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Kabir MF, Yin KN, Jeffree MS, Ahmedy FB, Zainudin MF, Htwe O, Jahan S, Hossain MZ, Hossain KMA, Hossain T, Jahid IK, Chakrovorty SK. Clinical presentation of post-COVID pain and its impact on quality of life in long COVID patients: a cross-sectional household survey of SARS-CoV-2 cases in Bangladesh. BMC Infect Dis 2024; 24:375. [PMID: 38575878 PMCID: PMC10993502 DOI: 10.1186/s12879-024-09267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden. PURPOSE The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS. METHODS This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00). RESULTS The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4-3.8), chest pain 2.4% (95% CI; 1.8-3.1), joint pain 2.8% (95% CI; 2.2-2.3), headache 3.1% (95% CI; 2.4-3.8), and abdominal pain 0.3% (95% CI; 0.01-0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF (P < 0.001) compared to asymptomatic cases. CONCLUSION Three out of ten people with long COVID experience painful symptoms, which can significantly reduce their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease.
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Affiliation(s)
- Md Feroz Kabir
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Khin Nyein Yin
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia.
| | - Mohammad Saffree Jeffree
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Fatimah Binti Ahmedy
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
| | | | - Ohnmar Htwe
- Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sharmila Jahan
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Md Zahid Hossain
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - K M Amran Hossain
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Tofajjal Hossain
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Iqbal Kabir Jahid
- Department of Microbiology, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Sonjit Kumar Chakrovorty
- Department of Microbiology, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
- Dhaka College of Physiotherapy, under the Faculty of Medicine, University of Dhaka, Dhaka, Bangladesh
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Than WW, Hossain Parash MT, Binti Abdul Majeed N, Nyein Yin K, Pg Baharuddin DMB, Fahmy EHAM, Mohd Daud MNB. A Case-Control Study on Factors Associated With Secondary Amenorrhea Among the Medical Students of Universiti Malaysia Sabah. Cureus 2023; 15:e47625. [PMID: 38022313 PMCID: PMC10667791 DOI: 10.7759/cureus.47625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND AND AIM This study aimed to evaluate the association between body mass index (BMI), anxiety, stress, depression, hormones, and secondary amenorrhea among female medical students at Universiti Malaysia Sabah (UMS). METHODS In this case-control study, UMS undergraduate female medical students aged 19-25 years who did not menstruate in the last three months (with a previous history of a regular menstrual cycle) or six months (with a history of irregular menstruation) were included as cases (40 students), and students with similar criteria but no menstrual irregularities were recruited in the study as controls (40 students). The study was conducted at Polyclinic UMS from January 1, 2021, until December 31, 2022. The chi-squared test and odd ratio examined the association of the above-mentioned factors with the secondary amenorrhea. A p-value less than 0.05 was considered significant, and an odds ratio if the confidence interval did not contain one was considered significant. RESULT Both the groups had a similar frequency of different BMI grades. The cases exhibited significantly higher levels of depression, anxiety, and stress than the controls. Again, the cases demonstrated higher estradiol (E2), testosterone, and thyroid-stimulating hormone (TSH) levels and lower levels of luteinizing hormone (LH) than those with regular menstruation. The research also revealed that a one-unit decrease in follicle-stimulating hormone (FSH) levels corresponds to a threefold increase in the risk of experiencing secondary amenorrhea, while the risk escalates to fourfold for LH. Moreover, E2, testosterone, and TSH levels exhibited protective effects on secondary amenorrhea. CONCLUSION Anxiety, serum LH, and FSH were significantly associated with secondary amenorrhea. Future studies should address the diurnal variation of the hormones and consider the participants' circumstances to get a proper effect of hormonal influence and stress.
