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Vibrio vulnificus is a facultative anaerobic, alkalophilic, halophilic, mesophilic, Gram-negative bacterium that can cause severe wound infection, sepsis and diarrhea. This paper reported a case of 85-year-old male patient infected with Vibrio vulnificus due to being stabbed by a sea shrimp. This patient also had diabetes with a long history of alcoholism. Due to bacterial pathogenicity and the patient's underlying diseases, his condition deteriorated rapidly. Based on the rapid diagnosis of Vibrio vulnificus using the next-generation sequencing（NGS）technology and blood culture method, as well as the selection of the most effective antibiotics via drug sensitivity test, this patient underwent precise antimicrobial treatment, thorough debridement and drainage within the shortest possible time, and thus the prognosis of this patient was greatly improved. In this paper, we have systematically explored the epidemiology, clinical features, diagnosis and treatment of Vibrio vulnificus infection, thus providing a practical reference for the clinicians to quickly identify and treat possible Vibrio vulnificus infection in diabetic patients after contacting with sea water or seafood.

Aim To present the management of a patient who developed a fistula from a uretero-ileostomy anastomosis of the ileal conduit by applying intra-conduit negative pressure through a dual tube. Case report The patient was a 73-year-old man diagnosed with bladder cancer who underwent a radical cystectomy and formation of an ileal conduit in our centre. A fistula occurred in the ileal conduit less than 1 week after the surgery. Urine leaked continuously into the pelvic cavity which put the patient at risk of fluid and electrolyte imbalances. A further operation to suture the fistula to contain the leakage was suggested. To save the patient from a further operation, intra-conduit negative pressure through a dual tube was attempted to assist with management of the fistula. This conservative treatment promoted successful closure of the fistula. Method It is clinically challenging to manage a urinary fistula associated with an ileal conduit in a conservative way. This is because the fistula is deep within the body cavity and it is almost impossible for the fistula to heal spontaneously. The literature reveals previous conservative treatment has been mostly unsuccessful. Surgical suturing of the fistula is the most used method but is not always an ideal choice. By applying intra-conduit negative pressure through a dual tube system to the ileal conduit, the aim was to facilitate closure of the fistula. Conclusion In this case report the application of intra-conduit negative pressure through a dual tube to contain a fistula from a uretero-ileostomy anastomosis of an ileal conduit was found to be safe and effective. This method of conservative treatment is worth promoting. [ABSTRACT FROM AUTHOR]

This case study describes the nursing management of one case of irritant contact dermatitis from faecal fluid around the peristomal skin of a patient with an ileostomy who presented to the outpatient department 1 month postoperatively. This postoperative complication occurred as a result of the stoma being located within wrinkles in the abdomen, causing the appliance to leak and skin ulceration to develop, which prevented firm adherence of the appliance base plate to the peristomal skin. Furthermore, the patient was very anxious as a result of these complications. In this patient's case, the initial goals were to assess and address the peristomal skin complications, provide an appliance with convexity that could be fixed with a belt to stabilise the appliance as early as possible, and finally commence strengthening psychological counselling and dietary guidance for the patient and her family. These nursing interventions were found to reduce the incidence of faecal dermatitis complications around the stoma, improve the patient's quality of life and thus worth applying. [ABSTRACT FROM AUTHOR]

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet count which can cause fatal hemorrhage. ITP patients with antiplatelet glycoprotein (GP) Ib-IX autoantibodies appear refractory to conventional treatments, and the mechanism remains elusive. Here we show that the platelets undergo apoptosis in ITP patients with anti-GPIbα autoantibodies. Consistent with these findings, the anti-GPIbα monoclonal antibodies AN51 and SZ2 induce platelet apoptosis in vitro. We demonstrate that anti-GPIbα antibody binding activates Akt, which elicits platelet apoptosis through activation of phosphodiesterase (PDE3A) and PDE3A-mediated PKA inhibition. Genetic ablation or chemical inhibition of Akt or blocking of Akt signaling abolishes anti-GPIbα antibody-induced platelet apoptosis. We further demonstrate that the antibody-bound platelets are removed in vivo through an apoptosis-dependent manner. Phosphatidylserine (PS) exposure on apoptotic platelets results in phagocytosis of platelets by macrophages in the liver. Notably, inhibition or genetic ablation of Akt or Akt-regulated apoptotic signaling or blockage of PS exposure protects the platelets from clearance. Therefore, our findings reveal pathogenic mechanisms of ITP with anti-GPIbα autoantibodies and, more importantly, suggest therapeutic strategies for thrombocytopenia caused by autoantibodies or other pathogenic factors. [ABSTRACT FROM AUTHOR]