Polyetheretherketone (PEEK) as a new type of thermoplastic engineering plastic, has good biological activity, elastic modulus close to human cortical bone and radiation permeability, and has been widely used in medical field. This study aims to explore the safety and clinical efficacy of using 3D printing personalized PEEK materials to repaire scapular bone defects after bone tumor resection. A total of 6 patients who underwent the implantation of 3D printed PEEK scapular prosthesis from January 2020 to December 2021 in Yunnan Cancer Hospital were retrospectively analyzed. There were 3 males and 3 females, with age ranged from 14 to 52 years. There were 1 case of synovial sarcoma, 1 of Ewing's sarcoma, and 4 of chondrosarcoma. PEEK prosthesis was designed and fabricated based on CT data before surgery. Tumor resection and prosthesis replacement were performed under the premise of ensuring safe surgical boundaries, including 2 cases of total scapular prosthesis replacement and 4 cases of partial scapular prosthesis replacement. The operation time was 90-170 min, and the intraoperative blood loss was 100-400 ml. All 6 patients received satisfactory follow-up, with a tumor progression free survival time of 16-28 months. No tumor recurrence or metastasis was observed, and all patients survived tumor free. At last follow-up, the Constant-Murley shoulder joint score was a minimum of 62 points and a maximum of 68 points. The Japanese Orthopaedic Association's shoulder joint score was 63 points minimum and 78 points maximum. Computer-aided design 3D printing PEEK material prosthesis has certain advantages in the treatment of scapular tumor limb salvage. It has light weight, well adapted, relatively simple installation, good histocompatibility, and can obtain a better appearance and function of the shoulder joint after operation. It can become one of the options for limb salvage treatment of scapular tumor.

Objective:To analyze the complications of vacuum-assisted microwave in the treatment of axillary hyperhidrosis and bromhidrosis.Methods:The clinical data of patients with axillary hyperhidrosis and axillary bromhidrosis admitted to the Laser Aesthetic Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences from April 2018 to May 2019 were retrospectively analyzed. All patients received vacuum-assisted microwave therapy under tumescent anesthesia. The template with appropriate size was selected for transfer printing, and then microwave treatment was carried out according to the marked points. The energy level was 1-5. The hyperhidrosis severity scale (HDSS) was used to grade the hyperhidrosis severity score, and the changes of grading before and after operation were compared to evaluate the curative effect.Results:In the 103 cases, there were 16 males and 87 females, aged from 18 to 62 years. The HDSS scores at 3 months(1.28±0.29)and 12 months(1.70±0.62) after treatment were significantly lower than those before treatment(3.13±0.27) ( P<0.01). In the 103 cases, 99 cases had no postoperative complications and had definite postoperative effect, 4 cases had postoperative complications, including 1 case of infection with local skin necrosis, 1 case of blister and skin scald and 2 cases hematomas(3 sides). Among the 2 cases of hematomas, 1 case had severe necrosis of subcutaneous tissue and fat liquefaction. The incidence of complications was about 3.88% (4/103). Conclusions:Vaccum-assisted microwave is effective in the treatment of hyperhidrosis and bromhidrosis, and the incidence of complications is low. The correct operation and proper treatment of complications can achieve satisfactory result.

Objective:To analyze the complications of vacuum-assisted microwave in the treatment of axillary hyperhidrosis and bromhidrosis.Methods:The clinical data of patients with axillary hyperhidrosis and axillary bromhidrosis admitted to the Laser Aesthetic Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences from April 2018 to May 2019 were retrospectively analyzed. All patients received vacuum-assisted microwave therapy under tumescent anesthesia. The template with appropriate size was selected for transfer printing, and then microwave treatment was carried out according to the marked points. The energy level was 1-5. The hyperhidrosis severity scale (HDSS) was used to grade the hyperhidrosis severity score, and the changes of grading before and after operation were compared to evaluate the curative effect.Results:In the 103 cases, there were 16 males and 87 females, aged from 18 to 62 years. The HDSS scores at 3 months(1.28±0.29)and 12 months(1.70±0.62) after treatment were significantly lower than those before treatment(3.13±0.27) ( P<0.01). In the 103 cases, 99 cases had no postoperative complications and had definite postoperative effect, 4 cases had postoperative complications, including 1 case of infection with local skin necrosis, 1 case of blister and skin scald and 2 cases hematomas(3 sides). Among the 2 cases of hematomas, 1 case had severe necrosis of subcutaneous tissue and fat liquefaction. The incidence of complications was about 3.88% (4/103). Conclusions:Vaccum-assisted microwave is effective in the treatment of hyperhidrosis and bromhidrosis, and the incidence of complications is low. The correct operation and proper treatment of complications can achieve satisfactory result.

