Meningitis and sepsis caused by Streptococcus suis in an elderly woman: A CARE-compliant case report.

RATIONALE: Streptococcus suis (S suis)-associated infections are uncommon but life-threatening diseases. The clinical manifestations vary from general symptoms of bacterial infection to fatal meningitis. The clinical manifestation and routine diagnostic testing is not specific enough to obtain well-time diagnosis. PATIENT CONCERNS AND DIAGNOSIS: We report a case of meningitis and sepsis caused by S suis infection. A 70-year-old woman presented to our emergency department with generalized pain. After hospital admission, her condition rapidly deteriorated to fever, intracranial hypertension, and disturbance of consciousness. Examination of the blood and cerebrospinal fluid with metagenomic next-generation sequencing and bacterial cultures revealed S suis infection. INTERVENTIONS AND OUTCOMES: After anti-infection therapy with meropenem and vancomycin, the patient recovered and was discharged from the hospital with no residual effects. LESSONS: Human infections with S suis are extremely rare. If clinicians encounter a patient with fever, disturbance of consciousness, and intracranial hypertension, especially those who have been exposed to raw pork, S suis infection should be considered. Metagenomic next-generation sequencing can be a useful adjunct for the rapid diagnosis of S suis infection and aid in the planning of clinical treatment. Meanwhile, public health awareness is necessary to limit the risk of S suis infection.

The Impact of COVID-19 Pandemic Lockdown on Emergency Department Visits in a Tertiary Hospital.

Purpose: This study aimed to highlight the impact of the COVID-19 pandemic lockdown on emergency department (ED) visits of non-COVID-19 patients in a tertiary hospital and evaluate protocol development during this period. Patients and Methods: Clinical data of patients who visited the ED of Foshan Hospital of Traditional Chinese Medicine during the first-level response in Foshan, Guangdong province in 2020 (from January 23 to February 24) and the same period in 2019 and 2021 were collected. A retrospective cross-sectional analysis was performed to understand the characteristics of critically ill patients and compare the proportion of hospitalizations, deaths, and emergency ambulance calls (EACs). Results: The number of patients presenting to the ED was significantly decreased, with a 37.75% reduction in 2020 (6196) compared to the same period in 2019 (9954). A rise in patient ED presentations was observed in the same period in 2021 (10,503). This decline was mostly in the 15-45 age group. In 2019, 2020, and 2021, critically ill patients treated by the ED totaled 568 (5.706%), 339 (5.495%), and 590 (5.617%), respectively. Compared to the same period in 2019 and 2021, the proportion of critically ill patients with respiratory system involvement, severe trauma, and poisoning decreased most significantly in 2020 (P<0.05). In contrast, the rates of EACs, hospitalizations, and deaths increased significantly (P<0.05). Conclusion: The number of ED visits to hospitals was decreased during the 2020 lockdown, while the rates of EACs, hospitalizations, and deaths increased significantly though there were no documented COVID-19 cases. Optimizing emergency medical resources and ensuring the safety of healthcare providers and patients were essential to provide efficient emergency diagnosis and treatment during the lockdown.

Impact of lockdown policies during the COVID-19 outbreak on a trauma center of a tertiary hospital in China.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a major and costly public health emergency. AIM: To investigate the impact of China's lockdown policies during the COVID-19 outbreak on the level I trauma center of a tertiary comprehensive hospital of Traditional Chinese Medicine. METHODS: All patients admitted to our trauma center during a lockdown in 2020 and the same period in 2019 were enrolled. We collected data on demographics, daily visits, injury type, injury mechanism, injury severity score, and patient management for comparative analysis. RESULTS: The total number of patients in the trauma center of our hospital decreased by 50.38% during the COVID-19 Lockdown in 2020 compared to the same period in 2019. The average number of trauma visits per day in 2019 was 47.94, compared to 23.79 in 2020. Comparing the patients' demographic data, loss of employment was the most predominate characteristic in 2020 compared to 2019, while there was no significant difference in gender, age, and marital status between both periods. During the lockdown period, the proportion of traffic accident-related injuries, injuries due to falls greater than 1.5 m, and mechanical injuries decreased significantly, whereas the proportion of injuries caused by falls less than 1.5 m, cuts, assault, bites, and suicidal tendencies and other injuries increased relatively. In addition, the proportion of patients with minor injuries increased and serious injuries decreased during the lockdown. The hospitalization rate increased significantly, and there was no significant difference in emergency surgery and death rates. CONCLUSION: The lockdown policies during the COVID-19 outbreak significantly altered the number and mechanism of traumatic events in our hospital, which can be monitored regularly. Our results suggest that mandatory public health prevention and control measures by the government can reduce the incidence of traumatic events and the severity of traumatic injuries. Emergency surgery and mortality rates remain high, increased because of factors such as family injury and penetrating injury, and hospitalization rates have increased significantly. Therefore, our trauma center still needs to be fully staffed. Finally, from the perspective of the injury mechanism, indoor trauma is a major risk during a lockdown, and it is particularly important to develop prevention strategies for such trauma to reduce the medical burden of the next catastrophic epidemic.

Effect of Pressure Stresses on Cell Viability and Protein Expression of Fascial Fibroblast.

BACKGROUND: Many physical and mechanical phenomena occur during the acupuncture and tuina regime, and pressure is one of the most basic mechanical phenomena. OBJECTIVES: To understand the cellular bio-physical mechanism of basic mechanical stimulation via acupuncture and tuina by investigating the effect of different in vitro pressures on the cell viability and protein expression differences that originate from the facial fibroblasts around the meridians. MATERIALS AND METHODS: In vitro culture of the facial fibroblasts around the meridians was conducted using different pressures to perform single and multiple stimulation(s) on the cells. Thus, the changes in the fibroblast cell viability (cell viability rate and diameter) were tested, and changes in the fibroblast protein expression were observed. RESULTS: We found that the pressure stimulation may excite the fascial fibroblast viability at the acupoint and increase cell viability. Two interactive factors are involved: the pressure intensity and the number of pressure stimulations. In addition, we found that all three pressures lead to significant regulation effects on the protein expression of the meridian-related fascial tissue fibroblasts, and clustering analysis revealed that 100 kPa pressure stimulation exhibits the most evident effect on the protein expression which is the pressure inducing the most differentiated protein expression. CONCLUSIONS: During the in vitro pressure process, the difference in the cell viability rate and protein expression of the facial fibroblasts around the meridians may (from a cell mechanics' point-of-view) reveal the cytobiological and therapeutic mechanism of the basic mechanical stimulation via acupuncture and tuina on the facial fibroblasts around the meridians.