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Affiliation(s)
- Win Win Than
- Obstetrics and Gynecology, Faculty of Medicine, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong, MYS
| | - M Tanveer Hossain Parash
- Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | | | - Khin Nyein Yin
- Rehabilitation Medicine, Hospital Universiti Malaysia, Kota Kinabalu, MYS
- Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | | | - Ehab Helmy Abdel Malek Fahmy
- Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Mohd Nazri Bin Mohd Daud
- Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
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Kabir MF, Yin KN, Jeffree MS, Ahmedy FB, Jahan S, Islam MW, Jahid IK, Sivan M, Chakrovorty SK, Hossain KMA. Profile of long COVID symptoms needing rehabilitation: a cross-sectional household survey of 12,925 SARS-CoV-2 cases between July and December 2021 in Bangladesh. Arch Public Health 2023; 81:132. [PMID: 37461092 PMCID: PMC10351147 DOI: 10.1186/s13690-023-01140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND AND AIMS It is important to determine the profile of long COVID (LC) symptoms within the scope of rehabilitation in Bangladesh. This study's objective was to estimate the newly experienced long COVID symptoms needing rehabilitation by determining the prevalence and spectrum of impairments due to LC in Bangladesh. METHODS A Cross-sectional household survey of 12,925 COVID-19 patients confirmed by RT-PCR from 24 testing facilities in Bangladesh. LC was diagnosed according to WHO working group definition. COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) was used to determine the symptom responses, symptom severity, new long COVID symptoms, and scope of rehabilitation. RESULTS The population proportion of LC symptoms requiring rehabilitation interventions are 0.22 [95% CI, 0.20-0.24] in Bangladeshi people diagnosed with SARS-CoV-2. Among them, 0.08 [95% CI, 0.07-0.09] had mild, 0.07 [95% CI, 0.06-0.09] had moderate, and 0.05 [95% CI, 0.04-0.06] had severe long COVID symptoms (LCS). There was a significant positive correlation between LCS and functional disabilities (r = 0.889, p < 0.001), while a negative correlation was observed between the severity of symptoms and overall health (r=-0.658, p < 0.001). In comparison to the pre-COVID status, 17 new LCS were observed and the increase in the scope of rehabilitation intervention among LCS ranged between 0.01 [95% CI, 0.001-0.01] and 0.21 [95% CI, 0.19-0.22]. In Bangladesh, 59% (n = 334) of the LC cases are out of reach for any rehabilitation interventions. CONCLUSION Nearly one-fourth of Bangladeshi Post-COVID-19 have long COVID (LC). Seventeen symptoms (LCS) were observed and more than half of the populations having long COVID are out of reach of any rehabilitation facilities.
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Affiliation(s)
- Md Feroz Kabir
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, 88400, Malaysia
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Khin Nyein Yin
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, 88400, Malaysia.
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, 88400, Malaysia
| | - Fatimah Binti Ahmedy
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, 88400, Malaysia
| | - Sharmila Jahan
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Md Waliul Islam
- Department of Physiotherapy, Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh
| | - Iqbal Kabir Jahid
- Department of Microbiology, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Sonjit Kumar Chakrovorty
- Department of Microbiology, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
| | - K M Amran Hossain
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
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Dong Y, Yin KN, Pi YL, Shen CA, Li F, Sun TJ, Yin DF, Huang YF. [The prevention and therapy of corneal ulcers in patients with large-area thermal burns]. Zhonghua Yan Ke Za Zhi 2022; 58:592-597. [PMID: 35959603 DOI: 10.3760/cma.j.cn112142-20220107-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the characteristics of ocular injury in patients with severe extensive thermal burns, and to explore the effective methods to prevent and treat corneal ulcers related to severe burns. Methods: A retrospective case series study. Between 2010 and 2019, Sixteen severe thermal burn patients with burn sizes>70% of the total body surface area involving the ocular region were admitted to the Burns and Plastic Surgery Division of Chinese PLA General Hospital, and consult with Ophthalmology Division. There were deep second-degree to fourth-degree burns in the eyelids. In the eleven surviving patients, 22 eyes presented ectropion. Eyelid full-thickness skin grafting (EFTSG) combined with or without tarsorrhaphy was performed in 20 eyes due to severe corneal exposure. Two eyes received partial blepharorrhaphy because of mild ectropion. The ocular manifestations and treatment outcomes were reviewed and assessed. Results: The majority of the patients were youth, and the average age was (36.8±10.4) years. The burn area was 84.0%±9.1% of the body surface area. Corneal ulcers secondary to lagophthalmos occurred at (35.1±15.6) days after burning in 75% (24/32) of eyes. Perforation was found in 18.8% (6/32) of eyes. Among the 22 operated eyes, the corneal ulcer was repaired in all 9 eyes receiving EFTSG with tarsorrhaphy, whereas ectropion recurred in 8 of 11 eyes only receiving EFTSG, and 4 eyes underwent further surgery due to corneal epithelial defects. Conclusions: In patients with severe large-area thermal burns, corneal ulcers are common complications. Prevention of corneal exposure is vital because the treatment of corneal ulceration is difficult due to eyelid deformity, inflammation and the absence of donor skin. Timely full-thickness skin grafting and blepharorrhaphy are effective approaches to preventing exposure keratopathy. To severe ulcers occur, conjunctival flap or Tenon's capsule covering combined with eyelid EFTSG and tarsorrhaphy is useful to rescue visual function.
