Objectives:To investigate the feasibility and ideal trajectory of medialized entry iliac screws(MEIS)placed in the posterior superior iliac in spinopelvic fixation through imaging and anatomic analyses,and to validate in clinical practice.Methods:The imaging data of 90 patients(45 males,45 females;57.5±1.6 years)without spinal or pelvic pathology who underwent pelvic CT scan in the radiology department of our hospital between June 2022 and September 2024 were collected.Three-dimensional pelvic reconstruction was performed using Mimics 21.0 software.The parameters of the bony channels of the iliac were measured and compared between males and females,including short and long axes of teardrop cross-section,the narrowest and widest inter-cortical distances of the iliac corridors,sacroiliac joint angles,and screw-to-sagittal plane angles.The ideal screw trajectory for MEIS was determined based on imaging and anatomical characteristics,and standard surgical procedures were formulated,which were applied in 5 patients.Results:No significant gender differences were observed in the narrowest iliac corridor width(males:15.19±1.81mm vs.females:15.01±2.24mm,P＞0.05),widest corridor width(males:24.16±1.66mm vs.females:24.44±2.92mm,P＞0.05),or sacroiliac joint angle(males:39.63°±4.13° vs.females:40.76°±2.94°,P＞0.05).However,significant gender dif-ferences were found in the screw-to-sagittal angle(males:30.38°±3.15° vs.females:26.72°±5.64°,P＜0.05),as well as in the teardrop short axis(males:22.00±1.25mm vs.females:20.47±1.73mm,P＜0.05)and long axis(males:32.92±2.85mm vs.females:30.80±1.48mm,P＜0.05).Notably,the narrowest and widest inter-cortical distances of the iliac corridors,and short and long axes of teardrop cross-section exceeded the diameter(9mm)of a iliac screw(P＜0.001).Postoperative imaging examinations of the 5 patients who underwent this surgical procedure showed that all implants were stably positioned,with satisfactory improvement in symptoms and functional outcomes.Conclusions:The MEIS placement in the posterior superior iliac is safe and feasible,which can serve as a new option for iliac screw placement trajectory in spinopelvic fixation.

Objectives:To investigate the feasibility and ideal trajectory of medialized entry iliac screws(MEIS)placed in the posterior superior iliac in spinopelvic fixation through imaging and anatomic analyses,and to validate in clinical practice.Methods:The imaging data of 90 patients(45 males,45 females;57.5±1.6 years)without spinal or pelvic pathology who underwent pelvic CT scan in the radiology department of our hospital between June 2022 and September 2024 were collected.Three-dimensional pelvic reconstruction was performed using Mimics 21.0 software.The parameters of the bony channels of the iliac were measured and compared between males and females,including short and long axes of teardrop cross-section,the narrowest and widest inter-cortical distances of the iliac corridors,sacroiliac joint angles,and screw-to-sagittal plane angles.The ideal screw trajectory for MEIS was determined based on imaging and anatomical characteristics,and standard surgical procedures were formulated,which were applied in 5 patients.Results:No significant gender differences were observed in the narrowest iliac corridor width(males:15.19±1.81mm vs.females:15.01±2.24mm,P＞0.05),widest corridor width(males:24.16±1.66mm vs.females:24.44±2.92mm,P＞0.05),or sacroiliac joint angle(males:39.63°±4.13° vs.females:40.76°±2.94°,P＞0.05).However,significant gender dif-ferences were found in the screw-to-sagittal angle(males:30.38°±3.15° vs.females:26.72°±5.64°,P＜0.05),as well as in the teardrop short axis(males:22.00±1.25mm vs.females:20.47±1.73mm,P＜0.05)and long axis(males:32.92±2.85mm vs.females:30.80±1.48mm,P＜0.05).Notably,the narrowest and widest inter-cortical distances of the iliac corridors,and short and long axes of teardrop cross-section exceeded the diameter(9mm)of a iliac screw(P＜0.001).Postoperative imaging examinations of the 5 patients who underwent this surgical procedure showed that all implants were stably positioned,with satisfactory improvement in symptoms and functional outcomes.Conclusions:The MEIS placement in the posterior superior iliac is safe and feasible,which can serve as a new option for iliac screw placement trajectory in spinopelvic fixation.