Objective:To explore the application value of perioperative nursing information management system based on mobile applications (APP) in Orthopedic Operating Room.Methods:A total of 55 patients who underwent orthopedic surgery from February 2018 to January 2019 were set as the control group adopting routine perioperative nursing information management. A total of 57 patients who underwent orthopedic surgery from February 2019 to January 2020 were set as the observation group carrying out the perioperative nursing information management system based on mobile APP. We compared the waiting time for consecutive operations, operation time, operation safety check implementation rate, Operating Room nursing quality score, incidence of medical disputes and patient satisfaction of two groups of patients.Results:The waiting time for consecutive operations and operation time of patients in the observation group were shorter than those in the control group with statistically significant differences ( P<0.05) . The operation safety check implementation rate before anesthesia, before operation and before leaving the room in the observation group was higher than those in the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of medical disputes and patient satisfaction between the observation group and the control group ( P>0.05) . Conclusions:The application of perioperative nursing information management system based on mobile APP in Orthopedic Operating Room can effectively improve nurses' work efficiency and nursing quality, and ensure patient safety to a certain extent.

Objective:To discuss the application effect of lean management based on time-action method in Operating Room of General Surgery Department.Methods:A total of 106 patients who underwent surgery in General Surgery Department of Jizhong Energy Xingtai Mining Group General Hospital from April 2018 to March 2020 were selected. According to the admission time, 51 patients admitted from April 2019 to March 2020 were set as the observation group, and 55 patients admitted from April 2018 to March 2019 were set as the control group. The control group adopted routine nursing management, while the observation group accepted lean management based on time-action method on this basis. The quality of Operating Room management, operation efficiency, nursing risk events and occurrence of postoperative infection were observed and compared between the two groups.Results:In the observation group, the scores and total scores of item preparation, sterility, cooperation of nursing staff and equipment management after intervention were respectively (17.94±1.58) , (18.15±1.67) , (25.50±1.86) , (26.74±1.93) and (88.45±5.34) , higher than (16.01±1.33) , (15.92±1.28) , (23.11±1.75) , (24.63±1.81) and (79.71±4.86) in the control group, and the differences were statistically significant ( t=6.821, 7.749, 6.816, 5.809, 8.822; P<0.01) . The preoperative preparation time, time of transporting patients and the overtime of nursing staff in the observation group were respectively (26.35±8.12) , (20.26±5.48) , (134.40±19.84) min, which were lower than (38.56±10.27) , (31.05±9.13) and (209.38±25.96) min of the control group, and the differences were statistically significant ( t=6.755, 7.306, 6.816, 16.611; P<0.01) . The incidence of nursing risk in the observation group was 1.96%, which was lower than12.73% in the control group (χ 2=4.396, P=0.036) . The total incidence of postoperative infection in the observation group was 5.88%, which was lower than 20.00% in the control group (χ 2=4.601, P=0.032) . Conclusions:The use of lean management based on the time-action method for Operating Room of General Surgery Department can improve quality of nursing and operation efficiency, reduce postoperative infections and reduce the incidence of nursing risk events.

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Objective:Analysis of clustering characteristics of coronavirus disease 2019 (COVID-19) in Guangdong Province.Methods:The COVID-19 cases in Guangdong Province onset from January 1 to February 29, 2020 were collected from Chinese information system for disease control and prevention and Emergency Public Reporting System. Obtain the epidemiological survey data of the cluster epidemic situation, and clarify the scale of cluster epidemic situation, the characteristics of the index cases, family and non-family subsequent cases. Calculate serial interval according to the onset time of the index cases and subsequent cases, secondary attack rate based on the close contacts tracking results, the characteristics of different cases in the clustered epidemic were compared.Results:A total of 283 cluster were collected, including 633 index cases, 239 subsequent cases. Families are mainly clustered, the total number involved in each cluster is in the range of 2-27, M( P25, P75) are 2.0 (2.0, 4.0). During January 15 to February 29, the secondary attack rate is 2.86% (239/8 363) in Guangdong Province, the family secondary attack rate was 4.84% (276/3 697), and the non-family secondary attack rate was 1.32% (61/4 632). According to the reporting trend of the number of cases in Guangdong Province, it can be divided into four stages, the rising stage, the high platform stage, the descending stage and the low level fluctuation period. The secondary attack rate of the four stages were 3.5% (140/3 987), 2.3% (55/2 399), 2.6% (37/1 435), 1.3% (7/542), respectively. The difference was statistically significant ( P=0.003). Conclusion:COVID-19 cluster mainly occurs in families in Guangdong Province. The scale of the clustered epidemic was small; the serial interval was short; and the overall secondary attack rate was low.

