Objective:To investigate the clinical characteristics and risk factors for patients with chronic periprosthetic joint infection (PJI) combined with sinus tract.Methods:The patients with PJI following hip and knee arthroplasty from July 2014 to January 2020 in our institution were retrospectively reviewed. There were 96 males and 101 females, aged from 26 to 86 years with mean age of 62.02±13.54 years. There were 95 hip PJI patients (48.2%, 95/197), 102 knee PJI patients (51.8%, 102/197), 68 patients (34.5%, 68/197) with sinus tract, 129 patients (65.5%, 129/197) without sinus tract, 162 patients (82.2%, 162/197) with positive culture results and 35 patients (17.8%, 35/197) with negative culture results. The patients were divided into two groups according to the sinus tract formation. The diagnosis of PJI was based on the 2011 Musculoskeletal Infection Society (MSIS) criteria. All of the included patients underwent serological laboratory tests (white blood cell count, neutrophil percentage, lymphocyte percentage, hemoglobin, platelet count, mean platelet volume, urea, creatinine, albumin, erythrocyte sedimentation rate, C-reactive protein) and pathogen isolation. The influence of sinus tract on the above test and the effects of complications on sinus tract formation were analyzed. We further investigated the relationship between sinus tract formation and the features of pathogen. In addition, the risk factors for sinus tract formation were analyzed.Results:The mean values of all serological tests were without statistical difference between the groups with and without sinus tract ( P>0.05). The presence of complications had no effect on the occurrence of sinus tract ( P>0.05). The incidence of sinus tract with highly virulent pathogen infection group (52.1%, 25/48) was significantly higher than that in low virulence pathogen group (27.5%, 19/69), in culture negative patients (40.0%, 14/35) and in other cases (22.2%, 10/45; χ 2=11.519, P=0.009). There was no statistical difference between groups based on the Gram staining, antibiotic resistance and polymicrobial infection. Multivariate logistic regression analysis revealed positive associations of extra joint infections ( OR=4.426, 95% CI: 1.095, 17.884) and high virulent pathogen infections ( OR=2.633, 95% CI: 1.171, 5.918) and negative association of age ≥70 ( OR=0.436, 95% CI: 0.205, 0.927) with the risk of sinus tract formation. Conclusion:The presence of sinus tract has no effect on the routine serum tests in patients with chronic PJI. There is only virulence factor which might affect sinus tract formation. For patients with the extra joint infections and high virulence pathogen infections, the formation of sinus tract should be vigilant during treatment.

Objective:To evaluate the clinical efficacy of single-stage total hip arthroplasty (THA) combined with intra-articular antibiotic injection in managing postoperative infections following internal fixation of hip fractures.Methods:A retrospective analysis was conducted on 25 patients who underwent single-stage THA for infection following internal fixation of hip fractures from January 2013 to January 2021 at the Department of Joint Surgery, First Affiliated Hospital of Xinjiang Medical University. The cohort comprised 15 males and 10 females, with an average age of 61.52±13.06 years (range, 32-89 years) and an average body mass index of 24.04±3.84 kg/m 2 (range, 18-34 kg/m 2). The fractures included 13 femoral neck fractures, 6 intertrochanteric fractures, 4 acetabular fractures, 1 proximal femoral fracture, and 1 combined acetabular and intertrochanteric fracture. Preoperative joint cavity puncture or intraoperative joint fluid extraction, biochemical analysis, microbial culture, and drug sensitivity tests were performed. During surgery, infected internal fixation devices were removed, and hip prostheses were implanted following thorough debridement. Postoperatively, patients received intravenous and intra-articular sensitive antibiotics based on bacterial culture and drug sensitivity results. Joint stability was evaluated according to the Engh standard, and hip function was assessed using the Harris score. Results:Microbial cultures were positive in 12 cases, identifying Staphylococcus epidermidis (4 cases), Staphylococcus aureus (2 cases), Escherichia coli (2 cases), Enterobacter cloacae (1 case), Pseudomonas aeruginosa (1 case), Corynebacterium striatum (1 case), and a mixed infection of Staphylococcus epidermidis and Enterococcus faecalis (1 case). All 25 patients were followed for an average of 56.64±26.38 months (range, 24-123 months). Intravenous and intra-articular antibiotic treatment was administered to all patients. One case experienced sinus tract formation and pus discharge on the 20th postoperative day, diagnosed as periprosthetic infection, resulting in treatment failure, yielding an infection control rate of 96% (24/25). All patients demonstrated stable prosthesis fixation with no subsidence, loosening, or osteolysis. At the final follow-up, the Harris hip score improved significantly from a preoperative score of 26.69±13.47 to 92.30±5.60 ( t=22.882, P<0.001). Complications included 2 cases of hip dislocation, 2 cases of deep venous thrombosis in the lower extremities, 1 case of poor wound healing, and 1 case of periprosthetic fracture. Conclusion:Single-stage THA combined with intra-articular antibiotic injection is effective in controlling infections following internal fixation of hip fractures. This approach not only achieves a high infection control rate but also reconstructs hip joint function, resulting in satisfactory postoperative outcomes.

