Objective To compare of the efficacy of two distinct debridement techniques in membrane induction therapy for chronic tibial osteomyelitis.Methods A retrospective study was conducted on 52 patients with Cierny-Mader type IV A/B chronic tibial osteomyelitis who were treated at the Third Affiliated Hospital of Zunyi Medical University between July 2016 and December 2023.Five patients were diagnosed and treated before 2020,while 47 were managed from 2020 onward.Patients were divided into two groups:a local debridement group(n=28)and an en bloc osteotomy group(n=24).Perioperative outcomes—including operative time,incision length,intraoperative blood loss,and length of hospital stay—were assessed,along with clinical efficacy at 6 months,12 months,and final follow-up.Clinical outcomes were evaluated using the Hospital for Special Surgery(HSS)knee score,the American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score,joint range of motion(knee flexion-extension and ankle plantarflexion-dorsiflexion),recurrence rate,and the Paley classification for infectious bone defects.Results The local debridement group exhibited significantly less intraoperative blood loss(P<0.05),shorter operative time(P<0.05),and reduced hospital stay(P<0.05),as well as higher AOFAS and HSS scores at both 6 and 12 months postoperatively(P<0.05).In contrast,the osteotomy group demonstrated superior Paley classification outcomes at 6 months,12 months,and final follow-up(P<0.05),along with lower rates of infection recurrence.Longitudinal analysis indicated significant improvements in AOFAS scores,HSS scores,and joint mobility over time in both groups(P<0.05).However,no statistically significant differences were observed between groups in terms of functional scores or joint mobility parameters at final follow-up(P>0.05).Conclusion En bloc osteotomy combined with the induced membrane technique(Masquelet technique)enables more comprehensive debridement,minimizes the necessity for repeated surgical interventions,reduces postoperative complications,lowers the risk of recurrence,and promotes enhanced bone healing.

Objective To compare of the efficacy of two distinct debridement techniques in membrane induction therapy for chronic tibial osteomyelitis.Methods A retrospective study was conducted on 52 patients with Cierny-Mader type IV A/B chronic tibial osteomyelitis who were treated at the Third Affiliated Hospital of Zunyi Medical University between July 2016 and December 2023.Five patients were diagnosed and treated before 2020,while 47 were managed from 2020 onward.Patients were divided into two groups:a local debridement group(n=28)and an en bloc osteotomy group(n=24).Perioperative outcomes—including operative time,incision length,intraoperative blood loss,and length of hospital stay—were assessed,along with clinical efficacy at 6 months,12 months,and final follow-up.Clinical outcomes were evaluated using the Hospital for Special Surgery(HSS)knee score,the American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score,joint range of motion(knee flexion-extension and ankle plantarflexion-dorsiflexion),recurrence rate,and the Paley classification for infectious bone defects.Results The local debridement group exhibited significantly less intraoperative blood loss(P<0.05),shorter operative time(P<0.05),and reduced hospital stay(P<0.05),as well as higher AOFAS and HSS scores at both 6 and 12 months postoperatively(P<0.05).In contrast,the osteotomy group demonstrated superior Paley classification outcomes at 6 months,12 months,and final follow-up(P<0.05),along with lower rates of infection recurrence.Longitudinal analysis indicated significant improvements in AOFAS scores,HSS scores,and joint mobility over time in both groups(P<0.05).However,no statistically significant differences were observed between groups in terms of functional scores or joint mobility parameters at final follow-up(P>0.05).Conclusion En bloc osteotomy combined with the induced membrane technique(Masquelet technique)enables more comprehensive debridement,minimizes the necessity for repeated surgical interventions,reduces postoperative complications,lowers the risk of recurrence,and promotes enhanced bone healing.

Objective:To explore the HIV-1 drug resistance in patients with HIV/AIDS in Guilin city following the failure of antiretroviral treatment (ART).Methods:Plasma samples were collected from patients in Guilin who had received ART for more than 1 year and had a HIV viral load greater than or equal to 1 000 copies/ml from January 2019 to December 2023, and demographic information was also collected for HIV-1 genotype subtype analysis and drug resistance testing to determine the resistance mutation loci and the susceptibility of the strains to drugs.Results:A total of 766 patient samples with failed ART collection and successful amplification were collected, of which 536 (69.97%, 536/766) were male, with an average age of 53 years; a total of 8 HIV-1 subtypes were detected, with CRF01_AE (80.55%, 617/766), CRF07_BC (11.10%, 85/766) and CRF08_BC (6.92%, 53/766) predominated. The drug resistance analysis showed that the HIV-1 drug resistance rate was 34.86% (267/766), including nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitor (PI), with dual resistance to NRTIs/NNRTIs (48.31%, 129/267) and NNRTIs resistance (43.07%, 115/267) predominantly. A total of 37 resistance mutation sites were detected, 14 NRTIs-associated mutation sites mainly included M184V/I (47.57%, 127/267), K65R (18.73%, 50/267), K70E/N/T/G/R (13.11%, 35/267), etc., and 18 NNRTIs-associated mutation sites mainly included K103 N/R (56.93%, 152/267), V179 D/E/T (21.72%, 58/267), G190C/S/Q (17.23%, 46/267), and V106I/M (16.85%, 45/267), etc.; and 5 PIs-associated mutation sites was the highest with L10V/I mutation rate (3.00%, 8/267).Conclusions:HIV/AIDS patients in Guilin have shown favorable outcomes in antiviral therapy, with a relatively low overall incidence of drug resistance. However, it is essential to enhance surveillance to reduce the spread of drug-resistant strains in the future.

