OBJECTIVE:To systematically evaluate therapeutic efficacy of local application of gentamicin collagen sponge in the prevention of surgical incision infection,and to provide evidenced-reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP and Wanfang databases,randomized controlled trials (RCTs) about lo-cal application of gentamicin collagen sponge(trial group)vs. routine surgery disposal(control group)in the prevention of surgical incision infection were collected. After data extraction and quality evaluation with modified Jadad scale,Meta-analysis was per-formed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 literatures were included,involving 7752 patients. The results of Meta-analysis showed that the incidence of surgical incision infection in trial group was significantly lower than control group,with statistical significance [OR=0.71,95%CI(0.61,0.84),P<0.001]. The packet statistics showed that the incidence of surgical incision infection in cardiovascular surgery group [OR=0.59,95%CI(0.37,0.96),P=0.03] and skin soft tissue operation group [OR=0.34,95%CI(0.15,0.75),P=0.008] were significantly lower than control group. There was no statistical significance in the incidence of incision infection between digestive system operation group and control group [OR=0.62,95%CI(0.25,1.54), P=0.30]. The incidence of surgical incision infection in≤30 d group was significantly lower than control group[OR=0.58,95%CI (0.41,0.82),P=0.002];there was no statistical significance between more than 30 d group and control group [OR=0.86,95%CI (0.71,1.04),P=0.13]. The incidence of surgical incision infection [OR=0.65,95%CI(0.52,0.82),P<0.001] in gentamicin high-dose group (>100 mg) was significantly lower than control group;there was no statistical significance between gentamicin low-dose group (≤100 mg) and control group [OR=0.96,95%CI(0.72,1.28),P=0.77]. CONCLUSIONS:Local application of gentamicin collagen sponge may have certain effect on the prevention of surgical infection. Different types of surgery,observation time and dose have different prevention effects. It should be used carefully according to clinical practice.

Objective To assess the value of contrast-enhanced ultrasound(US)in differential diagnosis of hyperechoic hepatic lesions when compared to conventional US.Methods Eighty-four hyperechoic liver lesions in 66 patients were examined using both conventional and contrast-enhanced US techniques.Results Receiver operating characteristic analysis revealed a significant improvement in the discrimination of malignant versus benign hyperechoic hepatic lesions (area under the receiver operating characteristic curve,0.867±0.045 at conventional US,0.997±0.003 with contrast-enhanced US(P＜0.0001).For correct diagnoses types of hyperechoic liver lesions,contrast-enhanced US improved from 64.3% to 92.9%,comic)ared with conventional US (P＜0.001).Conclusions Contrast-enhanced US showed a significant improvement in characterization and differentiation of hyperechoic hepatic lesions when compared to conventional US.

Objective To evaluate the technique and clinical results of the modular fluted tapered stems for treating periprosthetic femoral fractures in revision hip arthroplasty.Methods From August 2007 to February 2014,fourteen patients (14hips) with periprosthetic femoral fractures underwent revision hip arthroplasty with modular fluted tapered stem.A retrospective analysis was performed involving all patients who were followed-up more than 2 years.The subjects consisted of 4 males and 10 females with mean age of 73.4±6.6 years (range,62-82 years) at the time of revision.All patients were unilateral with 8 left hips and 6 right hips.The status of primary arthroplasty was bipolar hemiarthroplasty in 3 patients and total hip arthroplasty in 11 patients.Nine cases were with cemented stems,5 cases with uncemented stems.The interval from primary hip arthroplasty to revision surgery ranged from 40 to 163 months,with an average of 120.9±31.9 months.Eight cases with Vancouver type B3 periprosthetic femoral fracture were found preoperatively,6 cases with aseptic loosening and bone deficiency occurred periprosthetic femoral fracture during the operation.Based on the Paprosky classification system for femoral bone deficiency:type ⅢA in 8 hips,type ⅢB in 5 hips,type Ⅳ in 1 hip.Both the femoral and the acetabular components were revised in 9 patients.All femoral fractures were treated with cable fixation,and the cortical allograft struts were used to augment femoral bone stock in 7 patients.The patients were followed up at 6 weeks,3 months,6 months,9 months,12 months and annually thereafter.Harris Hip Score System and radiographic examination was used to evaluate the clinical results,including fracture union,implant stability,bone stock,hip joint function and postoperative complications.Results The mean duration of follow-up was 62.1 ±22.2 months (range,30-96 months).The mean times of fracture union were 6.2±2.5 months (range,3-12 months).The Harris Hip Score improved from 29.6± 10.3 preoperatively to 86.3±4.2 postoperatively (t=-21.6,P=0.00).Thirteen cases (93％,13/14) had the stem subsidence of 4.9±2.5 mm (range,0-9 mm).Thirteen cases (93％,13/14) were presented with femoral bony restoration.Two cases showed incorporation of the allograft in 7 patients.One patient developed deep venous thrombosis of lower limbs,and one suffered from subcutaneous hematomas after surgery.There was no infection,aseptic loosening,dislocation or periprosthetic fracture complications at the followup.Conclusion The short-medium term results of the modular fluted tapered prosthesis applied in periprosthetic femoral fractures are encouraging in revision hip arthroplasty.The present technology can provide reliable primary stability and can tolerate minimal subsidence postoperatively.

