Accuracy of intercellular adhesion molecule-1 for diagnosing sepsis: A systematic review and meta-analysis protocol.

BACKGROUND: Sepsis is a complex and life-threatening systemic disease. A positive blood culture is the criterion standard of diagnosis for sepsis; however, it does not produce results for 24 to 72 hours. Besides, the clinical manifestations of sepsis are variable and nonspecific. Therefore, a new diagnostic biomarker for diagnosis of sepsis should be developed. The present study aims to assess the diagnostic value of intercellular adhesion molecule-1 (ICAM-1) in individuals with sepsis. METHODS: The literature will be searched in PubMed, EMBASE, the Cochrane Library, and Web of Science databases from the inception of each database up to June 2019. The methodological quality of eligible study will be assessed by Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). Stata 15.1 software (version 15.1, Stata Corporation) will be used to calculate the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, pre-test probability, post-test probability, and summary receiver-operating characteristic curve for diagnostic value of ICAM-1. The I statistic will be used to test heterogeneity. Subgroup analysis will be used to explore the source of inconsistency. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system will be used to assess the certainty of evidence. This study will be conducted fully following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of diagnostic test accuracy. RESULTS AND CONCLUSIONS: Our study will detect the potential of ICAM-1 for diagnosing the patients with sepsis and the results will be submitted to a peer-reviewed journal. DISCUSSION: The evidence will indicate that ICAM-1 is a valuable biomarker for detecting sepsis. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.

[The design and transposition principles of expanded flap for treatment of cheek skin-soft tissue defect].

OBJECTIVE: To explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps. METHODS: According to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps, rotation-advanced skin flaps or transposition skin flaps to repair the defect. In this group of 269 cases, the defects were secondary to hemangioma, various scars, nevus or nevus excision. RESULTS: In all 269 cheek defects, 305 expanded flaps were developed which included 145 rotation-advanced flaps, 121 advanced skin flaps and 39 transposition skin flaps. 52 of them generated complications, including blood circulation disorder of the distal part of flaps, hematoma, infection, injection, lower eyelid ectropion, expander extrusion and capsule contracture. Mostly, these complications didn't affect the final results. CONCLUSIONS: The principles presented in this article are the guidelines to treat the skin-soft tissue defect of check with tissue expansion. The satisfied results come from the reasonable flap designs.