Objective To analyze the direct economic burden caused by surgical site infection(SSI)in orthopedics and joint surgery,and provide evidence-based support for intervention measures.Methods 3 348 hospitalized pa-tients in the department of orthopedics and joint surgery of a hospital from July 2021 to July 2023 were selected.They were divided into an infection group and a control group based on whether they had SSI.The propensity score matching(PSM)method was adopted to match the two groups of patients in a 1∶1 ratio.The length of hospital stay and various hospitalization expenses between patients with different types of SSI and control group were compared.Results Among 3 348 hospitalized patients,259 had SSI,with an incidence of 7.74％.Superficial incisional wound infection had the highest number of patients(n=177,68.34％),followed by deep incisional wound infection(n=65,25.10％),organ/space infection had the lowest number of patients(n=17,6.56％).After PSM matching,257 pairs were successfully matched,with a matching rate of 99.23％.Infection group extended length of hospital stay by 18 days compared with the control group(P＜0.001).The total hospitalization expenses and individual hos-pitalization expenses of infection group were all higher than those of the control group(all P＜0.001).Among the various expenses,difference in drug expense was the largest,with an increase of 5 067.83 Yuan in Western medi-cine(P＜0.001)and 957.30 Yuan in antimicrobial agents(P＜0.001).Patients with different types of SSI all had longer hospital stay compared with the control group.Patients with deep incisional wound infection,superficial inci-sional wound infection,and organ/space infection had an extended hospital stay of 26,18,and 13 days,respectively(all P＜0.05).The total hospitalization expenses,Western medicine expenses,and antimicrobial agent expenses of patients with different types of SSI were all higher than those of the control group(all P＜0.05).Conclusion The occurrence of postoperative SSI in patients in the department of orthopedics and joint surgery can prolong the length of hospital stay,resulting in huge economic losses for the patient and the hospital.Effective control of healthcare-associated infection is of great significance for optimizing medical resources,improving medical quality,and ensuring patient safety.

Objective To analyze the direct economic burden caused by surgical site infection(SSI)in orthopedics and joint surgery,and provide evidence-based support for intervention measures.Methods 3 348 hospitalized pa-tients in the department of orthopedics and joint surgery of a hospital from July 2021 to July 2023 were selected.They were divided into an infection group and a control group based on whether they had SSI.The propensity score matching(PSM)method was adopted to match the two groups of patients in a 1∶1 ratio.The length of hospital stay and various hospitalization expenses between patients with different types of SSI and control group were compared.Results Among 3 348 hospitalized patients,259 had SSI,with an incidence of 7.74％.Superficial incisional wound infection had the highest number of patients(n=177,68.34％),followed by deep incisional wound infection(n=65,25.10％),organ/space infection had the lowest number of patients(n=17,6.56％).After PSM matching,257 pairs were successfully matched,with a matching rate of 99.23％.Infection group extended length of hospital stay by 18 days compared with the control group(P＜0.001).The total hospitalization expenses and individual hos-pitalization expenses of infection group were all higher than those of the control group(all P＜0.001).Among the various expenses,difference in drug expense was the largest,with an increase of 5 067.83 Yuan in Western medi-cine(P＜0.001)and 957.30 Yuan in antimicrobial agents(P＜0.001).Patients with different types of SSI all had longer hospital stay compared with the control group.Patients with deep incisional wound infection,superficial inci-sional wound infection,and organ/space infection had an extended hospital stay of 26,18,and 13 days,respectively(all P＜0.05).The total hospitalization expenses,Western medicine expenses,and antimicrobial agent expenses of patients with different types of SSI were all higher than those of the control group(all P＜0.05).Conclusion The occurrence of postoperative SSI in patients in the department of orthopedics and joint surgery can prolong the length of hospital stay,resulting in huge economic losses for the patient and the hospital.Effective control of healthcare-associated infection is of great significance for optimizing medical resources,improving medical quality,and ensuring patient safety.