Objective:To analyze the research literature related to end tuberculosis (TB) using bibliometric methods, so as to provide researchers with insights into current research trends and hotspots in this field.Methods:A search was conducted using the Web of Science core collection data base on March 5, 2024. The research was limited to articles and reviews published between 2014 and 2023. The results were visualized with VOSviewer, and an analysis was performed on the involved national, international research cooperation networks and keyword clustering.Results:A total of 1 092 articles related to end TB research were retrieved and screened, with a total citation counts of 14 871 and an average citation counts of 13.62 per article. The United States of America had the highest number of publications (328 articles, 30.04%), while China ranked seventh (100 articles, 9.16%). International scientific collaboration network analysis indicated that countries primarily included the United Kindom, the United States of America, Switzerland, South Africa, the Netherlands, Australia, and India, which had formed close cooperation in the field of end TB research. Keyword clustering analysis suggested that current research hotspots in end TB field included cost analysis related to TB, management of latent TB individuals, strategies for TB prevention and control, key technologies in TB elimination, and TB epidemiology and associated risk factors.Conclusions:Over the past decade, the number of publications and citations in the field of end TB is relatively high. International research collaboration has been extensive, and the research content covers multiple dimensions, including the management and cost analysis of different disease stages, technological innovations, considerations for comprehensive control strategy, and epidemiology.

Objective:To systematically quantify the access to screening and surveillance service of liver cancer in populations in China, especially a series of sub-indicators of the availability.Methods:Following the specific indicators applied by the International Agency for Research on Cancer in the session of availability and use of screening practices in several cancer screening handbooks, information about the access/availability of liver cancer screening and surveillance in population in China were collected; the indicators included local policies and guidelines, procedures most commonly used or recommended, population coverage and participation rate, compliance and related factors, treatment rate, acceptability, equity and others. Systematic review approach was used, combined with searching core literatures/monograph, websites of governments and available program reports, for a systematic analysis on the access to liver cancer screening and surveillance in populations in China.Results:A total of 34 journal articles were included from the systematic review and most of which were about the participation of secondary liver screening or surveillance compliance; additional information were mainly obtained from the other sources. Overall, there were clearly recommended screening and surveillance procedures for liver cancer in the three major cancer screening programs funded by the central government of China. It was estimated that 0.09% of the population aged 35-74 years were covered by liver cancer screening in 2019 in China. The overall participation rates of secondary screening ranged from 37.5% to 62.3% in three major programs, the median compliance rate of surveillance was reported as 26.9% ( Q1, Q3: 23.5%, 41.0%) in the 6 included studies. Two studies reported the factors affecting the participation and compliance. A large-scale multicenter analysis showed that the subject acceptability to alpha fetoprotein test combined with ultrasound screening was as high as 99.3% in high-risk population in urban area. The treatment rate of liver cancer founded by screening, surveillance or follow-up was estimated to be >90% in rural population. No studies of equity were obtained via the systematic review. Conclusions:The public health service programs in China all recommend specific procedures for liver cancer screening in general population and surveillance for high-risk individuals. However, the overall availability needs to be improved, particularly in the indicator of population coverage. Participation rates of screening and compliance rates of surveillance varied among the included programs and the studies, suggesting that the influencing factors need to be further identified. The relatively high subject acceptability suggests the potential demands for screening service. More efforts are needed to address the access to screening and surveillance of liver cancer in populations in China.