OBJECTIVE To explore the clinical characteristics and risk factors for surgical site infections(SSI)in the patients undergoing type Ⅰ incision surgeries of grade Ⅲ and Ⅳ so as to provide theoretical bases for effective prevention and control of SSI.METHODS The clinical data were prospectively collected from 280 patients with SSI who received major type Ⅰ incision surgeries of grade Ⅲ and Ⅳ in the key departments of the Second Affiliated Hospital of Jiaxing University from Jan.2021 to Jun.2024,and randomly from another 280 patients without infec-tions.The enrolled patients were assigned as the infection group and the no infection group,respectively.The clin-ical characteristics of the SSI were analyzed.The baseline data,including sex,age,hypertension,diabetes melli-tus,hyperlipidemia,heart disease,hepatorenal function,nutrition status,preoperative length of hospital stay,operation duration,implantation materials,emergency surgery,intraoperative warm maintenance,microscope,blood loss volume,blood transfusion and postoperative intensive care unit(ICU)stay as well as severe hypopro-teinemia,were collected from the enrolled patients.Univariate analysis and logistic regression analysis were per-formed for the influencing factors for the SSI.RESULTS A total of 16,706 patients underwent neurosurgery,or-thopedics and cardiothoracic surgery,280 of whom had SSI,the incidence of SSI was 1.68％.Totally 264 strains of bacteria were isolated,53.03％of which were gram-positive bacteria,46.97％were gram-negative bacteria;Staphylococcus aureus was the most common species of pathogenic bacteria.The result of multivariate logistic a-nalysis showed that the nutrition status,operation duration,microscope,postoperative ICU and severe hypopro-teinemia were the risk factors for the SSI(P＜0.05).CONCLUSIONS The SSI is common among the patients un-dergoing type Ⅰ incision surgeries of grade Ⅲ and Ⅳ.It is necessary for the hospital to take targeted interven-tion measures in early stage based on the risk factors.

OBJECTIVE To explore the clinical characteristics and risk factors for surgical site infections(SSI)in the patients undergoing type Ⅰ incision surgeries of grade Ⅲ and Ⅳ so as to provide theoretical bases for effective prevention and control of SSI.METHODS The clinical data were prospectively collected from 280 patients with SSI who received major type Ⅰ incision surgeries of grade Ⅲ and Ⅳ in the key departments of the Second Affiliated Hospital of Jiaxing University from Jan.2021 to Jun.2024,and randomly from another 280 patients without infec-tions.The enrolled patients were assigned as the infection group and the no infection group,respectively.The clin-ical characteristics of the SSI were analyzed.The baseline data,including sex,age,hypertension,diabetes melli-tus,hyperlipidemia,heart disease,hepatorenal function,nutrition status,preoperative length of hospital stay,operation duration,implantation materials,emergency surgery,intraoperative warm maintenance,microscope,blood loss volume,blood transfusion and postoperative intensive care unit(ICU)stay as well as severe hypopro-teinemia,were collected from the enrolled patients.Univariate analysis and logistic regression analysis were per-formed for the influencing factors for the SSI.RESULTS A total of 16,706 patients underwent neurosurgery,or-thopedics and cardiothoracic surgery,280 of whom had SSI,the incidence of SSI was 1.68％.Totally 264 strains of bacteria were isolated,53.03％of which were gram-positive bacteria,46.97％were gram-negative bacteria;Staphylococcus aureus was the most common species of pathogenic bacteria.The result of multivariate logistic a-nalysis showed that the nutrition status,operation duration,microscope,postoperative ICU and severe hypopro-teinemia were the risk factors for the SSI(P＜0.05).CONCLUSIONS The SSI is common among the patients un-dergoing type Ⅰ incision surgeries of grade Ⅲ and Ⅳ.It is necessary for the hospital to take targeted interven-tion measures in early stage based on the risk factors.

