Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.

Objective To explore the application value of mammary gland remodeling to one-stage repair local defects after partial excision.Methods The clinical data of 62 breast patients undergoing mammary gland remodeling to one-stage repair local defect after partial excision between January 2011 and December 2014 were reviewed.Results All patients recovery,the average operative time was 60 min,the average hospital stay was 7 days,the average cost was 5 216 yuan,1 case with postoperative concurrent incision infection,6 cases with postoperative hematoma.The cosmetic results were excellent or good rate was 87.1％ (54/62),and fair rate was 12.9％ (8/62).The breasts showed natural and symmetrical appearance during a follow-up of 12-36 months.Conclusions The application of mammary gland remodeling to one-stage repair local defect after partial excision is a safe and economical method.

Objective To investigate the clinical efficacy and safety of intravenous immunoglobulin and interferon in the treatment of hand foot and mouth disease complicated with viral encephalitis .Methods 80 cases of hand foot and mouth disease complicated with viral encephalitis were randomly divided into the three groups according to the random number table .27 cases in the control group were given comprehensive symptomatic treatment ,27 cases in the study group 1 were given gamma globulin ,and 26 cases in the study group 2 were given interferon .The clinical efficacy,improvement of disease ,incidence of adverse reactions of the three groups were compared .Results Defer-vescence time ,seizure control time ,time of skin rash subsided ,time of psychiatric symptoms relieved and the average hospitalization time in the study 1 group were (3.65 ±0.28)d,(4.04 ±0.33)d,(3.86 ±0.27)d,(5.83 ±0.36)d and (7.53 ±0.83)d,which were significantly less than those in the control group (t=8.43,8.58,9.15,9.80,8.96, all P<0.05).Those in the study 2 group were (3.92 ±0.29)d,(4.21 ±0.32)d,(4.27 ±0.30)d,(6.32 ±0.43)d and (8.10 ±0.72)d,which were significantly less than the control group (t=7.99,8.17,8.54,9.18,8.55,all P<0.05);however,there were no significant differences between the study 1 group and the study 2 group(t=1.12, 2.04,1.67,1.38,2.21,all P>0.05).The incidence rate of adverse reaction among the three groups showed no sta-tistically significant difference (χ2 =2.17,P>0.05).Conclusion Intravenous immunoglobulin and interferon have significant effect in the treatment of hand foot mouth disease complicated with viral encephalitis , which can quickly improve symptoms ,shorten treatment time and have high safety and good clinical application value .

Objective To study the curative effect and practicability of traditional anterior cervical surgery for cervical spondylosis.Methods retrospective lyunaly2ed,104 cage8 of anterior cervical sugery from June 1997 tO October 2005 Among them,there were 17 patients with radculopathy,31patients with cervical myelopathy,56 patients with combination of myelopathy and radieulopathy.all cases were treated by traditional anterior trephiement to excise prominent uncleus+interbedy fusion with auto-ilium graft.Results The resuhs were evaluated by Odom.The cases were all followed up.13 excellent,68 good,23 fair,0 poor.Excellent/good rate is 77.9%.The average medical coat of one patient is 4200 RMB.Conclusion The traditional Anterior cervical surgery for cervical mydopathy is safe、effective、practical.

Objective:To investigate the relationship between mandibular second molar calcification stage and cervical vertebrae maturity.Methods:Samples were derived from panoramic radiographs and lateral cephalograms of 500 subjects (223 males and 277 females)aged 9 to 18 years.Demirjian Index(DI)and cervical vertebrae maturation indicators(CVMI)were used for the evaluation of dental and skeletal maturity.Results:A significantly association was found between DI and CVMI(P <0.001).DI stage E was associated with CVMI Ⅱ(pre-peak of pubertal growth spurt).DI stages F and G was associated with CVMI Ⅲ and Ⅳ(peak of pu-bertal growth spurt).DI stage H was associated with CVMI Ⅴ and Ⅵ(end of pubertal growth spurt).Conclusion:DI and CVMI are significantly associated.Mandibular second molar DI stage is a reliable indicator of skeletal maturity.