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Affiliation(s)
- Y Dong
- The Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
| | - K N Yin
- The Burns and Plastic Surgery Division of Chinese PLA General Hospital, Beijing 100048, China
| | - Y L Pi
- The Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
| | - C A Shen
- The Burns and Plastic Surgery Division of Chinese PLA General Hospital, Beijing 100048, China
| | - F Li
- The Burns and Plastic Surgery Division of Chinese PLA General Hospital, Beijing 100048, China
| | - T J Sun
- The Burns and Plastic Surgery Division of Chinese PLA General Hospital, Beijing 100048, China
| | - D F Yin
- The Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
| | - Y F Huang
- The Ophthalmology Division of Chinese PLA General Hospital, Beijing 100853, China
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Abstract
Spinal tuberculosis often leads to neurological deficit and subsequent deterioration in functional outcomes. This review assesses the recent evidence on functional outcomes in spinal tuberculosis, highlighting functional recovery, assessment tools for functional measures, and associative factors for functional recovery. Using PubMed, a literature search was done using the terms “spinal tuberculosis,” “tuberculous spondylitis,” “tuberculous spondylodiscitis,” and “functional outcome” for original articles published between January 2010 and December 2019. A total of 191 search results were found. Detailed screening showed that 19 articles met the eligibility criteria: 13 of these focused on surgical methods, four on conservative management, and two on rehabilitation approaches. The outcome measures used for functional assessment were the Oswestry Disability Index (11 articles), Japanese Orthopaedic Association score (n=3), modified Barthel Index (n=2), Functional Independence Measure (n=2), and 36-item Short-Form Health Survey (n=1). Functional outcome was mainly affected by pain, spinal cord compression, and inpatient rehabilitation. No significant difference in functional outcome was found between conservative management and surgery for cases with uncomplicated spinal tuberculosis. Most studies focused on surgery as the mode of treatment and used pain-related functional measures; however, these assessed functional limitations secondary to pain, and not neurological deficits. Further studies may consider examining functional outcomes in spinal tuberculosis by utilizing spinal cord-specific functional outcome measures, to evaluate outcome measures as a prognostic tool, and to measure functional outcomes from specific rehabilitation interventions.
