Objective To evaluate risk factors for surgical site infection(SSI) in patients with thoracolumbar fracture,and provide basis for making prevention and control measures.Methods Patients with thoracolumbar fractures operation in the department of spinal surgery of a hospital between January 2010 and March 2015 were monitored through information monitoring system,on-site visit,and telephone follow-up,incidence of SSI was investigated,risk factors were performed univariate analysis.Results A total of 326 patients undergoing thoracolumbar fracture operation were monitored,15(4.60％) had SSI.SSI were high in patients≥60 years old,underwent operation at nonlaminar air flow operation room,didn't receive antimicrobial prophylaxis 30 minutes prior to operation,preoperative hospital stay ＞3 days,operation duration ＞3 hours,as well as with diabetes mellitus and chronic respiratory disease (all P＜ 0.01).Conclusion Risk factors for SSI in patients undergoing thoracolumbar fractures operation were patients with older age,receive operation at non-laminar air flow operation room,didn't receive antimicrobial prophylaxis,long length of preoperative hospital stay and operation duration,as well as combined with diabetes mellitus and chronic respiratory disease,preventive measures should be taken to reduce the incidence of infection.

Objective To analyze the clinical features of the multiple trauma patients combined with spine and spinal cord injuries.Methods A retrospective study was performed in 143 multiple trauma patients combined with spine and spinal cord injuries admitted to our department between March 2004 and March 2009.The parameters including injury cause,segment of injuries,associated injuries,complications,treatment methods and outcomes were analyzed.Results Falling and traffic accidents were the main causes for the injuries of spine and spinal cord,accounting for 53.8%(77 cases)and 38.5%(55 cases),respectively.The injured segments involved 101 lumbar vertebrae(50.8%),61 thoracic vertebrae(30.7%),29 cervical spines(14.6%)and 8 sacrococcygeal vertebrae(4.0%).The associated injuries were located at chest(163 regions,38.6%),abdomen(84 regions,19.9%),head and neck(77 regions,18.3%),extremity(65 regions,15.4%),face(17 regions,4.0%)and body surface(16 regions,3.8%).The early complications included electrolyte disturbances in 33 patients (16.8%),respiratory infection in 30(15.3%)and abdominal distention in 19(9.7%).The late complications were malnutrition in 26 patients(13.3%),amyotrophy in 23(11.7%)and deep vein thrombus in 11(5.6%).Treatment methods were operations and expectant treatments in 106 patients (74.1%)and 37(25.9%)respectively.According to American Spinal Injury Association(ASIA)scale,there were 20 patients(14.0%)at grade E before treatment and 53(37.1%)at grade E after treatment.Of all,12 patients were died of mainly multiple organ failure(MOF),cerebral hernia and malnutrition,with mortality rate of 8.39%.There showed an increase of complication and mortality rate with increase of ASIA grade(P ＜ 0.05).Conclusions The spine and spinal cord injuries in patients with multiple trauma are mainly caused by high energy injuries and characterized by high injury severity,complex associated injuries,multiple complications,difficult management and high mortality rate.

Objective To investigate the incidence, clinical symptoms, correlative risk factors and prognosis of dysautonomia in patients with severe traumatic brain injury. Methods A total of 142patients with severe traumatic brain injury treated from January 2008 to March 2010 were retrospectively surveyed to compare the clinical features of dysautonomia group and control group. Logistic regression was used to analyze the risk factors for dysautonomia. At 6 months post-trauma, the Glasgow Outcome Score (GOS) was used to measure the outcome. Results Of all the patients, 94 patients survived and were followed up. There were 16 patients ( 17% ) diagnosed as dysautonomia depended on clinical symptoms,with statistical difference in aspects of GCS, coma duration, ICU time and average length of stay (ALOS)(P < 0.05). The patients with dysautonomia tended to have poorer outcome ( P < 0.05 ) and showed a positive association with diffuse axonal injury (DAI) ( OR = 11. 25, CI 7.65-16.54 ). Conclusion Dysautonomia has high incidence and is usually severe in patients with severe traumatic brain injury,when DAI may contribute to its occurrence and result in poor prognosis.

An recombinant vector pCSV-EPO for expression of EPO cDNA in mammalian cells was constructed by the techniques of gene recombinant, PCR amplification and region-specific mutagenesis. The pCSV-EPO was introduced into COS7 cells by DEAE-dextran-mediated transfection. The expression of the EPO was demonstrated by EPO-ELISA assay. At 48h post transfection, the EPO level was 25ng/ml and 72 h was 17ng/ml.

Objective:To reveal the epidemiologic characteristics of hepatitis B virus (HBV) infection in HIV positive population in China.Methods:We collected research papers published from 2010 to 2019 on HBV co-infection in HIV positive population in China through literature retrieval, screening and quality evaluation. The Meta-analysis was conducted after extracting relevant data from the research papers meeting the inclusion criteria.Results:Twenty-seven studies were included with 69 816 samples. The pooled HBV infection rate in HIV positive population in China was 11.29%. The HBV co-infection rate was higher in the western China (10.73%) and southern China (14.18%), while lower in northern China (6.36%). The HBV infection rates were 11.22%, 12.76%, 9.58%, 11.32% and 10.34%, respectively, in HIV-positive population infected through blood or blood products transfusion, intravenous drug use, homosexual contact, heterosexual contact and unknown transmission routes. Population infected with HIV caused by mother-to-child transmission had the lowest HBV infection rate (2.87%). The HBV infection rate in HIV positive males was 1.29 times higher than that in HIV positive females in southern China.Conclusions:The HBV infection rate in HIV positive population is significantly higher than that in general population. More attention should be paid to the prevention and control of HBV co-infection in HIV positive population.