Objective To retrospectively analyze pathogen distribution,antimicrobial resistance,and their chan-ging trends in patients with infectious endophthalmitis admitted to a hospital in Xingtai area during the past 10 years.Methods Patients with infectious endophthalmitis and were detected pathogens admitted to Hebei Eye Hos-pital from January 2014 to December 2023 were selected for a retrospective study.Culture results and antimicrobial resistance of pathogens from patients with endophthalmitis were summarized and analyzed.The mutation character-istics of resistance genes and cassette chromosome recombinase genes in methicillin-resistant Staphylococcus epider-midis(MRSE)strains were explored.In vitro virulence between MRSE strains carrying mutant and non-mutant genes was compared using serum killing test.Results A total of 671 patients(671 eyes)with infectious endoph-thalmitis were included in the study,with 484 pathogenic strains(from 484 eyes)isolated.The average age of pa-tients was(65.66±25.14)years old.There were no statistically significant differences in the constituent rates of pathogens among infectious endophthalmitis patients of different genders and ages(both P＞0.05).Incidence of in-fectious endophthalmitis was higher in summer and lower in winter.Except 2018,there were statistically significant differences in the constituent rate of infectious endophthalmitis among different seasons from 2016 to 2023(all P＜0.05).A total of 176 strains of Staphylococcus epidermidis,81 strains of Streptococcus,and 48 strains of Pseudo-monas aeruginosa were isolated.The resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,and oxacillin were all over 40％,with a resistance rate of 64.20％to penicillin.From 2019 to 2023,the resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,oxacillin,compound sulfamethoxazole,and cipro-floxacin were all higher than those from 2014 to 2018,and the differences were all statistically significant(all P＜0.05).The resistance rates of Streptococcus to azithromycin,erythromycin,and clindamycin were all over 80％.The resistance rate of Pseudomonas aeruginosa to both ciprofloxacin and piperacillin exceeded 70％.Among the 113 MRSE strains,the resistance genes ermA,ermB,and ermC accounted for 12.39％(n=14),13.27％(n=15),and 74.34％(n=84),respectively.The cassette chromosome recombinase genes mainly included ccrA1-ccrB1,ccrA2-ccrB2,and ccrA3-ccrB3 types.Gene mutations were detected from all three types of resistance genes,with a mutation rate of 81.42％(92/113).The colony count of antimicrobial-resistant gene-mutated Staphylococcus epi-dermidis was higher than that of non-mutated strains in serum killing test at 2 and 3 hours(both P＜0.05).Conclusion The constituent rates of pathogens in infectious endophthalmitis remained stable over the 10 years,with the highest proportion in summer and the lowest in winter.The detection rate of antimicrobial-resistant pathogens presented rising tendency,and the resistance gene of MRSE was mainly ermC.Testing and monitoring of MRSE strains should be strengthened in clinic to prevent the cloning and spread of resistance genes.

