Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3％)developed early postoperative infectious complications,including intra-abdominal infections(4.1％),surgical site infections(3.7％),and pulmonary infections(5.6％).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P＜0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95％CI=4.194-12.935),smoking(OR=3.079,95％CI=2.261-4.913),and preoperative albumin＜35 g/L(OR=0.572,95％CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3％)developed early postoperative infectious complications,including intra-abdominal infections(4.1％),surgical site infections(3.7％),and pulmonary infections(5.6％).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P＜0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95％CI=4.194-12.935),smoking(OR=3.079,95％CI=2.261-4.913),and preoperative albumin＜35 g/L(OR=0.572,95％CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To investigate the application value of biological muscle flap in laparo-scopic radical proximal gastrectomy with esophagogastric anastomosis.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 10 patients with adeno-carcinoma of esophagogastric junction who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from May 2023 to August 2023 were collected. All patients were males, aged (65±5)years. All patients underwent laparoscopic radical proximal gastrectomy and esophagogastric anastomosis with digestive tract reconstruction using the esophagogastric biological muscle flap. Observation indicators: (1) surgical situations and early complications; (2) follow-up and late com-plications. Measurement data with normal distribution were represented as Mean± SD, and measure-ment data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations and early complications. All 10 patients success-fully completed the surgery without conversion to open surgery, and the operation time was (166±18)minutes. Cases with digestive tract reconstruction as end-to-side anastomosis and Overlap anas-tomosis were 1 and 9, respectively. The time of digestive tract reconstruction, the number of lymph node dissected, volume of intraoperative blood loss, time to postoperative first anal exhaust, time to postoperative first intake of liquid food, duration of postoperative hospital stay were (40±12)minutes, 24±6, (41±9)mL, (3.4±0.5)days, (4.1±1.0)days, (8.3±0.7)days in the 10 patients. Of 4 cases with postoperative early complications, 1 case developed pulmonary infection (Clavien-Dindo grade Ⅱ) on the second day after surgery, with pulmonary infection absorbed after 5 days of antibiotic treat-ment. Two cases experienced chest distress and shortness of breath on the third day after surgery, with the diagnosis of a small to moderate amount of pleural effusion after chest B-ultrasound examination. After pleural puncture and active treatment, the symptoms of them were improved and the pleural effusion disappeared. There was 1 case with choking sensation when eating solid food, which was started from the third week after surgery. Upper gastrointestinal imaging revealed mild anastomotic stenosis of Clavien-Dindo grade Ⅰ in the patient, who was improved after conservative treatment. On the 7th day after surgery, all 10 patients underwent upper gastrointestinal angiography, and no anastomotic leakage or stenosis occurred. There was no sign of contrast agent reflux in the supine position and 30° head down position. (2) Follow-up and late complications. All 10 patients were followed up for 59.5(range, 31.0-127.0)days. The esophageal reflux scale score of 10 patients was 1.4±0.3. During the follow-up, 1 case underwent gastroscopy on 40 days after surgery, which showed reflux esophagitis with Los Angeles grade as B and the Clavien-Dindo grade as Ⅰ. There was no clinical symptom such as heartburn or acid reflux. Results of 24-hour pH monitoring showed that the patient experienced 24 instances of reflux in an upright position and 15 instances of reflux in a supine position, with no prolonged reflux. The total reflux time within 24 hours was 75 minutes. The DeMeester score was 38.3. Results of esophageal pressure measurement showed that the esophageal contraction morphology was normal, but the anastomotic opening was not well relaxed. The rest of 9 cases had no complication such as reflux esophagitis.Conclusion:Biological muscle flap applied in the laparoscopic radical proximal gastrectomy with esophagogastric anastomosis is safe and feasible, with satisfied short-term efficacy.