Objective To construct an artificial airway stability scheme for in-hospital transport of patients with severe neurological diseases,and to explore the application effect.Methods A total of 210 patients from June 2022 to September 2023 admitted to Jiaxing Second Hospital Neurosurgery Intensive Care Unit(NICU)completed in-hospital transport to examination area of artificial airway nerve severe were selected as the research object,104 patients from June 2022 to January 2023 as control group,received regular transport care,106 patients from February to September 2023 in intervention group received nosocomial transport artificial airway stability scheme.The incidence of airway-related adverse events,transit time and family satisfaction were compared between two groups.Results The incidence of airway-related adverse events in intervention group was lower than that in control group.The transit time in intervention group(19.08±3.17)min was faster than that in control group(25.50±4.84)min.The family satisfaction of intervention group was higher than that of control group,the difference was statistically significant(P＜0.05).Conclusion The implementation of NICU in-hospital transport artificial airway stability program can effectively reduce the incidence of airway-related adverse events and transit time,improve family satisfaction.

Objective To construct an artificial airway stability scheme for in-hospital transport of patients with severe neurological diseases,and to explore the application effect.Methods A total of 210 patients from June 2022 to September 2023 admitted to Jiaxing Second Hospital Neurosurgery Intensive Care Unit(NICU)completed in-hospital transport to examination area of artificial airway nerve severe were selected as the research object,104 patients from June 2022 to January 2023 as control group,received regular transport care,106 patients from February to September 2023 in intervention group received nosocomial transport artificial airway stability scheme.The incidence of airway-related adverse events,transit time and family satisfaction were compared between two groups.Results The incidence of airway-related adverse events in intervention group was lower than that in control group.The transit time in intervention group(19.08±3.17)min was faster than that in control group(25.50±4.84)min.The family satisfaction of intervention group was higher than that of control group,the difference was statistically significant(P＜0.05).Conclusion The implementation of NICU in-hospital transport artificial airway stability program can effectively reduce the incidence of airway-related adverse events and transit time,improve family satisfaction.

Objective To analyze the correlation between the concentration of serum and cerebrospinal fluid clusterin(CLU)and the severity of acute traumatic brain injury(TBI).Methods A total of 102 patients with acute moderate and severe TBI admitted to the Second Hospital of Jiaxing from September 2019 to October 2020 were included in the study,and were divided into two batches in chronological order.The first batch of 20 cases were tested for serum CLU content and its time expression map for 4 consecutive days after injury by Western blot;The second batch of 82 cases were divided into groups according to Glasgow coma score(GCS),Rotterdam-CT score and brain contusion and laceration volume,the CLU concentration in serum and cerebrospinal fluid was detected by enzyme linked immunosorbent assay(ELISA)at peak time according to the serum CLU time expression map,and the differences of CLU concentrations between the groups were compared;The correlation between CLU concentration and patients'general data,GCS score,Rotterdam CT score and brain contusion and laceration volume was analyzed by Spearman correlation coefficient;The factors affecting CLU concentration were analyzed by multiple linear regression.Results The serum CLU concentration gradually increases in patients after TBI,and reached the peak at 3 days after injury;There was no statistical difference in serum CLU concentration in two GCS groups,three Rotterdam-CT score groups and two brain contusion and laceration volume groups(P>0.05),but there was a statistical difference in cerebrospinal fluid CLU concentration(P<0.05);Cerebrospinal fluid CLU concentration was negatively correlated with GCS score(r=-0.542,P<0.05),and positively correlated with Rotterdam-CT score and brain contusion and laceration volume(r=0.414,0.738,P<0.05);There was statistical difference in the influence of brain contusion and laceration volume on cerebrospinal fluid CLU concentration(β=8.074,P<0.001).Conclusion The concentration of CLU in cerebrospinal fluid can reflect the severity of TBI,which is mainly related to the volume of brain contusion and laceration.