【Objective】 To establish a management information system (referred to as the system) for plasma collection stations in Zhejiang province, so as to explore the current situation of plasma donors and implement effective supervision in Zhejiang. 【Methods】 The system was developed and connected to four plasma collection stations that were officially operating in Zhejiang in terms of plasma station setting and approval, as well as the publicity, recruitment and management of plasma donors, information management of the whole process of plasma collection, management of deferral plasma donors, plasma quality management and administrative supervision etc. Relevant plasma donor information was uploaded to the system by each plasma station, and information before (January 2016 to December 2020) and after (January 8, 2021 to June 2021) the system was collected. Information included the number of plasma donors/donations, demographic information of eligible plasma donors in the past 5 years, the type of plasma donors, and the deferral donors after the system was activated. The online approval of Plasma Donation Certificate and the intelligent supervision of key points of plasma apheresis stations in Zhejiang were also conducted. The frequency and composition ratio were described, and chi-square test was used for statistical analysis. 【Results】 The system (V1.0) was established and was officially launched on January 8, 2021, realizing the interconnection of blood donation and plasma donation information as well as the unified management of 24 quality indicators. Since the system was applied (January 8, 2021-June 2021), the proportion of donors both donated blood and plasma over the province was 3.56 (832/23 389), and 352 deferred donors were masked by the system. And 30.11% (106/352) , who intended to donate plasma, were deferred due to insufficient interval after blood donation; 11.65% (41/352) due to permanent masking in blood donations; 23.86% (23.86%) , who intended to donate blood, were deferred due to insufficient interval after plasma donation ( 84/352); 34.38% (121/352) due to permanent masking in plasma donations. The median approval rate of four plasma stations applying for Plasma Donation Certificate before the system (January 1, 2016 to January 7, 2021) and after the system (January 8 to June 2021) were 93.38% (10 609/11 361) vs 99.50% (2 602/2 615). Before the system was put into launch, the ratio of male to female donors and the proportion of regular donors showed an overall upward trend, while the age decreased slightly. The median proportion of women in the past 5 years was 61.52 %, significantly higher than that in last 6 months after the launch(58.86%). 【Conclusion】 The application of the system can realize information interconnection between blood centers and plasma collection stations in Zhejiang as well as the real-time supervision of plasma collection process, which is helpful to overcome the shortcomings in plasma donor management.

Objective To analyze the distribution characteristics and clinical significance of al-lergens in children with allergic diseases in Yangzhou area.Methods A total of 1,025 children who were treated in the Affiliated Hospital of Yangzhou University from December 2022 to December 2023 and tested for allergens were selected as study objects.The detection results of allergens were collect-ed and the distribution characteristics of allergens were analyzed.Results Among the 1,025 chil-dren with allergy-related diseases,83.41％(855 cases)tested positive for allergens,with a positive rate of 66.24％(679 cases)for inhalant allergens and 61.17％(627 cases)for food allergens.The most common allergens were milk(36.20％),molds(33.27％),and house dust mites(30.34％).There was no statistically significant difference in the positive rate of allergens among different age groups(P＞0.05).The positive rate of allergen detection in boys was higher than that in girls,the difference was statistically significant(P＜0.05).The positive rate of inhalation allergens in children with respiratory symptoms was higher than that of food allergens,and the positive rate of food aller-gens in children with digestive tract symptoms was higher than that of inhalation allergens(P＜0.05).For children with immune system diseases such as skin symptoms and allergic purpura,there was no statistically significant difference in the positive rates of inhalant and food allergens(P＞0.05).Conclusion The most common allergens in children with allergic diseases in Yangzhou area are milk,molds,and dust mites.Allergen testing can provide reference opinions for the prevention,di-agnosis,and treatment of allergic diseases in children in Yangzhou area.

