OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

Objective To observe the clinical efficacy of Tongyuan acupuncture in the treatment of acute gouty arthritis.Methods A total of 126 cases of patients with definitive diagnosis of acute gouty arthritis admitted to the wards and outpatient clinics of Guangzhou Nansha District Hospital of Traditional Chinese Medicine from November 2023 to June 2024 were selected as the study subjects.The patients were randomly divided into observation group and control group according to the random number table method,with 63 cases in each group.The control group was given health training and conventional treatment,while the observation group was given Tongyuan acupuncture on the basis of treatment in the control group.Patients in both groups were treated for 14 consecutive days.After two weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes in the clinical symptom scores,the Visual Analogue Scale(VAS)scores of pain,the levels of musculoskeletal ultrasonography(synovial proliferation,blood flow signals,and joint fluid)before and after the treatment were observed in patients of both groups.The changes of blood uric acid(UA),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),tumor necrosis factor α(TNF-α),and interleukin 1(IL-1)before and after treatment were compared between the two groups.Results(1)The total effective rate was 95.24%(60/63)in the observation group and 84.13%(53/63)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the clinical symptom scores and VAS scores of the patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the serum UA,ESR,and CRP levels of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the TNF-α and IL-1 levels of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the musculoskeletal ultrasound indicators of the two groups of patients were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Tongyuan acupuncture in the treatment of acute gouty arthritis can significantly improve the clinical symptoms of patients,reduce the level of patients'blood UA and inflammatory factor.

OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Development of thoracolumbar vertebra (TLV) and rib primordium (RP) is a common evolutionary feature across vertebrates, although whole-organism analysis of the expression dynamics of TLV- and RP-related genes has been lacking. Here, we investigated the single-cell transcriptome landscape of thoracic vertebra (TV), lumbar vertebra (LV), and RP cells from a pig embryo at 27 days post-fertilization (dpf) and identified six cell types with distinct gene expression signatures. In-depth dissection of the gene expression dynamics and RNA velocity revealed a coupled process of osteogenesis and angiogenesis during TLV and RP development. Further analysis of cell type-specific and strand-specific expression uncovered the extremely high level of HOXA10 3'-UTR sequence specific to osteoblasts of LV cells, which may function as anti-HOXA10-antisense by counteracting the HOXA10-antisense effect to determine TLV transition. Thus, this work provides a valuable resource for understanding embryonic osteogenesis and angiogenesis underlying vertebrate TLV and RP development at the cell type-specific resolution, which serves as a comprehensive view on the transcriptional profile of animal embryo development.

Objective:To study the factors related to infection by multiple drug-resistant bacteria (MDROs) in patients with infectious pancreatic necrosis (IPN).Methods:A retrospective study was conducted on the clinical data of 134 IPN patients with definitive etiologies treated in the Department of General Surgery, the Third Affiliated Hospital of Guizhou Medical University from January 2009 to February 2020. There were 85 males and 49 females. The age was (46.69±14.11) years. The IPN patients were divided into the multiple and the non-multiple MDROs infection groups based on drug resistance of pathogens in drainage fluid. The difference between the two groups of patients, including the number of antibacterial drugs used, the number of combined antibacterial drugs, the length of ICU stay, and other related factors were analyzed. Univariate and multivariate analyses were performed.Results:Among the 134 patients with IPN, 41 (30.60%) had complex MDROs infection and 93 (69.40%) had non complex MDROs infection. Univariate analysis showed that the course of disease, APACHE II score, extrapancreatic infection, number of surgical operations, time from onset to operation, patency of drainage tube, length of ICU stay, time of using antibiotics, number of changing courses of antibiotics, number of combined antibiotics, blood glucose and glycosylated hemoglobin were related to occurrence of multiple MDROs (all P<0.05); Multivariate analysis showed that glycated hemoglobin ( OR=3.957, 95% CI: 1.073-14.600), time from onset to operation ( OR=6.086, 95% CI: 1.263-29.325), number of changing courses of antibiotics ( OR=3.560, 95% CI: 1.077-11.772), number of combined antibiotics ( OR=3.560, 95% CI: 1.077-11.772), length of ICU stay ( OR=3.590, 95% CI: 1.126-11.448) were independent risk factors of MDROs infection in IPN patients ( P<0.05). Conclusion:Early debridement of infective foci, good control of blood glucose, reduced length of ICU stay, rational use of antibiotics to avoid unnecessary changing courses of antibiotics, appropriate use of combination of antibiotics could reduce the number of MDROs infection in IPN patients.

Objective To investigate the gestational weight gain and quality of life in women with gestational diabetes mellitus(GDM) who used Free-Style Libre Flash Glucose Monitoring System. Methods From August of 2017 to January of 2019, the GDM patients diagnosed in the Department of Endocrinology in 3 ClassⅢ Grade A hospitals in Guangzhou were selected and divided into the observation group(n=39) and control group(n=43) according to their glucose monitoring willingness. The Free-Style Libre Flash Glucose Monitoring System was used for the observation group(sensor changed every 14 days) combined with the fingertip blood glucose monitor, it was necessary to monitor fingertip blood glucose contrast when hypoglycemia was identified by sensors. Pregnant women at other monitoring points could selectively monitor fasting and postprandial blood glucose. In the control group, after assigned into the group patients only monitored their fingertip blood glucose(at lease 2 times/d, including fasting and 2h postprandial blood glucose). The two groups were all instructed by self-management on diet, exercise etc according to the result of blood glucose monitor, the Wechat management was included to instruct them of the daily life diary recording method. World Health Organization-5 Well-Being Index (WHO-5) was adopted at the beginning of the study and the second week of follow-up to investigate the well-being index score of the patients in the two groups; at the end of pregnancy, the average perinatal blood sugar level, incidence of hypoglycemia events and the eligible rate of weight gain in different BMI patients were recorded. Results At the 2nd week, the score of well-being index in the observation group was higher than that in the control group with statistical significance(P=0.037).There was no statistically significant difference in fasting and 2 h postprandial glucose between the two groups (P＞0.05). There was no significant difference in blood sugar control (fasting and 2 hours after meal) between the two groups (P＞0.05), but the detection rate of hypoglycemia in the group using Free-style Libre glucose monitoring system was higher than that in the control group (P=0.042). By the end of pregnancy, stratified analysis showed that the qualified rate of weight gain in the observation group with BMI between 18.5 and 24.9 kg/m2 before pregnancy was higher than that in the control group with statistical significance(P=0.035). Conclusions The use of Free- Style Libre Flash Glucose Monitoring System in GDM patients makes gestational weight control more reasonable and painless, and improves the well-being index of patients.

