Descending necrotizing mediastinitis caused by Streptococcus constellatus: A case report and review of the literature.

RATIONALE: Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here, we shared a successful diagnosis and treatment case of DNM that originates from oral to neck and mediastinum caused by Streptococcus constellatus (S constellatus). S constellatus is a clinically uncommon gram-positive coccus and is known for its ability to form abscesses. Timely surgical drainage and the correct use of antibiotics are key to successful treatment. PATIENT CONCERNS: A 53-year-old male admitted to hospital with painful swelling of the right cheek, persistent oral pus and moderate fever lasting 1 week, followed by rapid development of a mediastinal abscess. DIAGNOSES: He was diagnosed with DNM caused by S constellatus. INTERVENTIONS: On the evening of admission, an emergency tracheotomy and thoracoscopic exploration and drainage of the right mediastinum, floor of the mouth, parapharynx and neck abscess were performed. Antibiotics were administered immediately. OUTCOMES: At 28 days post-operatively, the abscess was absorbed, bilateral lung exudate decreased and the patient temperature, aspartate transaminase, alanine transaminase, bilirubin and platelets returned to normal. The patient was discharged after completing 4 weeks of antibiotic therapy. Follow-up at 3 months after discharge revealed no recurrence of the abscess. LESSONS: Early surgical drainage and antibiotics treatment are important in mediastinal abscesses and infectious shock due to Streptococcus asteroids.

Impact of Cluster Nursing on Nursing on VAS Score and Urinary Function of Patients after Percutaneous Nephrolithotomy with Pneumatic Lithotripsy (PCNL).

Objective: To explore the effects of cluster nursing on VAS score and urinary system function of patients after percutaneous nephrolithotomy with pneumatic lithotripsy (PCNL). Methods: November 2019-January 2019, 114 patients with PCNL who received treatment in our hospital were selected and randomly divided into two groups: the control group and the study group. The study group received cluster nursing, and the control group received routine nursing. Compare the Barthel index (BI), between two groups, SAS score, complications rate, surgical outcomes, pain scores, quality of life scores, knowledge awareness rate, and satisfaction rate were compared. Results: There were no significant variations in Bi and SAS scores before the nursing (P > 0.05). The BI ratings were clearly higher after nursing, whereas the SAS and pain levels were considerably lower, however, the research group altered more dramatically (P0.05). The study group's incidence of complications was lower (P0.05) than the control group's; the study group's hospitalization cost was lower, and the hospitalization and lower bed activity were shorter (P0.05); after the nursing, the organised quality score was significantly higher in both groups, but the research group changed more dramatically (P0.05). Compared with the control group, the knowledge of the research team was higher (P < 0.05); after the nursing, both group satisfaction scores were obviously high, but the study group changes more significantly (P < 0.05). Conclusion: After PCNL treatment, the patient receives cluster therapy, improving the patient's anxiety, reducing the degree of pain, and improving the quality of life in patients, and the patient satisfaction is high. Therefore, cluster nursing is worthy of extensive application in the postoperative care of patients with PCNL.

Interface Effects on He Ion Irradiation in Nanostructured Materials.

In advanced fission and fusion reactors, structural materials suffer from high dose irradiation by energetic particles and are subject to severe microstructure damage. He atoms, as a byproduct of the (n, α) transmutation reaction, could accumulate to form deleterious cavities, which accelerate radiation-induced embrittlement, swelling and surface deterioration, ultimately degrade the service lifetime of reactor materials. Extensive studies have been performed to explore the strategies that can mitigate He ion irradiation damage. Recently, nanostructured materials have received broad attention because they contain abundant interfaces that are efficient sinks for radiation-induced defects. In this review, we summarize and analyze the current understandings on interface effects on He ion irradiation in nanostructured materials. Some key challenges and research directions are highlighted for studying the interface effects on radiation damage in nanostructured materials.