Objective To analyze the distribution characteristics and clinical significance of al-lergens in children with allergic diseases in Yangzhou area.Methods A total of 1,025 children who were treated in the Affiliated Hospital of Yangzhou University from December 2022 to December 2023 and tested for allergens were selected as study objects.The detection results of allergens were collect-ed and the distribution characteristics of allergens were analyzed.Results Among the 1,025 chil-dren with allergy-related diseases,83.41％(855 cases)tested positive for allergens,with a positive rate of 66.24％(679 cases)for inhalant allergens and 61.17％(627 cases)for food allergens.The most common allergens were milk(36.20％),molds(33.27％),and house dust mites(30.34％).There was no statistically significant difference in the positive rate of allergens among different age groups(P＞0.05).The positive rate of allergen detection in boys was higher than that in girls,the difference was statistically significant(P＜0.05).The positive rate of inhalation allergens in children with respiratory symptoms was higher than that of food allergens,and the positive rate of food aller-gens in children with digestive tract symptoms was higher than that of inhalation allergens(P＜0.05).For children with immune system diseases such as skin symptoms and allergic purpura,there was no statistically significant difference in the positive rates of inhalant and food allergens(P＞0.05).Conclusion The most common allergens in children with allergic diseases in Yangzhou area are milk,molds,and dust mites.Allergen testing can provide reference opinions for the prevention,di-agnosis,and treatment of allergic diseases in children in Yangzhou area.

Objective:To explore the in vitro antibacterial effects of low-intensity pulsed ultrasound (LIPUS) combined with 3.5 g/L povidone iodine solution on the biofilm of methicillin-resistant staphylococcus aureus (MRSA). Methods:Immature (cultured for 24 hours) and mature (cultured for 72 hours) MRSA biofilms were established on the surfaces of glass slides or confocal dishes. They were randomly divided into 4 groups ( n=9) according to different intervention methods. In the control group, glass slides or confocal dishes were placed in 500 mL of physiological saline for 3 minutes; in the PI group, glass slides or confocal dishes were placed in 500 mL of 3.5 g/L povidone iodine solution for 3 minutes; in the LIPUS group, glass slides or confocal dishes were placed in 500 mL of physiological saline and simultaneously intervened with LIPUS for 3 minutes; in the LIPUS & PI group, glass slides or confocal dishes were placed into 500 mL of 3.5 g/L povidone iodine solution and simultaneously intervened with LIPUS for 3 minutes. After intervention, confocal microscopy (CLSM) and scanning electron microscopy (SEM) were used to observe and compare the structure, morphology, bacterial survival, and viable cell count of the MRSA biofilms among the 4 groups. Results:On the MRSA biofilms cultured for 24 and 72 hours, CLSM and SEM observed sparse biofilms in the LIPUS group and LIPUS & PI group, and also a large number of dead bacteria in the LIPUS & PI group. On the MRSA biofilms cultured for 24 hours, the bacterial colony counts in the control group, PI group, LIPUS group, and LIPUS & PI group were (1.21±0.45)×10 6 CFU/mL, (3.38±2.81)×10 3 CFU/mL, (1.82±0.37)×10 3 CFU/mL, and (69.67±27.93) CFU/mL, respectively. Except for the comparison between PI group and LIPUS group, which showed no statistically significant difference ( P>0.05), there were statistically significant differences between the other groups when compared pairwise ( P<0.05). On the MRSA biofilms cultured for 72 hours, the bacterial colony counts in the control group, PI group, LIPUS group, and LIPUS & PI group were (3.01±0.70)×10 6 CFU/mL, (1.80±1.52)×10 5 CFU/mL, (2.10±0.52)×10 3 CFU/mL, and (68.67±19.55) CFU/mL, respectively. There were statistically significant differences between the 4 groups when compared pairwise ( P<0.05). Conclusions:Application of LIPUS or 3.5 g/L povidone iodine alone for 3 minutes on the immature or mature MRSA biofilms in vitro only leads to partial antibacterial activity. However, LIPUS can enhance the in vitro antibacterial effect of 3.5 g/L povidone iodine on the MRSA biofilms at different maturity levels.