Objective To study of primary colorectal adenocarcinoma histone H2B single prime generalization (uH2B) and its relationship with clinicopathological parameters.Methods Colonic canceRtissue samples and para-carcinoma tissue of gastrointestinal surgery resection of 83 cases were selected from January 2013 to January 2016 in ouRhospital,and normal colon tissue of 20 cases was collected,and uH2B protein expression level in tissue samples was observed using immunohistochemical staining,and its relationship with clinical pathological parameters of patients with primary colonic carcinoma was analyzed.Results The positive expression rate of uH2B protein in colon canceRtissues was 46.99%,which was loweRthan 83.13% of adjacent tissues and 90.00% in normal colon mucosa,the differences were statistically significant (P<0.05);But there was no significant difference in the positive expression of uH2B protein in adjacent tissues and normal colonic mucosa (P>0.05);The positive expression rate of tumoRuH2B protein in colon canceRtissues in the TNM stage was correlation with degree of differentiation and lymph node metastasis (P<0.05),and it had no significant relationship with the patient′s age,gender,tumoRinvasion depth,tumoRsize (P>0.05).Conclusion The decreased expression rate of uH2B protein in colon carcinoma tissue is correlated with the TNM stage,differentiation degree and lymph node metastasis of the patients.

Objective To study of primary colorectal adenocarcinoma histone H2B single prime generalization (uH2B) and its relationship with clinicopathological parameters.Methods Colonic canceRtissue samples and para-carcinoma tissue of gastrointestinal surgery resection of 83 cases were selected from January 2013 to January 2016 in ouRhospital,and normal colon tissue of 20 cases was collected,and uH2B protein expression level in tissue samples was observed using immunohistochemical staining,and its relationship with clinical pathological parameters of patients with primary colonic carcinoma was analyzed.Results The positive expression rate of uH2B protein in colon canceRtissues was 46.99%,which was loweRthan 83.13% of adjacent tissues and 90.00% in normal colon mucosa,the differences were statistically significant (P<0.05);But there was no significant difference in the positive expression of uH2B protein in adjacent tissues and normal colonic mucosa (P>0.05);The positive expression rate of tumoRuH2B protein in colon canceRtissues in the TNM stage was correlation with degree of differentiation and lymph node metastasis (P<0.05),and it had no significant relationship with the patient′s age,gender,tumoRinvasion depth,tumoRsize (P>0.05).Conclusion The decreased expression rate of uH2B protein in colon carcinoma tissue is correlated with the TNM stage,differentiation degree and lymph node metastasis of the patients.

Objectives To investigate the prevalence of heterogeneous vancomycin intermediate Staphylococcus aureus(hVISA) and the sensitivity of hVISA to novel antibiotics,and to explore the risk factors and infection attributable mortality associated with hVISA infection.Methods A total of 456 methicillin resistant Staphylococcus aureus (MRSA) isolates were isolated in Zhongshan Hospital from January,2008 to November,2010.All MRSA isolates were investigated for hVISA by two agar screening methods BHIA5T (brain-heart infusion containing teicoplanin 5 mg/L)or BHIA6V (brain-heart infusion containing vancomycin 6 mg/L),as well as macroEtest method(MET).Possible hVISA isolates were tested by modified population analysis profile-area under the curve (PAP-AUC).The minimal inhibitory concentrations(MICs) of vancomycin,teicoplanin and linezolid were determined by microbroth dilution as recommended by Clinical Laboratory Standards Institute(CLSI).The contribution difference between hVISA and vancomycin susceptible Staphylococcus aureus (VSSA) in different MIC range was compared.A retrospective case-control study of the patients with hVISA infection or VSSA infection was carried out and statistical analysis was performed using t test,Mann-Whitney test,x2 test and Fisher exact test.Results A total of 105 isolates of hVISA were screened by BHIA5T and BHIA6V (23.0％) with other 23 isolates by MET(5.0％) and 21 by PAP-AUC(4.6％).All isolates were 100％ sensitive to vancomycin,teicoplanin and linezolid.The vancomycin MIC [(1.76 ±-0.16) mg/L] in hVISA group was significantly higher than that in VSSA group[(1.09 ± 0.07)mg/L,P ＜ 0.01],which was a potential risk factor for hVISA infection.The retrospective study showed chronic obstructive pulmonary disease (COPD) was also a risk factor for hVISA infection of the lower respiratory tract.No significant difference in infection attributable mortality was showed between the hVISA group and the VSSA group.Conclusions The overall prevalence of hVISA in Zhongshan Hospital is estimated as 4.6％,while the prevalence of hVISA isolated from blood is as high as 12.5％.All isolates are 100％ sensitive to vancomycin and linezolid.COPD is a risk factor for hVISA infection of the lower respiratory tract.