BACKGROUND:Recently, there are many documents al over the world reporting hypotoxicity infection after fracture internal fixation surgery, but reports are different on whether it is necessary for chronic hypotoxicity infection internal fixation removal post surgery. There are no fixed judgment criteria of curative effects, which leads to inexact conclusion of treatment method. ＜br> OBJECTIVE:To observe the curative effects of taking rifampicin and ciprofloxacin with transfer of skin flap in the treatment of chronic hypotoxicity infection with sinus formation after fracture surgery on tibial plateau and ankle. METHODS:A total of 56 cases of chronic hypotoxicity infection after fracture surgery of tibial plateau and ankle were col ected from September 2005 to December 2012. 30 cases in the therapy group were treated with ＜br> levofloxacin and rifampicin with transfer of skin flap. 26 cases in the control group were treated with conventional intravenous antibiotics with local debridement to remove internal fixation. In both groups, the course of disease was 3 to 6 months. The erythrocyte sedimentation rate, kidney function and radiographic indices were reviewed every 1 to 3 months, and curative effects were evaluated. ＜br> RESULTS AND CONCLUSION:During the fol ow-up visit of 6-24 months, no recurrence happened to the cured and improved patients. In the therapy group, 24 cases were cured, 4 cases were improved, and 2 cases were invalid, with a total effective rate of 93%. In the control group, 11 cases were cured, 6 cases were improved and 9 cases were invalid with the total effective rate of 65%.χ2 test showed that therapeutic effects were significantly better in the therapy group than in the control group (P＜0.05). These data indicated that rifampicin and ciprofloxacin with transfer of skin flap for chronic hypotoxicity infection with sinus formation after fracture surgery of tibial plateau and ankle showed good curative effects.

Objective To report a multi-center series of 600 consecutive cases of completely video-assisted thoracoscopic lobectomy with 3-year follow-up results. Methods Data from 600 consecutive patients who underwent attempts for thoracoscopic lobectomy between September 2006 and August 2010 in Peking University People's Hospital, Jiangsu Cancer Hospital and Beijing Haidian Hospital were collected. Of these, 315 males (52.5%) and 285 females (47.5%), the average age was ( 59.1 ± 12.6 ) years( 15 - 86 years). Perioperative variables were assessed using standard descriptive statistics and 3-year survival was estimated by Kaplan-Meier analyses. Results One hundred and nineteen cases were diagnosed as benign disease and 481 cases were malignancy. 68.9% (82/119) of the benign cases were chronic infectious disease and the majority of the malignancy was non-small cell lung cancer, especially adenocarcinomas which comprised 65.9% (317/481) of all malignancies.Fifty-four cases required conversion to thoracotomy with a conversion rate of 9%. Of the VATS accomplished group, the median operation time was 180 min(30 -40 min), median blood loss 200 ml( 10 - 1500 ml) . Benign surgery took significantly less time, had shorter drainage time and hospitalization time, and lower morbidity than that for malignancies ( P = 0.001, P ＜0.01, P = 0.004, P = 0.020, respectively). Non-small cell lung cancer patients had a 3 -year survival of 85.4%, and pathologic stage Ⅰ patients 91.2%. Conclusion This largest case series and the first report 3-year survival in China confirms that completely thoracoscopic lobectomy surgery we performed have reached short- and middle-term standards compared with that of the western country.

