosis and ERS. NEDD4L was found to interact with GRP78 and ubiquitinate its lysine of 324 site directly. Caffeine treatment induced the expression of NEDD4L, resulting in the ubiquitination and inhibition of GRP78. CONCLUSION: Caffeine mitigated the acute liver injury by stimulating NEDD4L expression, which inhibited GRP78 expression via ubiquitination at its K324 site. Low dose of caffeine could be a promising therapeutic treatment for acute liver injury.

The Potential Activity of Lingzhi or Reishi Medicinal Mushroom, Ganoderma lucidum (Agaricomycetes), to Alleviate Liver Injury in Adults with Acute Mushroom Poisoning: A Retrospective Study.

In the study, we retrospectively reviewed cases of patients with acute mushroom poisoning admitted to seven hospitals from May 2016 to May 2021. In total, we analyzed 153 acute mushroom poisoning cases. Of these patients, 135 survived and 18 died; no correlation of Ganoderma lucidum treatment with in-hospital mortality was observed (odds ratio = 1.598, P = 0.589). We further analyzed 61 patients who survived with liver injury according to whether they were treated with G. lucidum. Both length of hospital stay and hospitalization expenses in the G. lucidum treatment group were significantly lower than the control, with values of 6.69 ± 3.98 days vs. 9.27 ± 5.30 days (t = 2.174, P = 0.034) and 16,336.49 ± 12,615.76 CNY vs. 27,540.08 ± 23,709.57 CNY (t = 2.382, P = 0.020), respectively. Moreover, cases with a blood purification treatment time > 48 h of the G. lucidum group were significantly less than that of the control (30% vs. 69.23%; χ2 = 4.891, P = 0.027). As a result, G. lucidum seems to be a beneficial treatment in acute mushroom poisoning with liver injury.

Risk Factors and Outcome Variables of Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients.

PURPOSE: This study's goal was to explore risk factors affecting short-term prognosis of cardiorenal syndrome type 1 (CRS1) in acute myocardial infarction (AMI) patients. METHODS: In this retrospective analysis of CRS1 in AMI patients hospitalized from January 2011 to December 2014, the patients were classified into deceased or survivor groups. Clinical data, including demographics, laboratory results, and 28-day outcomes, were collected. RESULTS: The incidence rate of CRS1 in AMI patients was 15.2% (274 in 1801). Ultimately, 88 patients were enrolled and 25 (28.4%) were classified into the deceased group, while 63 were classified into the survivor group. There were statistically significant differences between the groups for hypertension, mechanical ventilation, KIDGO stage, NT-proBNP, Hb, ALB, PCI, decreased LVEF, 7th-day SCr value, and the highest SCr value recorded within 7 days (all P < 0.05). Multivariate logistic regression showed that the following factors were significantly related to whether a patient died: requiring mechanical ventilation, increased NT-proBNP levels and 7th-day SCr values, and decreased LVEFs. The APACHE II, SOFA, and SASP II scores on the 7th day were significantly higher in the deceased group (all P < 0.05). The accuracy of APACHE II, SOFA, and SASP II scores on the 7th day for predicting death were 84.1%, 78.4% and 79.5%, respectively. The AUC of 7th-day APACHE II, SOFA, and SASP II scores was 0.844, 0.803, and 0.827, respectively, with no statistically significant differences between the three scores (P > 0.05). CONCLUSION: The mortality rate of CRS1 in AMI patients was 28.4% (25 in 88) within 28 days. Mechanical ventilation, increased NT-proBNP levels, the 7th-day SCr value, and decreased LVEF were related to death in AMI patients with CRS1. APACHE II, SOFA, and SAPS II scores on the 7th day were satisfactorily accurate in predicting death within 28 days.

The Clinical Effects of Febuxostat Alone or Combined with Arthroscopic Surgery for Gout: A Single-Center Retrospective Study.