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Affiliation(s)
- Lionelson Norbert Yong
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Fatimah Ahmedy
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Khin Nyein Yin
- Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Julia Patrick Engkasan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Li F, Chi YF, Hu Q, Yin KN, Liu W, Chen Q, Zhang QX, Chen X, Cao FC, Liang ZL, Sun YJ. [Effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn]. Zhonghua Shao Shang Za Zhi 2018; 34:714-718. [PMID: 30369140 DOI: 10.3760/cma.j.issn.1009-2587.2018.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn. Methods: Clinical data of 40 children with deep partial-thickness burn wounds on trunk and limbs, admitted to our burn ward from January 2016 to June 2017, conforming to the study criteria, were retrospectively analyzed. They were divided into conventional treatment group (CT, n=19) and minimally invasive tangential excision group (MITE, n=21) according to the different treatments. The patients in group CT were treated with eschar-reserving therapy firstly. When tangential excision was performed, the roller knife was used, and no necrotic tissue left on the wound bed was considered the proper depth of excision. Razor-thickness skin grafting was performed to cover the wound when adipose tissue exposed markedly after tangential excision. Dressing change was performed within 48 h after the operation and repeated every 2 days. Unhealed wounds were covered by razor-thickness skin grafting. The patients in group MITE were treated with tangential excision in the early stage post burn. The tangential excision was operated with electric dermatome, and the thickness was set at 0.1 mm to excise the surface of eschar until the sporadic punctate hemorrhage on wound surface was observed and some necrotic tissue was left on the wound bed. Porcine acellular dermal matrix was applied after tangential excision. The first dressing change was often performed about 1 week after the operation. Razor-thickness skin grafting was performed to cover the unhealed wounds. The length of wound healing, high fever, antibiotic usage, and hospital stay, times of later operation, and hospitalization expenses of patients in the 2 groups were recorded. The excisional eschar and wound bed tissue of patients in group MITE were harvested for pathological observation. Data were processed with t test and Fisher's exact probability test. Results: (1) There were no statistically significant differences in length of high fever and length of hospital stay and hospitalization expenses between patients in the 2 groups (t=-1.67, -1.93, 0.31, P>0.05). The lengths of wound healing [(24.8±2.5) d] and antibiotic usage [(4.4±0.7) d] of patients in group MITE were significantly shorter than those in group CT [(33.3±2.5) and (7.0±0.7) d, t=-2.44, -2.44, P<0.05], and times of later operation of patients in group MITE [(0.29±0.14) times] were significantly less than those in group CT [(0.79±0.21) times, t=-2.03, P<0.05]. (2) The thickness of the excisional eschar of patients in group MITE was about 150 μm. The eschar has epidermis and upper dermis. Some necrotic tissue was left on the wound bed. Conclusions: The treatment for pediatric deep partial-thickness burn wounds on trunk and limbs with minimally invasive tangential excision using electric dermatome in the early stage post burn can accelerate wound healing, shorten length of antibiotic usage, and reduce times of later operations.
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Affiliation(s)
- F Li
- Burn Institute, the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
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Zhang XL, Chai JK, Li BL, Ma L, Yin KN, Zhang DH, Feng R. [Effect of mitochondrial apoptosis on pulmonary fibrosis in rats with severe scald injury]. Zhonghua Yi Xue Za Zhi 2016; 96:1602-6. [PMID: 27266692 DOI: 10.3760/cma.j.issn.0376-2491.2016.20.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the role of mitochondrial apoptosis on pulmonary fibrosis in rats with severe scald injury. METHODS According to the random digital table, a total number of 32 Wistar rats were divided into 4 groups: sham burn (group A), burn group (group B), 12-week post burn recovery group (group C), and 12-week post burn recovery plus a second burn injury group (group D). In group A and group B, lung tissues were harvested on post burn day 4. After received first burn injury 12 weeks, the group C and group D received separately a second sham burn injury and burn injury. Lung tissues were harvested on post burn day 4 after the second burn injury. All tissues were examined for cells apoptosis by Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL). Pulmonary fibrosis was assessed by Masson trichrome staining and Sirius red staining. The protein expression levels of cleaved Caspase-3, Bax and Bcl-2 were assessed by Western blot. RESULTS Both Masson trichrome staining and Sirius red staining showed obvious pulmonary fibrosis in group C and group D. The apoptosis rates of group B, C and D were significantly higher than that in group A ((15.50±3.30)%, (7.88±3.10)%, (15.88±3.23)% vs (2.10±1.07)%, all P<0.05). Compared to group A, cleaved Caspase-3 levels were significantly higher in group B, C and D ((0.59±0.11), (0.33±0.08), (0.73±0.13) vs (0.16±0.05), all P<0.05). The ratio of Bax/Bcl-2 in group B, C and D also increased significantly ((2.08±0.30), (0.83±0.09), (1.54±0.12) vs (0.64±0.05), all P<0.05). CONCLUSION Severe burn injury can induce pulmonary fibrosis and mitochondrial apoptosis may play an important role in the development of pulmonary fibrosis.
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Affiliation(s)
- X L Zhang
- Department of Burns and Plastic Surgery, Burns Institute, the First Hospital Affiliated to the Chinese PLA Hospital, Beijing 100048, China
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