Objective:To study the evolution of Traditional Chinese Medicine (TCM) syndromes of 171 cases of Kawasaki disease (KD) under the intervention of gamma globulin therapy based on factor analysis.Methods:A cross-sectional study. 171 cases of KD children hospitalized in the Department of Cardiology of Guangzhou Women's and Children's Medical Center from July 2019 to December 2020 were collected. All patients were treated with intravenous gamma globulin (2 g/kg) for 1 week. According to the results of the treatment with C-ball, 171 children with C-ball sensitive KD were selected to collect the four diagnostic data, and the representative syndromes of defensive level, qi level, yin level, and nutritive level were observed. Factor analysis was used to analyze the evolution of syndrome in 171 children with KD c-ball sensitivity.Results:The result of factor analysis showed that the KMO statistics of 171 children with c-ball sensitivity before treatment was 0.792, and Bartley test was significant ( P<0.01). 16 common factors were extracted, and 23 syndromes were screened, mainly including defensive level disorder, qi level disorder,nutritive level disorder,yin level disorder, heat stagnation and blood stasis syndrome. One week after treatment, the statistic of KMO test was 0.787, and Bartley test was significant ( P<0.01). 9 common factors were extracted, and 10 syndromes were screened, mainly including qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome. Conclusion:Before treatment, the TCM syndromes in KD C-cell sensitive children are mainly nutritive level disorder, defensive level disorder, qi level disorder yin level disorder, and heat stagnation and blood stasis syndrome; after treatment, the main TCM syndromes are mainly qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome.

Objective:To observe the effects of hyperbaric oxygen combined with Xingnaojing injection on serum nerve injury，serum factors，and cognitive function in patients with acute carbon monoxide poisoning delayed encephalopathy（ACMPDE）.Methods:A total of 106 cases with ACMPDE who were admitted to the First People’s Hospital of Nanning from July 2018 to July 2020 were selected as the research subjects and divided into control group and research group according to the random number table method，with 53 cases in each group. The control group was given hyperbaric oxygen treatment for 20 days，while the research group was given Xingnaojing injection on the basis of the treatment in the control group for 20 days. The levels of hypersensitive C-reactive protein（hs-CRP），interleukin-6（IL-6），interleukin-10（IL-10），tumor necrosis factor - α（TNF - α），neuron specific enolase（NSE），5-hydroxytryptamine（5-HT），angiopoietin-2（Ang-2），inducible nitric oxide synthase（iNOS），malondialdehyde（MDA），superoxide dismutase（SOD）in the two groups were detected before and after treatment. The Montreal Cognitive Assessment Scale（MoCA），Mini-Mental State Examination（MMSE）and 36-Item Short Form Health Survey（SF-36）were used to evaluate the cognitive function and quality of life of the two groups of patients and to compare the clinical efficacy of the two groups after treatment.Results:The levels of hs CRP，TNF - α and IL-6 in the research group were lower than those in the control group（ P < 0.01），the level of IL-10 in the research group was higher than that in the control group（ P < 0.01），the level of 5-HT in the research group was higher than that in the control group（ P < 0.01），the levels of NSE，Ang-2，and iNOS in the research group were lower than those in the control group（ P < 0.01），the level of SOD in the research group was higher than that in the control group（ P < 0.01），and the level of MDA in the research group was lower than that in the control group（ P < 0.01）.The MMSE，MOCA and SF-36 scores of the research group were higher than those of the control group（ P < 0.01）. After treatment，the total effective rate of the research group（98.11%）was significantly higher than that of the control group（84.91%），and the difference was statistically significant（χ 2 = 4.371， P = 0.037）. Conclusion:Hyperbaric oxygen combined with Xingnaojing injection can improve the level of serum factors in patients with ACMPDE，inhibit inflammatory response，alleviate nerve injury，reduce oxidative stress response，and improve the cognitive function and the quality of life of patients，which is worthy of clinical application.