Objective: To investigate the therapeutic effect of Jin Long Capsule (JLC) combined with neoadjuvant chemotherapy on the invasive breast cancer, and to explore the mechanism of JLC in inhibiting multidrug resistance of breast cancer. Methods: 200 patients were divided into experimental group and control group (100 cases per group). The control group used TEC regimen for neoadjuvant chemotherapy. And the experimental group was treated with TEC regimen combined with oral JLC. According to the Miller & Payne grading system (MP), the efficacy of neoadjuvant chemotherapy was evaluated based on histopathological changes of breast cancer after neoadjuvant chemotherapy. Adverse effect was evaluated according to the classification criteria of the National Cancer Institute of the United States-The Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. The expression of P-glycoprotein (P-gp), glutathione thiol transferase (GST)-π and topoisomerase Ⅱα (TopoⅡα) in breast cancer tissues before and after neoadjuvant chemotherapy were detected by immunohistochemical staining. Results: There were 83 effective cases (83%) in the experimental group, which was higher than that in the control group (65.0%, P<0.05). The incidence of leukopenia, gastrointestinal reactions and alopecia in grade 3 to 4 of the experimental group were lower than those of the control group (all P<0.05). The positive rates of P-gp, GST-π and TopoⅡα expression in the control group were 65.0% (65/100), 61.0% (61/100) and 69.0% (69/100), respectively, and they were 80.6% (75/93), 78.5% (73/93) and 37.6% (35/93) after chemotherapy. The positive rates of P-gp and GST-π expression were significantly higher than those before chemotherapy (both P<0.05), whereas the positive rate of TopoⅡα expression was significantly lower than that before chemotherapy (P<0.05). In the experimental group, the positive rates of P-gp, GST-π and TopoⅡα expression before chemotherapy were 62.0% (62/100), 63.0% (63/100) and 69.0% (69/100), respectively, while after chemotherapy, they were 68.2% (60/88), 67.0% (59/88) and 63.6% (56/88). There was no significant difference in the positive rates and expression intensity of P-gp, GST-π and TopoⅡα before and after the chemotherapy (P>0.05). Conclusion Jin Long Capsule (JLC) can inhibit multidrug resistance, improve the efficacy of neoadjuvant chemotherapy, and reduce adverse reactions of breast cancer.

OBJECTIVE:To study the effects of Heishun tablets combined with Rheum palmatum on the pharmacokinetics of hypaconitine in rats. METHODS:Rats were randomly divided into single drug group(Heishun tablets decoction)and drug combi-nation group(Heishun tablets-R. palmatum mixture decoction),with 18 rats in each group. They were given relevant drugs intragas-trically,by 10 g(medicinal materials)/kg of Heishun tablets. 0.3 ml blood samples were collected before(0 h)and 0.083,0.167, 0.333,0.5,0.75,1,1.5,2,3,4,6,8,10 h after medication with 6 rats at each time point,respectively. The blood concentra-tion of hypaconitine was determined by HPLC-MS using palmatine hydrochloride as internal standard. DAS 2.0.1 software was used to calculate pharmacokinetic parameters. RESULTS:The linear range of hypaconitine was 0.102 4-100 ng/ml (r=0.998 7),and the limit of quantification was 0.1 ng/ml. The pharmacokinetic parameters of single drug group vs. drug combination group were as follows as tmax of (0.50 ± 0.086) h vs. (0.75 ± 0.132)h;t1/2 of (9.967 ± 1.123) h vs. (3.708 ± 0.507) h;AUC0-10 h of (26.087 ± 0.672) μg·h/L vs.(6.516 ± 1.135) μg·h/L;cmax of (6.124 ± 2.312) μg/L vs. (1.592 ± 0.051) μg/L. Compared with single drug group,t1/2,AUC0-10 h and cmax of hypaconitine were decreased in drug combination group,with statistical significance (P<0.05). CONCLUSIONS:R. palmatum can inhibit the absorption of hypaconitine in rats,and speed up the elimination of it in rats.