Objective:To investigate the influence of long non-coding RNA-CRNDE in stem cell properties and their mechanism in glioma.Methods:The CD133 +U251 stem cells (U251s) were isolated from human glioma cell line U251 by immunomagnetic beads. Cells were divided into U251s group, U251s-CRNDE group, U251 group, and U251-CRNDE group; CRNDE shRNA lentiviral vectors were transfected into cells in the U251s-CRNDE group and U251-CRNDE group to down-regulate the CRNDE expression. The CRNDE mRNA expression was detected by real-time fluorescent quantitative PCR (RT-qPCR); CCK-8 assay was used to detect the cell viability; Transwell assay was used to detect the cell invasion; wound healing method was used to detect the cell migration; plate cloning assay was employed to detect the clone formation; flow cytometry was used to detect the cell cycles; Western blotting was used to detect the expressions of A2B5, CD133, nestin, Sox2, Oct-4 and Nanog, as well as phosphatidylinositol kinase (PI3K)-protein kinase B (AKT)-mammalian target of rapamycin (mTOR) signal pathway key proteins (PI3K, AKT, phosphorylated-AKT, and mTOR). Results:The CRNDE mRNA expression in U251s group was significantly higher than that in U251 group ( P<0.05). As compared with U251s group, U251s-CRNDE group had significantly decreased cell viability, cell invasion and cell migration, statistically smaller number of cell colony, significantly decreased proportion of cells in G2/M phase, significantly increased proportion of cells in G1/G0 phase ( P<0.05); and the same trend was noted between U251 group and U251-CRNDE group. As compared with U251s group, U251s-CRNDE group had significantly decreased expressions of CD133, nestin, Sox2, Oct-4, PI3K, AKT, phosphorylated-AKT, and mTOR ( P<0.05). Conclusion:The CRNDE expression is increased in glioma stem cells, and down-regulation of CRNDE expression can inhibit the differentiation, metabolism and proliferation of glioma stem cells; and this effect is related to the regulation of PI3K-AKT-mTOR signaling pathway.

Objective To explore the effect of hypertonic saline combined with magnesium sulfate on severe craniocerebral injury.Methods Patients with severe craniocerebral injury admitted to our hospital from September 2017 to February 2019 were selected prospectively.With the informed consent of the patients' families,the patients were divided into control group and experimental group according to the random number table.Patients in the two groups accepted intracranial pressure monitoring;patients in the experimental group additionally accepted magnesium sulfate combined with hypertonic saline for a continuous use of 7 d.Incidences of high intracranial pressure,epilepsy,low intracranial perfusion,cerebral vasospasm,cerebral infarction,and intracranial pressure rebound,total mannitol dosages one week after injury,serum neuron specific enolase (NSE) level,and Glasgow outcome scale (GOS) scores and mortality rate 3 months after injury were analyzed and compared between the two groups.Results A total of 93 patients were enrolled;47 were into the control group and 46 into the experimental group.There were no significant differences in age,gender,Glasgow coma scale (GCS) scores and NSE levels at admission,and percentages of patients accepted craniotomy evacuation of hematoma or bone flap decompression between the two groups (P＞0.05).As compared with those in the control group,the total mannitol dosage one week after injury and serum NSE concentration were significantly lower,and GOS scores 3 months after injury in the experimental group were significantly higher(P＜0.05).Patients in the experimental group had significantly lower incidences of high intracranial pressure,cerebral vasospasm and intracranial pressure rebound as compared with patients in the control group (P＜0.05).Conclusion Hypertonic saline combined with magnesium sulfate can improve the prognoses of severe craniocerebral injury;it has few side effects and is cheap;it might be an effective cerebral protective agent.

Objective To prospectively explore the impact of hypocalcemia on the prognostic value of intracerebral hemorrhage.Methods A total of 410 patients consecutively admitted within 12 hours after intracerebral hemorrhage onset were divided into 3 groups based on admission serum calcium:low serum calcium group,normal serum calcium group and high serum calcium group.Baseline characteristics of patients including age,gender,Glasgow coma score(GCS),hematoma volume,etc were collected and analyzed.A follow-up was performed after 6 months.Final outcome was assessed using Glasgow outcome scale(GOS)with a score＞3 regarded as favourable prognosis,a score≤3 as unfavourable prognosis.Results Patients with low serum calcium had lower GOS,bigger hematoma volume,higher rate of operation,higher re-bleeding rate,more unfavourable prognosis than did the other 2 serum calcium groups.Multivariable Logistic regression analysis showed that patients with low serum calcium had poorer prognosis than patients with normal serum calcium after adjusting for other potential confounders(Odds ratio:3.01,95％ confidence interval:1.06-6.12,P＜0.05).Conclusions Hypocalcemia is an independent risk factor for the prognosis of patients with intracerebral hemorrhage.