Objective To investigate the epidemiological characteristics of an outbreak of respiratory tract infection caused by human rhinovirus （HRV） in a school in Nanxun District of Huzhou City， and provide scientific evidence for prevention and control of outbreaks of upper respiratory tract infection caused by HRV in the future. Methods The investigation was performed according to the Guidelines for Response to Outbreaks of Influenza-like Illness （2018 version）. It mainly referred to the records of nonattendance due to illness， morning and afternoon examination， and hospital treatment records， to search for cases. Then CDC staffs carried out epidemiological investigation on cases， interviewed the head teacher， and inspected the site. Throat swabs were collected for detection of SARS-CoV-2 and subsequently 14 common viruses that may cause upper respiratory tract infection. Results A total of 68 cases with HRV infection were identified. The first case and last case occurred on May 20 and 30， respectively. After a 3-day longest incubation period， there was no emerging case， suggesting the end of the outbreak. The incidence was 25.00% （11/44） in Class 101， 30.23% （13/43） in Class 109， 25.58% （11/43） in Class 110， 35.26% （16/45） in Class 211， and 39.96% （17/46） in Class 307. There was no significant difference in the incidence among classes （ χ ²=1.67， P >0.05）. The patients aged from 7 to 9 years. The incidence was 27.19% （31 / 114） in male and 34.58% （37/107） in female， with no significant difference （ χ ²=1.41， P >0.05）. The symptoms were mild， with no hospitalization， severe illness or death. The patients had mainly cough （100.00%）， sore throat （61.76%）， and runny nose （47.06%）， whereas had little muscle soreness （4.41%）. Of the patients， 69.12% visited hospitals， 23.53% took medicine by themselves， while 7.35% did not seek any medical treatment or medicine. Throat swabs were collected from 22 cases， testing negative for SARS-CoV-2. Then 14 common respiratory viruses were examined， of which HRV was positive in 16 cases. Conclusion Children with HRV infection have milder symptoms compared to influenza infection， which is difficult to be noticed by school teachers and parents. Students should maintain personal hygiene and develop health habits. Moreover， schools should strength relevant health education， implement morning and afternoon health inspection， and prevent students with illness to routinely go to schools.

Objective: To understand the epidemiological characteristics of an outbreak of respiratory tract infection caused by human metapneumovirus (hMPV) in a primary school in Huzhou City, and to provide scientific reference for the prevention and control of the outbreak of upper respiratory tract infection caused by hMPV in the future. Methods: The investigation was carried out according to the Guidelines for Handling Influenza Like Case Outbreaks (2018 version). The throat swabs were collected to carry out COVID-19 nucleic acid test. If negative, influenza virus and other common 14 upper respiratory tract virus detection would be conducted. Results: A total of 53 cases of human metapneumovirus infection were found, the first case was found on December 15, 2020; the cases concentrated from December 21 to December 26; the last case was on December 29. It lasted 15 days and the epidemic ended. All the cases were first year students, and the incidence rate of the affected classes was 44.92% (53/118), among which the incidence rate of 101 classes was 23.08% (9/39), 102 classes was 53.85% (21/39), 103 classes was 57.50%( 23/40 ), the difference was statistically significant( χ 2=10.07, P <0.05). The age of the patients ranged from 6 to 7 years. The morbidity rate of boys was 48.00%(24/50) and that of girls was 42.65% (29/68), with no significant difference( χ 2=0.33, P >0.05). The clinical symptoms of all cases were mild, mainly cough, sore throat, runny nose, only a small number of fever. Throat swabs of 20 patients were collected, and 13 cases were positive for human metapneumovirus nucleic acid. Conclusion The symptoms caused by human metapneumovirus are relatively mild, which is not easy to attract the attention of schools and parents. Schools should carry out relevant prevention and control knowledge publicity, do a good job in the morning and afternoon inspection, and put an end to classes with diseases.

ObjectiveTo determine the epidemiological characteristics and transmission factors of a varicella outbreak in a school in Nanxun District of Huzhou City， and assess the effect of prevention and control measures， which may provide scientific evidence for improvement in the response to varicella outbreak. MethodsData were collected by field epidemiological survey and analyzed by descriptive epidemiology. Statistical analysis was performed by SPSS 22.0 software. ResultsA total of 80 varicella cases were identified in this outbreak， which lasted 68 days. There were four peaks of incidence， involving 21 classes. The total incidence rate was determined to be 4.14%. Before the public health intervention， some cases were not isolated in time， which led to the initial spread in the class. After the mid-term examination， the outbreak further spread to multiple classes. Breakthrough varicella cases accounted for 48.75% of all the cases in the outbreak， among which 94.87% had been vaccinated for more than five years. However， there was no significant difference in the incidence of fever and rash between the breakthrough cases and non-breakthrough cases（P>0.05）. ConclusionTimely report， prompt response， and strict implementation of prevention and control measures remain crucial for effective containment of varicella outbreak.