Objective:To observe the effects of hyperbaric oxygen combined with Xingnaojing injection on serum nerve injury，serum factors，and cognitive function in patients with acute carbon monoxide poisoning delayed encephalopathy（ACMPDE）.Methods:A total of 106 cases with ACMPDE who were admitted to the First People’s Hospital of Nanning from July 2018 to July 2020 were selected as the research subjects and divided into control group and research group according to the random number table method，with 53 cases in each group. The control group was given hyperbaric oxygen treatment for 20 days，while the research group was given Xingnaojing injection on the basis of the treatment in the control group for 20 days. The levels of hypersensitive C-reactive protein（hs-CRP），interleukin-6（IL-6），interleukin-10（IL-10），tumor necrosis factor - α（TNF - α），neuron specific enolase（NSE），5-hydroxytryptamine（5-HT），angiopoietin-2（Ang-2），inducible nitric oxide synthase（iNOS），malondialdehyde（MDA），superoxide dismutase（SOD）in the two groups were detected before and after treatment. The Montreal Cognitive Assessment Scale（MoCA），Mini-Mental State Examination（MMSE）and 36-Item Short Form Health Survey（SF-36）were used to evaluate the cognitive function and quality of life of the two groups of patients and to compare the clinical efficacy of the two groups after treatment.Results:The levels of hs CRP，TNF - α and IL-6 in the research group were lower than those in the control group（ P < 0.01），the level of IL-10 in the research group was higher than that in the control group（ P < 0.01），the level of 5-HT in the research group was higher than that in the control group（ P < 0.01），the levels of NSE，Ang-2，and iNOS in the research group were lower than those in the control group（ P < 0.01），the level of SOD in the research group was higher than that in the control group（ P < 0.01），and the level of MDA in the research group was lower than that in the control group（ P < 0.01）.The MMSE，MOCA and SF-36 scores of the research group were higher than those of the control group（ P < 0.01）. After treatment，the total effective rate of the research group（98.11%）was significantly higher than that of the control group（84.91%），and the difference was statistically significant（χ 2 = 4.371， P = 0.037）. Conclusion:Hyperbaric oxygen combined with Xingnaojing injection can improve the level of serum factors in patients with ACMPDE，inhibit inflammatory response，alleviate nerve injury，reduce oxidative stress response，and improve the cognitive function and the quality of life of patients，which is worthy of clinical application.

Cervical cancer is a common female reproductive system malignant in developing countries. Radiotherapy plays a very important role in the treatment of cervical cancer, and brachytherapy is an essential part of cervical cancer radiotherapy. With the rapid development of CT and MRI imaging technology, brachytherapy cervical cancer has gradually developed from the traditional two-dimensional image-guided technology to three-dimensional image-guided technology. There are more and more treatment methods, including intracavitary brachytherapy, interstitial brachytherapy and intracavitary/interstitial brachytherapy. This paper reviews several common techniques of three-dimensional brachytherapy for cervical cancer, and discusses the dosimetric feasibility of internal and external integration irradiation.

Objective:To explore a method of improving the nursing service ability after total hip arthroplasty (THA) among nurses in villages and towns medical health institutions under the county medical community model and to evaluate its effects.Methods:From June 1 2018 to September 30 2019, we took Department of Orthopedics, Dazhu County People's Hospital of Dazhou of Sichuan Province, as the core, and united with county medical community built by villages and towns medical health institutions with the country in organizing the nursing theoretical knowledge and specialist service ability training after THA for 140 nurses of villages and towns medical health institutions within county medical community. Before and after training, we carried out the theoretical test and practice ability test in trainers, and implemented the consistency analysis in scores of nursing assessment scales for specialist service so as to evaluate the subjective training effect. We also compared the incidence of postoperative complications, functional recovery of hip joint as well as the satisfaction among 30 THA patients before (October 2017 to September 2018) and after (October 2018 to September 2019) training so as to explore the clinical effect.Results:Before and after training, scores of theoretical achievements of nurses of villages and towns medical health institutions were 60 (56, 62) and 82 (79, 85) respectively, and scores of practice ability were 52 (47, 62) and 86 (81, 91) respectively with statistical differences ( P<0.01) . After training, the incidence of postoperative complications was lower than that before training (6.67% vs. 26.67%) ; the postoperative satisfaction, scores of Harris Hip Score (HHS) one month and three months after surgery were higher than those before training [90.00% vs. 66.67%, (73.1±6.00) vs. (57.6±6.67) , (86.6±4.49) vs. (74.5±6.20) ]among 30 THA patients with statistical differences ( P<0.05) . Conclusions:Training with the county medical community model can improve the nursing service ability of nurses in villages and towns medical health institutions among THA patients, postoperative function of hip joint of THA patients as well as patient satisfaction.

Objective:To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19).Methods:The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio ( OR) and95% confidence interval ( CI). Results:A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use ( P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission ( P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant ( P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male ( OR=3.939, 95 %CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification ( OR=6.433, 95 %CI: 2.411-17.162, P<0.001), fatty liver ( OR=3.815, 95 %CI: 1.298-11.215, P=0.015), cholelithiasis ( OR=16.347, 95 %CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 ( OR=10.181, 95 %CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusions:The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.

Objective:To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19).Methods:The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio ( OR) and95% confidence interval ( CI). Results:A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use ( P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission ( P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant ( P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male ( OR=3.939, 95 %CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification ( OR=6.433, 95 %CI: 2.411-17.162, P<0.001), fatty liver ( OR=3.815, 95 %CI: 1.298-11.215, P=0.015), cholelithiasis ( OR=16.347, 95 %CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 ( OR=10.181, 95 %CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusions:The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.