Objective To investigate the expression and clinical significance of periostin (PN) in breast cancer and its adjacent tissues.Methods We evaluated 50 women with breast cancer.We determined PN expression by immunohistochemistry and analyzed positive expression in the tumors and adjacent tissue by paticnt age,TNM stage,SBR type,pathological type,lymph node metastasis,and other factors.Results PN expression in breast cancer and cancer adjacent tissues was associated with an increase in TNM staging (P =0.024),SBR type (P =0.012),and lymphatic metastasis (P =0.035).However,there was no significant correlation between age or pathological type (P ＞ 0.05).Condusion Expression of PN in breast cancer is associated with TNM staging,SBR type,and lymph node metastasis,and is involved in the pathological progression of breast cancer.PN may be a potential prognostic marker for breast cancer.

Objective: To investigate the determinants affecting the heart rate deceleration capacity (DC) in patients with dilated cardiomyopathy (DCM). Methods: One hundred patients with DCM (DCM group) and 202 healthy subjects (control group) were respectively enrolled. Echocardiography and 24 hours electrocardiogram were performed in all subjects. DC value was compared between the two groups. Multiple regression analysis was made to evaluate the related determinants of DC ((age, sex, echocardiographic parameters including the left atrial diameter (LAD) and left ventricular ejection fraction (LVEF)). Results: (1) DC value was significantly lower in DCM group than in control group( (4.40±2.03) ms vs. (7.30±1.81) ms, P<0.01), prevalence of DC value≤4.5 ms was significantly higher in DCM group than in control group (62% vs. 6%, P<0.01). (2) DC value in the DCM group decreased in proportion to increasing LAD dimension, DC value was (5.60±2.04) ms, (4.50±2.07) ms and (3.60±1.62) ms (P<0.05) in DCM patients with LAD≤40 mm, 40 mm50 mm, respectively. (3) DC value in the DCM group was negatively related to the LAD (r=-0.366, P<0.01), positively related to the LVEF (r= 0.241, P<0.01), but not related with age and sex. Multiple factors regression analysis showed that increased LAD was related to the reduced DC values independtly. Conclusion DC value of the patients in the DCM group is decreased, which indicate the decrease of the vagus nerve tension, and increased LAD is related to the reduced DC value independtly in DCM patients.

Objective:To summarise the experience in use of sural neurouascular flap in repair of the soft tissue defects of foot and ankle, and explore the methods in promoting the survival and appearance of the flap.Methods:Data of 10 patients who underwent sural neurocutaneous flap surgery for repairing soft tissue defects in the foot and ankle in the Department of Foot and Ankle of Xuzhou Renci Hospital from October 2019 to June 2020 were retrospectively analysed. Among the 10 patients, 8 were males and 2 were females, and the age ranged from 18 to 54 years old, with an average age of 42.5 years old; Causes of injury: 8 patients injured by traffic accident and 2 by incision necrosis after calcaneal fracture operation. The areas of soft tissue defect were 4.0 cm×6.0 cm-16.0 cm×10.0 cm. Sural neurouascular flap was used for the defect repairs. Method of optimisation: ①The small saphenous vein in the flap was separated and retained in the limb to optimise the venous circulation. ②Freed peroneal perforator vessels that entered the pedicle, and made the point where the vessels entering the pedicle as the rotation point. The pedicle contained the sural neurovascular bundle, the main trunk of the small saphenous vein and the fascia tissue, with a width about 2.0 cm. It not only increased the blood supply of the flaps, but also a good appearance of the pedicle. ③ The torsion of the pedicle was covered by an arc-shaped flap and transferred through an open channel to prevent compression. ④The donor site was covered with relay flap. According to the location of the donor site, a proximal peroneal artery perforator flap or medial and lateral sural artery perforator flap was selected. ⑤Sural nerve was anastomosed with the peripheral sensory nerve in some cases. The survival of the flap, Maryland Foot Function Score and British Medical Research Council (BMRC) sensory function evaluation were investigated in the follow-up to evaluate the functional recovery of the flap and limb.Results:All the 10 patients received the follow-up for 6 to 12 months, with an average of 8.5 months. The donor and recipient flaps survived completely with good appearance in lower limb, good soft texture, good elasticity and wear resistance. The sensation of the flap with nerve anastomosis in 3 cases was evaluated according to BMRC, and they achieved sensation recovery up to level of S 3 or above. The patients had great satisfactions. At the last follow-up, the curative efficacy was evaluated according to the Maryland scoring system. It ranged from 85 to 98 points, with an average of 91.6 point, 8 patients in excellent and 2 in good. Conclusion:Sural neurouascular flap can achieve a sufficient blood supply, a reasonable venous circulation and a high survival rate. The donor site was covered with relay flap to obtain a good appearance, and the anastomosed sensory nerve offered a good sensation. The function of foot and ankle recovered well, and the clinical effect was satisfactory.

Objective:To explore the application effect of health education based on feedback theory in perioperative nursing of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) .Methods:A total of 105 patients undergoing ERCP in the Third Hospital of Shanxi Medical University from February 2019 to June 2020 were selected as the research objects by the convenient sampling method. Patients were divided into the observation group ( n=53) and the control group ( n=52) according to random number table method. The control group was given routine health education, while the observation group was given health education based on feedback theory. The awareness of health education, self-management ability, bad mood and quality of life were compared between the two groups before and after intervention. Results:After intervention, scores of all dimensions of health education awareness questionnaire and the subscale scores of Adult Health Self-Management Ability Scale (AHSMSRS) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on feedback theory can improve the health education awareness, self-management ability of patients undergoing ERCP and improve their negative emotions.