OBJECTIVETo analyze the risk factors of surgical site infection (SSI) following posterior lumbar intervertebral fusion.

METHODSThis retrospective case-control study was conducted in 2904 patients undergoing posterior lumbar intervertebral fusion from 2011 to 2016. Forty-three patients with SSI within 30 days after the operation served as the case group, and 334 randomly selected patients without infection served as the control group. Age, gender, diabetes, body mass index (BMI), albumin level, multilevel procedures, subcutaneous fat thickness, surgery duration and the percentage of lumbar multifidus muscle fat infiltration were analyzed, and univariate and multivariate logistic regression analyses were performed to identify the risk factors of SSI.

RESULTSMultivariate logical regression analysis identified a female gender, subcutaneous fat thickness, multilevel surgery, and lumbar multifidus muscle fat infiltration as significant risk factors for SSI ( < 0.05). BMI was not correlated with fat infiltration in the lumbar multifidus muscle ( > 0.05).

CONCLUSIONSA female gender, multilevel surgery, subcutaneous fat thickness and fat infiltration in the multifidus muscle are related to SSI following posterior lumbar intervertebral fusion. Fat infiltration in the multifidus muscle was a spine-specific risk factor for SSI independent of BMI.

ObjectiveTo analyze the clinical characteristics and the use of traditional Chinese medicine （TCM） therapy in cancer patients with COVID-19， and to provide reference for making TCM prevention and treatment strategies and determining diagnosis and treatment priorities for patients with malignant tumors in the COVID-19 epidemic. MethodsThe medical records of 225 malignant tumor cases with COVID-19 who were admitted to 7 national research centers from January 1st to 20th， 2023 were retrospectively collected， and the main symptoms and duration after infection， nucleic acid negative conversion time， use of TCM therapy， and changes in adverse reactions after resuming anti-tumor treatment were analyzed. ResultsA total of 222 malignant tumor patients with COVID-19 were included in the analysis， involving 205 mild cases and 17 moderate cases. The top four most frequently reported clinical symptoms were fever （165 cases）， expectoration or dry cough （99 cases）， decreased appetite （95 cases） and fatigue （85 cases）， of which 40 expectoration or dry cough cases ， 37 fatigue cases and 29 decreased appetite cases lasted for more than 14 days. One hundred and five patients with nucleic acid detection report had a median negative conversion time of 14 days. The nucleic acid negative conversion time was significantly longer in patients with lung cancer compared to those with digestive system malignant tumors， and in those with myelosuppression than those without （P＜0.01）. During the infection period， 47.30% （105/222） of the patients used Chinese patent medicine， and 21.17% （47/222） were treated with herbal decoctions. The use of TCM in patients during the prevention and rehabilitation period， was 1.80%（4/222） and 7.21%（16/222）， respectively. Fifty-five patients resumed anti-tumor treatment after nucleic acid negative conversion， and received TCM simultaneously. Observed adverse reactions， including gastrointestinal reactions， bone marrow suppression， and neurotoxicity， were all grade 1 to 2， and no new adverse events occurred during follow-up. ConclusionCertain malignant tumor patients with COVID-19 had prolonged symptoms and nucleic acid negative conversion time Rational use of TCM can help to promote the rehabilitation of the patients and ensure the smooth process of anti-tumor treatment after infection.