PURPOSE: The purpose of the study was to retrospectively analyze the effects of febuxostat combined with arthroscopic debridement of monosodium urate crystal deposition and febuxostat treatment alone on uric acid levels and acute flares in gout patients. PATIENTS AND METHODS: We retrospectively analyzed gout patients who were treated from February 2016 to December 2020. Patients were divided into a control group (febuxostat treatment alone) or a combined group (febuxostat combined with arthroscopic surgery). We recorded and analyzed clinical data including age, sex, body mass index, comorbidities, lesion affected joints, acute flare times, medications history, febuxostat side effects, arthroscopic complications, and serum creatinine and uric acid levels changes. RESULTS: There were 80 patients in the control group and 93 patients in the combined group. At the beginning of treatment, the combined group had significantly higher disease severity (higher serum uric acid levels and more acute gout flare times). Arthroscopy was performed in 61 knees and 38 ankles, and 86 joints showed crystals deposition. Compared with baseline, follow-up results showed that serum creatinine significantly decreased in the combined group, and serum uric acid and acute gout flare times significantly decreased in both groups (all p < 0.05). In the comparison between the two groups at the follow-up endpoint, acute gout flare times did not differ significantly (p > 0.05), however, serum creatinine and uric acid levels were lower in the combined group compared with those in the control group (ps < 0.05). CONCLUSION: Febuxostat combined with arthroscopic debridement of monosodium urate crystal deposition or tophi had a superior effect on lowering uric acid levels and acute flare times in gout patients than did febuxostat alone.

Clinical Characteristics of Adult Hemophagocytic Lymphohistiocytosis in the Emergency Department.

PURPOSE: To determine the clinical manifestations and results of adult hemophagocytic lymphohistiocytosis (HLH) patients in our emergency department. METHODS: We retrospectively evaluated patients with HLH from 1 April 2018 to 31 December 2020. The clinical data of these patients (basic information, symptoms, vital signs, laboratory results, HLH diagnostic criteria, H Score, main treatments, outcomes) were collected. RESULTS: Thirty-three patients (23 males and 10 females; 40.55±18.78 years) with 34 clinical episodes (one male had two clinical episodes and died during the second episode) were enrolled. Twenty-five patients were placed in a "survivor" group, and nine patients were categorized into a "deceased" group. Fever, splenomegaly, hemoglobin <90 g/L and platelet count <100×109/L most commonly met the diagnostic standard for HLH. The H Score results in the survival group and deceased group was 212.4±37.18 and 252.1±40.95, respectively. Viral infection was the most common reason for HLH, followed by immune-system disease and cancer. Laboratory tests showed that deceased-group patients had multiple-organ dysfunction. Multivariate logistic regression showed that the lactate dehydrogenase (lactate dehydrogenase) level (P = 0.039; odds ratio, 0.999) was significantly related to death. CONCLUSION: In the emergency department, HLH should be considered for critically ill patients with fever, splenomegaly, low hemoglobin and low platelet count. The H Score might be useful to diagnose HLH quickly. In our study, 26.47% of HLH patients died in the emergency department, and patients with a significantly increased lactate dehydrogenase level had a markedly increased risk of death.

Clinical Features and Etiology of Musculoskeletal Infection with or without Sepsis in the Emergency Department.

BACKGROUND: Musculoskeletal infection (MSKI) is a common reason to seek medical care in the emergency department (ED). We aimed to determine the clinical characteristics and etiology of patients with MSKI in our ED, the characteristics of MSKI with sepsis, and the predictors of death in sepsis patients. METHODS: The study retrospectively analyzed patients with MSKI from April 1, 2017, to March 31, 2021. The patients were divided into non-sepsis and sepsis groups. Clinical data of these patients including their basic information, laboratory results, diagnostic results, and outcomes were collected. Statistical analysis was carried out using GraphPad Prism 5. RESULTS: In all, 106 patients (70 male, 36 female) were enrolled in this study: 43 MSKI patients with sepsis and 63 MSKI patients without sepsis. Five patients with sepsis died. The patients' age and sex ratio were no significantly different between the sepsis and non-sepsis groups. In the sepsis group, the ratio of rheumatic diseases, diabetes, coronary heart disease, and deep vein thrombosis was significantly different than that in the non-sepsis group (all p<0.05). Fifty-six patients (54.37%) had positive etiology results. Staphylococcus, streptococcus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli were the most common bacteria found in both groups, but sepsis patients had more Candida albicans infections than non-sepsis patients (p=0.0331, p<0.05). The five patients who died in the sepsis group had higher serum levels of creatinine and procalcitonin (PCT). Multivariate logistic regression analyses showed that PCT (p=0.026; odds ratio, 1.038) was significantly related to mortality. CONCLUSION: In MSKI patients, rheumatic diseases, diabetes, coronary heart disease, and deep vein thrombosis are the risk factors for sepsis. Staphylococcus, streptococcus, K. pneumoniae, P. aeruginosa, and E. coli were the most common bacteria in MSKI patients, while MSKI patients with sepsis had more C. albicans infections. Elevated PCT was significantly related to death in sepsis patients.