Objective To analyze the preventive effect and safety of intracisternal perfusion of nimodipine on delayed cerebral vasospasm(DCVS)after subarachnoid hemorrhage(SAH).Methods SAH patients treated with intracranial aneurysm clipping were divided into control group and treatment group according to cohort method.The control group was given basic treatment such as blood dilution,volume expansion and pressure boosting after operation.After DCVS was found,nimodipine injection 2.5-5.0 mL·h-1 was injected intravenously.The treatment group was given continuous perfusion of nimodipine solution(nimodipine injection:compound sodium chloride injection=1:19)for 48 h in the cerebral cistern on the basis of the control group,and the pumping speed was 20 mL·L-1.The course of treatment in both groups was 14 days.The incidence of DCVS was recorded at 3,5,7 and 14 days after operation.The neurological function[National Institutes of Health Stroke Scale(NIHSS)score],state of consciousness[Glasgow Coma Scale(GCS)score],serum DCVS mechanism indexes[platelet-derived growth factor receptor β(PDGFRβ),matrix metalloproteinase-9(MMP-9),prostacyclin I2(PGI2),fibrin degradation product(FDP)]were compared between the two groups before treatment and 14 days after treatment.The occurrence of postoperative complications such as delayed cerebral ischemia was recorded.The prognosis of the two groups was evaluated by modified Rankin scale(mRS)at 3 months after operation,and the safety was evaluated.Results In this study,39 cases were enrolled in the control group and 43 cases in the treatment group.The incidence of DCVS in the treatment group and the control group were 25.58％and 48.72％at 3 days after operation,20.93％and 43.59％at 5 days after operation,and 13.95％and 38.46％at 7 days after operation,respectively.The above indexes in the treatment group were significantly different from those in the control group(all P＜0.05).After 14 days of treatment,the NIHSS score of the treatment group and the control group were 2.08±0.43 and 2.96±0.52,respectively;the GCS score were 13.22±0.48 and 12.36±0.50,respectively;the serum PDGFRβ were(70.22±5.97)and(74.86±6.54)ng·mL-1,respectively;MMP-9 were(189.44±17.23)and(213.95±16.81)ng·mL-1,respectively;PGI2 were(96.18±5.84)and(89.44±6.27)ng·L-1;FDP were(1.62±0.50)and(2.13±0.48)mg·L-1,respectively.The above indexes in the treatment group were significantly different from those in the control group.The incidence of delayed cerebral ischemia in the treatment group was 4.65％,which was significantly lower than in the control group(23.08％,P＜0.05).Three months after operation,there were no deaths in the two groups.The mRS grades of the treatment group and the control group were(0.74±0.17)and(1.19±0.21)points,respectively;and the good prognosis rates were 97.67％and 82.05％,respectively.There were statistically significant differences in the above indicators between the treatment group and the control group(all P＜0.05).The total incidence of adverse drug reactions in the treatment group and the control group was 11.63％and 5.13％,respectively,and the difference was not statistically significant(P＞0.05).Conclusion Intracisternal nimodipine perfusion can reduce the incidence rates of DCVS and delayed cerebral ischemia after SAH,and improve the neurological function and prognosis of patients.

Objective To analyze the preventive effect and safety of intracisternal perfusion of nimodipine on delayed cerebral vasospasm(DCVS)after subarachnoid hemorrhage(SAH).Methods SAH patients treated with intracranial aneurysm clipping were divided into control group and treatment group according to cohort method.The control group was given basic treatment such as blood dilution,volume expansion and pressure boosting after operation.After DCVS was found,nimodipine injection 2.5-5.0 mL·h-1 was injected intravenously.The treatment group was given continuous perfusion of nimodipine solution(nimodipine injection:compound sodium chloride injection=1:19)for 48 h in the cerebral cistern on the basis of the control group,and the pumping speed was 20 mL·L-1.The course of treatment in both groups was 14 days.The incidence of DCVS was recorded at 3,5,7 and 14 days after operation.The neurological function[National Institutes of Health Stroke Scale(NIHSS)score],state of consciousness[Glasgow Coma Scale(GCS)score],serum DCVS mechanism indexes[platelet-derived growth factor receptor β(PDGFRβ),matrix metalloproteinase-9(MMP-9),prostacyclin I2(PGI2),fibrin degradation product(FDP)]were compared between the two groups before treatment and 14 days after treatment.The occurrence of postoperative complications such as delayed cerebral ischemia was recorded.The prognosis of the two groups was evaluated by modified Rankin scale(mRS)at 3 months after operation,and the safety was evaluated.Results In this study,39 cases were enrolled in the control group and 43 cases in the treatment group.The incidence of DCVS in the treatment group and the control group were 25.58％and 48.72％at 3 days after operation,20.93％and 43.59％at 5 days after operation,and 13.95％and 38.46％at 7 days after operation,respectively.The above indexes in the treatment group were significantly different from those in the control group(all P＜0.05).After 14 days of treatment,the NIHSS score of the treatment group and the control group were 2.08±0.43 and 2.96±0.52,respectively;the GCS score were 13.22±0.48 and 12.36±0.50,respectively;the serum PDGFRβ were(70.22±5.97)and(74.86±6.54)ng·mL-1,respectively;MMP-9 were(189.44±17.23)and(213.95±16.81)ng·mL-1,respectively;PGI2 were(96.18±5.84)and(89.44±6.27)ng·L-1;FDP were(1.62±0.50)and(2.13±0.48)mg·L-1,respectively.The above indexes in the treatment group were significantly different from those in the control group.The incidence of delayed cerebral ischemia in the treatment group was 4.65％,which was significantly lower than in the control group(23.08％,P＜0.05).Three months after operation,there were no deaths in the two groups.The mRS grades of the treatment group and the control group were(0.74±0.17)and(1.19±0.21)points,respectively;and the good prognosis rates were 97.67％and 82.05％,respectively.There were statistically significant differences in the above indicators between the treatment group and the control group(all P＜0.05).The total incidence of adverse drug reactions in the treatment group and the control group was 11.63％and 5.13％,respectively,and the difference was not statistically significant(P＞0.05).Conclusion Intracisternal nimodipine perfusion can reduce the incidence rates of DCVS and delayed cerebral ischemia after SAH,and improve the neurological function and prognosis of patients.