Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Severe allergic reactions to hydrogen peroxide solution and compound chlorhexidine gargle are rare, and most medical professionals have limited understanding of such cases. This article reports a case of anaphylactic shock in a patient with a periodontal abscess following oral flushing with hydrogen peroxide and compound chlorhexidine gargle. Drawing on domestic and international literature, it provides a reference for the emergency management of serious adverse reactions caused by these agents.
Humans ; Anaphylaxis/chemically induced* ; Anti-Infective Agents, Local/adverse effects* ; Chlorhexidine/adverse effects* ; Hydrogen Peroxide/adverse effects* ; Mouthwashes/adverse effects*

Objective This study aims to explore the application effect of a multidisciplinary teaching model(MDT)combined with problem-based learning(PBL)and case-based learning(CBL)in the standardized training of radiation oncology residents.The study aims to highlight its innovative teaching reform characteristics and enhance students'comprehensive quali-ties.Methods This study included 80 residents who underwent radiation oncology training in our hospital from October 2018 to October 2021.The participants were divided into a research group(n=40)that received MDT combined with PBL+CBL multi-track teaching and a control group(n=40)that received traditional lecture-based teaching(LBL).General information of the residents,including age,gender,and entrance exam scores,was collected.The total scores of the two groups in theoretical knowledge,case analysis,and skill operation after training were statistically analyzed.The comprehensive qualities of the resi-dents were evaluated in terms of self-learning ability,comprehension ability,thinking ability,practical ability,and learning in-terest.The scoring system ranged from 0 to 10,with higher scores indicating stronger comprehensive qualities.A questionnaire was used to assess the satisfaction of the residents with the teaching courses,categorized as very satisfied,satisfied,or dissatis-fied,and the overall satisfaction was calculated.Results The research group had significantly higher scores in theoretical knowl-edge,case analysis,skill operation,and total scores compared to the control group(P＜0.05).The research group also had higher scores in self-learning ability,comprehension ability,thinking ability,practical ability,and learning interest(P＜0.05).The overall satisfaction evaluation of the research group was significantly higher(P＜0.05).Conclusion In the teaching of ra-diation oncology,the MDT combined with PBL+CBL model,which focuses on the cultivation of practical and applied talents,can greatly enhance the enthusiasm and interest of residents in training,significantly improve teaching outcomes,and strengthen the comprehensive qualities of clinical physicians.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective This study aims to explore the application effect of a multidisciplinary teaching model(MDT)combined with problem-based learning(PBL)and case-based learning(CBL)in the standardized training of radiation oncology residents.The study aims to highlight its innovative teaching reform characteristics and enhance students'comprehensive quali-ties.Methods This study included 80 residents who underwent radiation oncology training in our hospital from October 2018 to October 2021.The participants were divided into a research group(n=40)that received MDT combined with PBL+CBL multi-track teaching and a control group(n=40)that received traditional lecture-based teaching(LBL).General information of the residents,including age,gender,and entrance exam scores,was collected.The total scores of the two groups in theoretical knowledge,case analysis,and skill operation after training were statistically analyzed.The comprehensive qualities of the resi-dents were evaluated in terms of self-learning ability,comprehension ability,thinking ability,practical ability,and learning in-terest.The scoring system ranged from 0 to 10,with higher scores indicating stronger comprehensive qualities.A questionnaire was used to assess the satisfaction of the residents with the teaching courses,categorized as very satisfied,satisfied,or dissatis-fied,and the overall satisfaction was calculated.Results The research group had significantly higher scores in theoretical knowl-edge,case analysis,skill operation,and total scores compared to the control group(P＜0.05).The research group also had higher scores in self-learning ability,comprehension ability,thinking ability,practical ability,and learning interest(P＜0.05).The overall satisfaction evaluation of the research group was significantly higher(P＜0.05).Conclusion In the teaching of ra-diation oncology,the MDT combined with PBL+CBL model,which focuses on the cultivation of practical and applied talents,can greatly enhance the enthusiasm and interest of residents in training,significantly improve teaching outcomes,and strengthen the comprehensive qualities of clinical physicians.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To systematically retrieve, analyze and evaluate risk prediction models of postoperative urinary retention, so as to provide a basis for the application and optimization of the model.Methods:The research on the risk prediction model of postoperative urinary retention was electronically retrieved in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc and other databases. The language of the literature was Chinese or English. The search period was from database establishment to February 20, 2023. Two researchers independently conducted literature screening and data extraction, and independently evaluated the bias risk and applicability of the included literature using the Prediction Model Risk of Bias Assessment Tool.Results:A total of 10 articles were included, including 17 risk prediction models for postoperative urinary retention. The areas under the receiver operating characteristic curve of 17 models were 0.700 to 0.920. The five most common predictors included in the model were age, gender, postoperative analgesia, diabetes, and operation time. The applicability of the model was good among the 10 studies, but there was some bias, mainly due to insufficient sample size, neglect of missing data and processing methods, overfitting issues, conversion of continuous variables into binary variables, and use of single factor screening for predictive factors.Conclusions:The risk prediction model of postoperative urinary retention has good prediction performance, but there is a certain risk of bias. The clinical value of the model needs further verification. External validation and continuous optimization are required for existing prediction models. Prospective research should also be carried out to develop a universal prediction model with good prediction performance, so as to provide an accurate and practical tool for clinical evaluation of postoperative urinary retention.

Female ; Humans ; Breast Neoplasms ; Testosterone ; Prolactin ; Estradiol ; Testosterone Congeners ; China

Objective:To investigate the stability and feasibility of using absorbable screws during Bernese periacetabular osteotomy.Methods:A retrospective analysis was conducted on a 36 year-old woman diagnosed with developmental dysplasia of the hip, who had undergone Bernese periacetabular osteotomy. Finite element analysis was used to simulate the stability of the acetabulum under loads of 10%, 20%, 50%, and 100% of the patient's weight. The structural stiffness of the pelvis and the maximum equivalent stress on the absorbable screws were observed under different conditions, including whether the acetabular bone block and the ilium were in contact, whether 3 or 4 screws were used, and whether a graft (including fibular cortical bone and PEEK grafts) was used.Results:The structural stiffness of the pelvis fixed with four screws increased by 67%-94% compared to that with three screws. After using a graft, the structural stiffness of the pelvis increased by 50%-83%. As the load increased, the maximum equivalent stress on the screws also increased. When the acetabular bone block and the ilium had no contact, no graft was used, and only three screws were used for fixation, the maximum equivalent stress could reach 518.9 MPa, while this value dropped to 61% when four screws were used (318.7 MPa). When the acetabular bone block and the ilium were in contact, the maximum equivalent stress was about 12% of that when there was no contact, regardless of the number of screws used. When a cortical bone graft or a PEEK graft was used, the maximum equivalent stress could drop to 21%-26% of that without a graft. When the screw strength was 130 MPa, a load of 20% of body weight was applied, and only three screws were used without a graft, the equivalent stress could exceed the strength of the screw; if four screws were used, the equivalent stress was slightly higher than the strength of the screw when a load of 50% of body weight was applied. However, when a graft was used (either cortical bone or PEEK), even when a load of 100% of body weight was applied, the equivalent stress was slightly lower than the strength of the screw.Conclusion:Absorbable screws can provide sufficient stability for Bernese periacetabular osteotomy. The contact between the acetabular bone block and the ilium, an increase in the number of screws, and the use of grafts (cortical bone and PEEK grafts) can further improve stability. Therefore, absorbable screws have broad application prospects in Bernese periacetabular osteotomy.