Objective:To construct and implement an evidence-based practice protocol for the prevention of surgical site infections (SSI) in pediatric patients undergoing orthopedic implant surgery based on the best available evidence, and to evaluate its effectiveness in a clinical setting.Methods:Adhering to the standard procedures of a continuous quality improvement model based on evidence, evidence was transformed into clinical practice through four stages: evidence acquisition, current status review, evidence introduction, and effect evaluation. Totally 301 pediatric patients who underwent orthopedic implant surgery from March to December 2021 at Guangzhou Women and Children's Medical Center, along with 79 medical staff involved in the project implementation were selected by convenience sampling. Patients were divided into three groups according to the time of admission for baseline review (from March to May, n=106), first-round review post-implementation of the evidence-based protocol (from June to August, n=110), and second-round review (from September to December, n=85). Comparisons were made regarding the incidence of SSI in pediatric patients before and after the application of the evidence-based protocol, the knowledge level of medical staff concerning SSI associated with orthopedic implant surgeries in pediatric patients, and the execution of review indicators before and after the application of evidence. Results:Following the implementation of the evidence-based protocol, the incidence of SSI in pediatric patients undergoing orthopedic implant surgery reduced significantly from 8.49% in the baseline review to 0 in the second-round review ( P<0.05). Furthermore, there was a statistically significant increase ( P<0.01) in the scores denoting the knowledge level of medical staff on SSI associated with such surgeries, from (75.91±11.19) to (96.42±7.13). Comparison of the execution of review standards before and after evidence application revealed statistically significant differences ( P<0.05 in all cases) . Conclusions:The initiation of this evidence-based practice project can standardize perioperative diagnostic and nursing behaviors of orthopedic implant surgery in medical and nursing staff, effectively safeguard the safety of pediatric patients, and reduce the occurrence of SSI.

Objective:Using bibliometrics to study the international literature on fat transplantation in recent 10 years, and to explore the research status, hot spots and development trend in this field.Methods:Literatures related to fat transplantation research from 2011 to 2020 were searched through the core collection of Web of Science database, and the literatures were screened strictly according to inclusion and exclusion criteria. Statistical analysis was conducted on the year, journal, first author, number of articles published by countries and institutions, and distribution of disciplines by bibliometrics. Citespace5.7.R5W software was used for co-citation analysis of the included literatures. Cooccurrence analysis and emergent word analysis were also carried out on the keywords in the literature. VOSviewer1.6.16 software was used to perform visual clustering of terms in the title and abstract of the included literature to reveal hot topics and research frontiers.Results:A total of 4 901 papers were included, and the number of annual publications continued to increase from 2011 to 2020. The top three publications during the study period were Plastic and Reconstructive Surgery (320 papers), Aesthetic Surgery Journal (171 papers), and PLoS One (113 papers). The first authors were Rafael Denadai (13 papers), Gentile Pietro(12 papers), Khouri Roger(6 papers). The most productive countries and institutions in this field were the United States (1 646 papers), China (853 papers), and Italy (383 papers). The organizations with the largest number of publications were the University of Pittsburgh (96 papers), Shanghai Jiao Tong University (78 papers), and Milan University (63 papers). There were 87 research categories in the literature related to fat transplantation, of which surgery was involved mostly. Visual analysis of Cites Pace5.7.R5W software showed that 4 901 references had established a co-citation network consisting of 381 nodes, 608 links and 12 clusters. There were 69 599 keywords in the literature, and the top five keywords from high to low were "transplantation" "adipose tissue" "stem-cell" "tissue" , and "obesity" . In the literature, the keywords with the highest intensity of outburst was "outcome" , and the keywords with the longest duration of outburst was "cartilage" . In recent years, the five keywords with outburst were "liver disease" "trial" "stromal vascular fraction" "outcome" , and " Akkermansia muciniphila" . VOSviewer1.6.16 software visualization clustering result showed that the application of fat transplantation in plastic surgery, the source of adipose tissue and its survival mechanism in vivo, and the laboratory research on fat regeneration were the three hot spots in the field of fat transplantation technology. Conclusions:The research on fat transplantation is on the rise in the world, and research institutions at home and abroad are conducting in-depth exploration on fat transplantation. Recent research focuses on improving the long-term survival rate of fat transplantation, and the research level is gradually in-depth at the molecular level.