ObjectiveTo understand the epidemiological characteristics of an outbreak of respiratory tract infections caused by Mycoplasma pneumoniae （MP） in a primary school in Huzhou City， Zhejiang Province， and to provide scientific reference for future prevention and control of school outbreaks of upper respiratory tract infections caused by M. pneumoniae. MethodsAccording to the requirements for investigating respiratory infectious disease outbreaks， basic information， clinical history and epidemiological information were collected from the cases. Throat swab samples of cases for COVID-19 nucleic acid testing， influenza A and B virus antigen testing， and serum samples for detecting total antibody of mycoplasma were also collected. ResultsA total of 47 cases related to M. pneumoniae infection were identified. The first case occurred on May 4， 2022， and the cases were concentrated between May 22 and May 31， 2022. The last case occurred on June 21， marking a duration of 48 days for the outbreak. All cases were second-grade students， with an incidence rate of 35.07% （47/134） in the affected classes， with Class 206 at 53.330% （24/45）， Class 207 at 38.64% （17/44）， and Class 211 at 13.33% （6/45）. There was a statistically significant difference in the incidence rates among the classes （χ²=16.57，P<0.05）. The incidence rate was 32.39% （23/71） for boys and 38.10% （24/63） for girls， with no statistically significant difference by gender （χ²=0.48，P>0.05）. The main clinical manifestations included cough， fever， and sore throat， and some cases exhibited signs of pneumonia. Pharyngeal swabs and serum samples were collected from 27 patients. The results were negative for pharynx swab samples， and positive for total mycoplasma antibody in 12 serum samples， with a positive rate of 44.44%. ConclusionSymptoms caused by M. pneumoniae are diverse in clinical manifestations， with atypical signs and a slow progression. Early cases tend to exhibit mild symptoms. The onset of the disease is not detected in time when students are attending classes. The school morning health checks fail to promptly detect it and trigger home isolation control measures， which all contribute to the outbreak of the epidemic. Schools should conduct relevant prevention and control campaigns， improve morning and afternoon health checks， and prevent students from attending classes while sick.

【Objective】 To investigate the effects of one-stage additional posterior pedicle screws （PPS） internal fixation on early Cage subsidence after oblique lateral interbody fusion （OLIF）. 【Methods】 We made a retrospective analysis of 118 patients with lumbar degenerative diseases treated with OLIF at the Department of Orthopedics， Sir Run Run Shaw Hospital， School of Medicine， Zhejiang University， from January 2016 to December 2019. We divided the patients into OLIF stand-alone group （58 ones） and OLIF with PPS fixation group （60 ones） according to the surgical procedure. All the patients had preoperative frontal and lateral radiographs of the lumbar spine， and CT and MR scans were performed. The clinical outcomes and reoperation rates of the two groups were compared at immediate postoperative follow-up and at 1， 3， 6 and 12 months. X-ray and CT examinations were performed to assess Cage subsidence in both groups at each postoperative follow-up. 【Results】 There was no statistical difference between the two groups in baseline data and surgical segmentation. Of the 118 patients with 141 discs who underwent OLIF surgery， 58 patients with 68 discs received OLIF stand-alone surgery and 60 ones with 73 discs received OLIF with PPS fixation. There were no significant differences in intraoperative bleeding， complications， or postoperative clinical outcomes between the two groups （P>0.05）， and the Cage subsidence rate was 22.4% in OLIF stand-alone group and 5% in OLIF with PPS fixation group， with significant difference between the two groups （P<0.01）. 【Conclusion】 Both OLIF stand-alone and OLIF additional PPS fixation can achieve good early clinical outcomes， and first-stage additional PPS fixation can significantly reduce the occurrence of Cage subsidence in the early postoperative period after OLIF.