Objective To analyze the detection rate of neonatal congenital malformation,and to explore the risk factors for neonatal malformation.Methods A total of 29 831 infants born in Shenzhen People's Hospital from January 2011 to December 2015 were analyzed retrospectively,the detection rate of congenital malformations was calculated,381 infants with congenital malformation were selected as malformation group,and 381 healthy infants were selected as healthy control group,and the risk factors of congenital malformation were analyzed.Results A total of 381 infants with congenital malformation were screened out,the incidence rate of congenital malformation being was 12.77‰(381/ 29 831 cases).The incidence rates of multi-finger or multi-toe,cleft lip,congenital heart disease were the high,which were 18.64％ (71/381 cases),17.32％ (66/381 cases) and 16.80％ (64/381 cases),respectively.The multiple Logistic analysis showed that birth children with low weight newborns (＜ 2 500 g),multiple births,preterm birth (＜ 37 weeks),pregnancies ＞ 1,low literacy levels of mothers,living in towns,late childbirth (≥ 35 years of age),pregnancy syndrome,viral infection during early pregnancy,medication history during pregnancy,rubella unvaccinated,exposure to harmful substance,smoking and alcohol during pregnancy and paternal smoking,chronic diseases,total 16 items were related risk factors for neonatal congenital malformations (all P ＜ 0.05).Among them,the impact of viral infection during early pregnancy,alcohol,smoking,pregnancy syndrome,exposure to harmful substance,medication history during pregnancy on the incidence of malformations in neonates was relatively serious.Conclusions The incidence rate of congenital malformations among neonates conforms to the present situations in China,which was closely correlated with genetic and environmental factors.Health education targeting pregnant women and the women of childbearing age should be carried cut to reduce the birth of neonatal congenital malformations.

New characteristics and changes of laboratory security were summarized,and then current status and problems of awareness of laboratory security of medical postgraduate under the new situation were analyzed in detail.Based on laboratory security education in Center of Experimental Teaching for Postgraduates in Medicine at Xi'an Jiaotong University,strategies to enhance their awareness and capacity of laboratory security were proposed.Compilation of textbooks on laboratory security,development of curriculum content,training of laboratory security practice,and establishment of evaluation system and laboratory access regulation,will be helpful to maximize safety of postgraduates and to guarantee security of laboratory.

The paper summarized the successful experience such as preliminarily establishing cultivation mechanism of manufacture-learning-research cooperation for postgraduates of science of Chinese pharmacology of Guangzhou University of Chinese Medicine,ensuring innovation ability training for postgraduates,getting reasonable configuration for social education resources,and put forward existing problems in traditional Chinese medicine system,such as the loose management and faulty evalution system.Suggestion is to futher perfect relevant rules and regulations,clear and definite responsibility of school and enterprise,reserch regularly to impove ideological education of postgraduates,etc.In the way,we can achieve the aim of promoting high-level talents of traditional Chinese medicine industry.