Objective To retrospectively analyze pathogen distribution,antimicrobial resistance,and their chan-ging trends in patients with infectious endophthalmitis admitted to a hospital in Xingtai area during the past 10 years.Methods Patients with infectious endophthalmitis and were detected pathogens admitted to Hebei Eye Hos-pital from January 2014 to December 2023 were selected for a retrospective study.Culture results and antimicrobial resistance of pathogens from patients with endophthalmitis were summarized and analyzed.The mutation character-istics of resistance genes and cassette chromosome recombinase genes in methicillin-resistant Staphylococcus epider-midis(MRSE)strains were explored.In vitro virulence between MRSE strains carrying mutant and non-mutant genes was compared using serum killing test.Results A total of 671 patients(671 eyes)with infectious endoph-thalmitis were included in the study,with 484 pathogenic strains(from 484 eyes)isolated.The average age of pa-tients was(65.66±25.14)years old.There were no statistically significant differences in the constituent rates of pathogens among infectious endophthalmitis patients of different genders and ages(both P＞0.05).Incidence of in-fectious endophthalmitis was higher in summer and lower in winter.Except 2018,there were statistically significant differences in the constituent rate of infectious endophthalmitis among different seasons from 2016 to 2023(all P＜0.05).A total of 176 strains of Staphylococcus epidermidis,81 strains of Streptococcus,and 48 strains of Pseudo-monas aeruginosa were isolated.The resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,and oxacillin were all over 40％,with a resistance rate of 64.20％to penicillin.From 2019 to 2023,the resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,oxacillin,compound sulfamethoxazole,and cipro-floxacin were all higher than those from 2014 to 2018,and the differences were all statistically significant(all P＜0.05).The resistance rates of Streptococcus to azithromycin,erythromycin,and clindamycin were all over 80％.The resistance rate of Pseudomonas aeruginosa to both ciprofloxacin and piperacillin exceeded 70％.Among the 113 MRSE strains,the resistance genes ermA,ermB,and ermC accounted for 12.39％(n=14),13.27％(n=15),and 74.34％(n=84),respectively.The cassette chromosome recombinase genes mainly included ccrA1-ccrB1,ccrA2-ccrB2,and ccrA3-ccrB3 types.Gene mutations were detected from all three types of resistance genes,with a mutation rate of 81.42％(92/113).The colony count of antimicrobial-resistant gene-mutated Staphylococcus epi-dermidis was higher than that of non-mutated strains in serum killing test at 2 and 3 hours(both P＜0.05).Conclusion The constituent rates of pathogens in infectious endophthalmitis remained stable over the 10 years,with the highest proportion in summer and the lowest in winter.The detection rate of antimicrobial-resistant pathogens presented rising tendency,and the resistance gene of MRSE was mainly ermC.Testing and monitoring of MRSE strains should be strengthened in clinic to prevent the cloning and spread of resistance genes.

Objective:To investigate the expression level and clinical value of serum miR-148a-3p and miR-551b-5p in patients with acute pancreatitis (AP).Methods:The clinical data of 152 patients with AP admitted to Danzhou people's Hospital from January 2017 to September 2020 were selected. According to the severity of their illness, they were divided into MAP group ( n=70), MSAP group ( n=40), and SAP group ( n=42). The SAP group was divided into survival group ( n=25) and death group ( n=17) according to the prognosis of the patients. Another 50 healthy people were selected as the control group. Fastening venous blood was collected on the day of onset, and the expression levels of serum miR-148a-3p and miR-551b-5p in each group were detected by real-time quantitative PCR. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. The expression levels of serum miR-148a-3p and miR-551b-5p were analyzed to evaluate the prognosis of SAP. The correlation between serum miR-148a-3p and miR-551b-5p expression levels in SAP patients was analyzed by Pearson method. Results:The expression levels of serum miR-148a-3p (3.18±1.27 vs 0.96±0.28) and miR-551b-5p (1.94±0.85 vs 0.51±0.12) in AP group were significantly higher than those in control group ( P<0.001). The expression levels of serum miR-148a-3p (4.36±1.70 vs 2.84±1.10, 2.50±0.92) and miR-551b-5p (2.80±1.04 vs 1.68±0.53, 1.42±0.45) in SAP group were significantly higher than those in MSAP group and MAP group ( P<0.001). The expression levels of serum miR-148a-3p (5.30±1.95 vs 3.47±1.40) and miR-551b-5p (3.62±1.37 vs 2.08±0.91) in death group were significantly higher than those in survival group ( P<0.001). ROC curve analysis showed that the AUC of the combination of miR-148a-3p and miR-551b-5 in judging the prognosis of SAP was significantly higher than that of the single index of miR-148a-3p and miR-551b-5[0.943(95% CI0.886-0.997) vs 0.860(95% CI0.797-0.924), 0.822(95% CI0.795-0.880)], with a sensitivity of 98.3% and specificity of 84.6%. Correlation analysis showed that there were positive correlation between the expression level of serum miR-148a-3p and miR-551b-5p in SAP patients ( r=0.835, P<0.001). Conclusions:The expression levels of miR-148a-3p and miR-551b-5p in serum of AP patients were significantly increased, and the combined detection of miR-148a-3p and miR-551b-5p had a good value in judging the prognosis of SAP.