Objective:To systematically review the characteristics of sleep patterns in the elderly with subjective cognitive decline (SCD) and the relationship between subjective cognitive decline and sleep disorders.Methods:Observational studies on sleep patterns in the elderly with SCD were retrieved by computer in Chinese and English databases such as PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , WanFang Data and VIP, and the retrieval time was from the establishment of the database to March 31, 2020. Two researchers independently conducted article screening, data extraction and quality evaluation according to the standard. The random-effects model was used for Meta-synthesis of studies with data that could be pooled, and descriptive analysis for studies that could not be pooled.Results:A total of 12 articles were included, with a total sample size of 67 474 cases. The prevalence of SCD in the elderly was 25.9% (95% CI: 6.4%-52.5%) . The sleep patterns of the elderly with SCD were characterized by decreased total sleep time, prolonged wake-time after sleep onset, and frequent awakenings at night. Compared with the normal elderly, the elderly with SCD had a higher risk of poor sleep quality, insomnia and excessive daytime sleepiness ( OR=2.1, 1.15, 2.6) , and excessive daytime sleepiness (ESD) increased the risk of SCD in the elderly ( OR=6.06) . Conclusions:Compared with the normal elderly, the overall sleep quality of the elderly with SCD is poor, and sleep disorders can increase the risk of SCD in the elderly. Existing studies have differences in the diagnostic criteria of SCD, and future studies need to further confirm the causal relationship between SCD and sleep disorders in the elderly.

Objective:Using bibliometrics to study the international literature on fat transplantation in recent 10 years, and to explore the research status, hot spots and development trend in this field.Methods:Literatures related to fat transplantation research from 2011 to 2020 were searched through the core collection of Web of Science database, and the literatures were screened strictly according to inclusion and exclusion criteria. Statistical analysis was conducted on the year, journal, first author, number of articles published by countries and institutions, and distribution of disciplines by bibliometrics. Citespace5.7.R5W software was used for co-citation analysis of the included literatures. Cooccurrence analysis and emergent word analysis were also carried out on the keywords in the literature. VOSviewer1.6.16 software was used to perform visual clustering of terms in the title and abstract of the included literature to reveal hot topics and research frontiers.Results:A total of 4 901 papers were included, and the number of annual publications continued to increase from 2011 to 2020. The top three publications during the study period were Plastic and Reconstructive Surgery (320 papers), Aesthetic Surgery Journal (171 papers), and PLoS One (113 papers). The first authors were Rafael Denadai (13 papers), Gentile Pietro(12 papers), Khouri Roger(6 papers). The most productive countries and institutions in this field were the United States (1 646 papers), China (853 papers), and Italy (383 papers). The organizations with the largest number of publications were the University of Pittsburgh (96 papers), Shanghai Jiao Tong University (78 papers), and Milan University (63 papers). There were 87 research categories in the literature related to fat transplantation, of which surgery was involved mostly. Visual analysis of Cites Pace5.7.R5W software showed that 4 901 references had established a co-citation network consisting of 381 nodes, 608 links and 12 clusters. There were 69 599 keywords in the literature, and the top five keywords from high to low were "transplantation" "adipose tissue" "stem-cell" "tissue" , and "obesity" . In the literature, the keywords with the highest intensity of outburst was "outcome" , and the keywords with the longest duration of outburst was "cartilage" . In recent years, the five keywords with outburst were "liver disease" "trial" "stromal vascular fraction" "outcome" , and " Akkermansia muciniphila" . VOSviewer1.6.16 software visualization clustering result showed that the application of fat transplantation in plastic surgery, the source of adipose tissue and its survival mechanism in vivo, and the laboratory research on fat regeneration were the three hot spots in the field of fat transplantation technology. Conclusions:The research on fat transplantation is on the rise in the world, and research institutions at home and abroad are conducting in-depth exploration on fat transplantation. Recent research focuses on improving the long-term survival rate of fat transplantation, and the research level is gradually in-depth at the molecular level.