Objective:Analysis of clustering characteristics of coronavirus disease 2019 (COVID-19) in Guangdong Province.Methods:The COVID-19 cases in Guangdong Province onset from January 1 to February 29, 2020 were collected from Chinese information system for disease control and prevention and Emergency Public Reporting System. Obtain the epidemiological survey data of the cluster epidemic situation, and clarify the scale of cluster epidemic situation, the characteristics of the index cases, family and non-family subsequent cases. Calculate serial interval according to the onset time of the index cases and subsequent cases, secondary attack rate based on the close contacts tracking results, the characteristics of different cases in the clustered epidemic were compared.Results:A total of 283 cluster were collected, including 633 index cases, 239 subsequent cases. Families are mainly clustered, the total number involved in each cluster is in the range of 2-27, M( P25, P75) are 2.0 (2.0, 4.0). During January 15 to February 29, the secondary attack rate is 2.86% (239/8 363) in Guangdong Province, the family secondary attack rate was 4.84% (276/3 697), and the non-family secondary attack rate was 1.32% (61/4 632). According to the reporting trend of the number of cases in Guangdong Province, it can be divided into four stages, the rising stage, the high platform stage, the descending stage and the low level fluctuation period. The secondary attack rate of the four stages were 3.5% (140/3 987), 2.3% (55/2 399), 2.6% (37/1 435), 1.3% (7/542), respectively. The difference was statistically significant ( P=0.003). Conclusion:COVID-19 cluster mainly occurs in families in Guangdong Province. The scale of the clustered epidemic was small; the serial interval was short; and the overall secondary attack rate was low.

Objective: To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound. Methods: From June 2016 to June 2018, 100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound-guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed. Results: Among 100 cases, 98 cases were successful, 2 cases failed, and the failure rate was 2%.The success rate of one-time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter(98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%), compared with two different diameter puncture catheterization, the difference was statistically significant(χ²=12.369, P<0.05). All 98 cases with successful puncture were followed up after operation (P<0.05), and there was no statistically significant difference between the two groups(P<0.05). The drainage tube was removed in 2 cases, bile duct infection was found in 2 cases, the remaining patients were unobstructed, and there were no obvious complications. Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple, reliable, safe and effective, and has a certain clinical value.It is worthy of popularizing and application.

Objective: To invesitgate the protein expression for leptin receptor in skeletal muscle in periodontitis and obese rat models, with the aim of exploring the effect of experimental periodontitis on adipokines receptors in insulin-targeting tissues and underlying mechanisms of skeletal muscle insulin resistance. Methods : Forty natal SD male rats were randomly divided into four groups, respectively: obese rats with periodontitis (OB+ CP group), obese rats without periodontitis (OB group), normal rats with periodontitis (CP group) and normal rats without periodontitis (C group). Obese rat model was established by subcutaneous injection of sodium glutamate. Experimental periodontitis was induced by ligation and inoculation of periodontal pathogens. Immunohistochemical analysis of leptin receptor expression in skeletal muscle of four groups was employed. Results: In the skeletal muscle, the protein for leptin receptor in the C group and CP group were popular and strong positive, and there was no statistically significant difference between the groups (P > 0.05). The protein expressions in the OB + CP group and OB group were decreased. Fewer protein expres⁃ sion was detected in the OB + CP group when compared with OB group (P < 0.05). A synergistic interaction between obesity and periodontitis was evident to the expression for the leptin receptor (P < 0.05). Conclusion Local infection induced by experimental periodontitis can barely down⁃regulate the protein expression for leptin receptor in the skeletal muscle. However, periodontitis can significantly down⁃regulate the protein expressions with the presence of obesity.