Objective To evaluate the value of serum kaliuretic peptide (KP) in predicting atrial fibrillation (AF) and its prognosis,by detecting serum KP levels in patients with severe sepsis.Methods Fifty-six patients with severe sepsis in Integrated Intensive Care Unit of Shajing Hospital of Shenzhen Affiliated to Guangzhou Medical University from January 2014 to August 2015 were collected as the case group.In addition 20 cases health checkup for the same period were collected as the control group.Serum KP were determined in all patients in the case group every day for 1 week after admission,meanwhile the APACHE-Ⅱ score was undertook,then according to heart guardianship and electrocardiogram whether occurrence of AF the case group were divided into AF group and non AF group.According to survival after 28 days again divided into survival group and death group,the relationship of serum KP with AF and the prognosis were analyzed.Serum KP was detected on the day of physical examination in the control group.Results (1) The incidence of AF was 32.1％(18/56) in 56 patients with severe sepsis.(2)Serum KP in admission to hospital in case group was significantly higher than that in the control group((234.2±73.5) pmol/L vs.(169.6±65.4) pmol/L;t =3.47,P =0.001).Serum KP in admission to hospital in AF group was significandy higher than that in the non AF group((306.0±35.6) pmol/L vs.(200.2±61.2) pmol/L;t =6.79,P =0.001).Serum KP in AF group before 1 day of the occurrence AF was significantly higher than of the admission to hospital ((339.2± 30.5) pmol/L vs.(306.0±35.6) pmol/L;P=0.007),serum KP on the day of occurrence AF was significantly higher than before 1 days of the occurrence AF((390.6±47.8) pmol/L vs.(339.2±30.5) pmol/L;P=0.006),there was no difference between the serum KP after 1 days of occurrence AF and on the day of occurrence AF(P=0.246),but began to gradually declining.Serum KP and APACHE-Ⅱ score in death group on admission to hospital were significantly higher than survival group((301.1±42.0) pmol/L vs.(199.8±61.5) pmol/L,(26.1±2.8) points vs.(19.9±4.3) points;t =6.44,5.67;P＜0.001).(3) Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with the occurrence of AF(r=0.679,P=0.010).According to AF grouping,serum levels of KP on admission to hospital draw ROC curve,the serum KP of AUC was 0.908(95％ CI:0.831-0.984),when the KP value was 351.5 pmol/L,the sensitivity of the occurrence AF was 89.9％,specificity of 97.4％.(4)Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with death(r=0.659,P =0.010),according to prognostic grouping,serum KP on admission to hospital and APACHE-Ⅱ score ROC curve was drew,the serum KP of AUC was 0.893 (95％ CI:0.811-0.974),when the KP value was 338.5 pmol/L,the sensitivity of death was 78.9％,specificity of 97.3％.Conclusion Early serum KP level can be used as an indicator to predict AF and prognosis in the patients with severe sepsis.

Objective:To investigate the joint associations of smoking and insufficient physical activity with hypertension, diabetes and dyslipidemia in male adults.Methods:Based on the data from the 2017 Nanjing Chronic Diseases Risk Factors Surveillance Program, 61 098 Nanjing residents aged 18 and older was randomly recruited from 12 districts, using the multi-stage stratified cluster sampling method. Information about smoking behaviors, physical activity and chronic disease-related indicators within the first 12 months before the survey was obtained through questionnaires.Results:Among the 29 848 valid male samples, the proportions of non-smokers, current smokers and ex-smokers were 59.6%, 37.2% and 3.2%, and the proportions of those who had physically active<600 MET-min/w (insufficient physically active) and ≥600 MET-min/w (adequate physically active) were 18.8% and 82.2%, respectively. In non-smokers, current smokers and ex-smokers, the prevalence of hypertension was 24.7%, 34.0% and 43.8%, and the prevalence of diabetes was 8.8%, 12.3% and 16.5%, and the prevalence of dyslipidemia was 26.8%, 36.1% and 41.9%, respectively. Multivariate logistic regression analysis showed that current smokers had a higher risk of hypertension ( OR=1.164, 95% CI: 1.086-1.248), diabetes ( OR=1.324, 95% CI: 1.207-1.452), and dyslipidemia ( OR=1.291, 95% CI: 1.216-1.371) than non-smokers in male adults. Compared with people who had adequate physical activity, someone with insufficient physical activity had higher hypertension ( OR=1.452, 95% CI: 1.331-1.583), diabetes ( OR=1.170, 95% CI: 1.041-1.315) and dyslipidemia ( OR=1.245, 95% CI: 1.158-1.338). And current smokers with insufficient physical activity had the highest risk of hypertension ( OR=1.749, 95% CI: 1.550-1.974), diabetes ( OR=1.363, 95% CI: 1.165-1.595), and dyslipidemia ( OR=1.614, 95% CI: 1.461-1.782) in male adults. Conclusions:Smoking and insufficient physical activity are risk factors for hypertension, diabetes, and dyslipidemia. People who is characterized by smoking together with insufficient physical activity presents with increased risk on developing hypertension, diabetes, and dyslipidemia.