In 2018, the myopia detection rate of children and adolescents aged 5-18 years old in Shaanxi Province was 54.9% (11 060/20 144). The myopia detection rate of girls ［58.6%(5 830/9 949)］ was higher than that of boys ［58.6% (3 416/5 830)］ ( P<0.001). In children and adolescents, the myopia detection rate increased with the age before their 16 years old, and saw a stable or downward trend after the age of 16. After adjusting the confounding factors, the myopia detection rate of children and adolescents from regions with per capita GDP>100 000 yuan was higherthan that of children and adolescents from regions with per capita GDP<50 000 yuan［ OR (95% CI):1.58(1.34-1.87)］.

In 2018, the myopia detection rate of children and adolescents aged 5-18 years old in Shaanxi Province was 54.9% (11 060/20 144). The myopia detection rate of girls ［58.6%(5 830/9 949)］ was higher than that of boys ［58.6% (3 416/5 830)］ ( P<0.001). In children and adolescents, the myopia detection rate increased with the age before their 16 years old, and saw a stable or downward trend after the age of 16. After adjusting the confounding factors, the myopia detection rate of children and adolescents from regions with per capita GDP>100 000 yuan was higherthan that of children and adolescents from regions with per capita GDP<50 000 yuan［ OR (95% CI):1.58(1.34-1.87)］.

Objective To investigate the the treatment of class Ⅲ malocclusion by orthognathic surgery combined with postoperative orthodontics.Methods Nine patients with skeletal class Ⅲ malocclusion were treated by surgery-first approach without pre-surgical orthodontic from January 2012 to August 2014.The studied sample consisted of 7 women and 2 men (aged 15-28 years old, mean age 19.7 years), who had obvious mandibular protrusion.2 to 3 days after surgery, intermaxillary traction was used to made the maxilla and mandible together by board;we replaced a rubber band every 2 to 3 days and lasted for four weeks.We would dismantle board and performed conventional orthodontic treatment after patient's facial swelling subsided, and the positional relationship between the jaw stabilized.Results The face type of 9 patients were greatly improved after orthodontic treatment for 6.5 to 19.5 months.Patients and their family members felt satisfied, and their occlusal function returned to normal.At 3 to 32 months follow-up, the postoperative appearance and occlusion were becoming good without obvious signs of recurrence.Conclusions The surgery-first approach is an effective method to treat skeletal class Ⅲ malocclusion.

OBJECTIVETo study the efficacy and safety of brucea javanica oil emulsion (BJOE) combining platinum-contained first-line chemotherapy in treating non small cell lung cancer (NSCLC).

METHODCochrane library, PubMed, EMBASE, VIP, CBM and CNKI were searched through computers. The search was finished in February, 2011. Randomized controlled trials (RCTs) of BJOE combining platinum-contained first-line chemotherapy were included. Two researchers extracted data and assess literature quality separately,and made a meta-analyses by RevMan 5.1.2 software.

RESULTTotally 22 RCTs involving 1512 patients were included. The Meta-analysis showed that compared with the pure application of platinum-contained first-line chemotherapy,the combination of BJOE and chemotherapy can enhance the near-term curative effect (RR = 1. 31, 95% CI: 1.18-1.45, P < 0. 000 01), improve the quality of life (RR = 1.78, 95% CI: 1.51-2. 09, P < 0.00001) and reduce the suppression of bone marrow (OR = 0.37, 95% CI: 0. 27-0. 51, P < 0.00001) and the gastrointestinal reactions (OR = 0.59, 95% CI: 0.44-0.80, P = 0.0007) ,with an improvement in organism immunity.

CONCLUSIONThe current evidence indicates that BJOE can enhance the chemotherapeutic effect on NSCLC patients, improve the quality of life and reduce adverse effect of platinum-contained chemotherapeutics and thus it is worth referring in clinic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brucea ; chemistry ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Emulsions ; administration & dosage ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Phytotherapy ; Randomized Controlled Trials as Topic ; Young Adult

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin (LIC) in the treatment of malignant pleural effusion (MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE,ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database,Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials (RCTs) about lentinan injection (LI) for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration's RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent.Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions,such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.

normal group, and the difference of bone mineral density was significant between two groups with lumbar spines and trochanter (P 0.05).③Osteoporosis grouping: The risk factors of osteoporosis may be found only in BMI between the two groups, and the difference was statistically significant (P