PURPOSE: We carried out the study aiming to explore and analyze the risk factors, the distribution of pathogenic bacteria, and their antibiotic-resistance characteristics influencing the occurrence of surgical site infection (SSI), to provide valuable assistance for reducing the incidence of SSI after traumatic fracture surgery. METHODS: A retrospective case-control study enrolling 3978 participants from January 2015 to December 2019 receiving surgical treatment for traumatic fractures was conducted at Tangdu Hospital of Air Force Medical University. Baseline data, demographic characteristics, lifestyles, variables related to surgical treatment, and pathogen culture were harvested and analyzed. Univariate analyses and multivariate logistic regression analyses were used to reveal the independent risk factors of SSI. A bacterial distribution histogram and drug-sensitive heat map were drawn to describe the pathogenic characteristics. RESULTS: Included 3978 patients 138 of them developed SSI with an incidence rate of 3.47% postoperatively. By logistic regression analysis, we found that variables such as gender (males) (odds ratio (OR) = 2.012, 95% confidence interval (CI): 1.235 - 3.278, p = 0.005), diabetes mellitus (OR = 5.848, 95% CI: 3.513 - 9.736, p < 0.001), hypoproteinemia (OR = 3.400, 95% CI: 1.280 - 9.031, p = 0.014), underlying disease (OR = 5.398, 95% CI: 2.343 - 12.438, p < 0.001), hormonotherapy (OR = 11.718, 95% CI: 6.269 - 21.903, p < 0.001), open fracture (OR = 29.377, 95% CI: 9.944 - 86.784, p < 0.001), and intraoperative transfusion (OR = 2.664, 95% CI: 1.572 - 4.515, p < 0.001) were independent risk factors for SSI, while, aged over 59 years (OR = 0.132, 95% CI: 0.059 - 0.296, p < 0.001), prophylactic antibiotics use (OR = 0.082, 95% CI: 0.042 - 0.164, p < 0.001) and vacuum sealing drainage use (OR = 0.036, 95% CI: 0.010 - 0.129, p < 0.001) were protective factors. Pathogens results showed that 301 strains of 38 species of bacteria were harvested, among which 178 (59.1%) strains were Gram-positive bacteria, and 123 (40.9%) strains were Gram-negative bacteria. Staphylococcus aureus (108, 60.7%) and Enterobacter cloacae (38, 30.9%) accounted for the largest proportion. The susceptibility of Gram-positive bacteria to Vancomycin and Linezolid was almost 100%. The susceptibility of Gram-negative bacteria to Imipenem, Amikacin, and Meropenem exceeded 73%. CONCLUSION Orthopedic surgeons need to develop appropriate surgical plans based on the risk factors and protective factors associated with postoperative SSI to reduce its occurrence. Meanwhile, it is recommended to strengthen blood glucose control in the early stage of admission and for surgeons to be cautious and scientific when choosing antibiotic therapy in clinical practice.
Humans ; Surgical Wound Infection/epidemiology* ; Male ; Female ; Risk Factors ; Retrospective Studies ; Middle Aged ; Adult ; Case-Control Studies ; Fractures, Bone/surgery* ; Aged ; Drug Resistance, Bacterial ; Logistic Models ; Anti-Bacterial Agents/therapeutic use* ; Incidence ; Bacteria/drug effects*

Objective:To explore the relationship between the prognostic nutritional index(PNI)and the prevalence of coronary heart disease(CHD)in adults.Methods:A cross-sectional analysis was conducted based on the 2017-2020 National Health and Nutrition Examination Survey(NHANES)database.A total of 12,141 adult participants were initially included and divided into CHD group and control group according to the disease status questionnaire.PNI was calculated using serum albumin level and lymphocyte count.Multivariable logistic regression was applied to explore the association between PNI and the prevalence of CHD in adults.Subgroup analysis was conducted to assess whether this association remained consistent across different populations.A restricted cubic spline model was con-structed to clarify the dose-response relationship between PNI and CHD prevalence in adults.Results:Among the 3,894 adult participants,200(5.14％)had CHD.The PNI level in CHD patients was significantly lower than that of the control group[(49.20±8.59)vs.(51.57±4.80),P＜0.001].Multivariable logistic regression analysis showed that,after adjustment for sex,age,race,marital status,body mass index(BMI),hypertension,diabetes and family history of cardiovascular disease,an increase in PNI was still independently associated with a lower prev-alence of CHD(odds ratio[OR]=0.92,95％CI 0.89～0.94,P＜0.001).The dose-response relationship indica-ted a negative linear correlation between PNI and CHD prevalence(P＜0.001).Subgroup analysis showed that the association between PNI and CHD differed significantly across BMI,hypertension and diabetes subgroups(P for in-teraction＜0.05 or＜0.01).Conclusion:Increasing PNI was significantly associated with a lower prevalence of CHD in adults,and this association was more pronounced in specific high-risk populations,such as those with obe-sity,hypertension,and diabetes.Our findings suggest that maintaining good nutritional status is of great significance in reducing the risk of CHD.

Based on the theory of 'bi （痹） of both body and viscera'， this paper systematically discussed the pathogenic evolution of rheumatoid arthritis （RA） complicated by sarcopenia from the perspective of traditional Chinese medicine （TCM）. It is proposed that a transformation pathway is muscle bi to spleen bi and then atrophy bi， and the core pathogenesis is diaharmony of ying （营） and wei （卫）. Combining modern molecular biology research， it is suggested that imbalances in skeletal muscle homeostasis mediated by the tumor necrosis factor-like weak inducer of apoptosis-ibroblast growth factor-inducible 14 （TWEAK-Fn14） axis may provide the material basis for the evolution of this disease. Furthermore， this authors proposed TCM treatment strategies， including "regulating and tonifying ying and wei， warming yang and moving bi， nourishing the viscera by supporting the body"， and "promoting the spleen and resolving turbidity， clearing heat and promoting circulation， regulating the organs and calming the body". These strategies emphasize the simultaneous treatment of body and viscera， integrated prevention and treatment， so as to provide TCM theoretical foundation and clinical approaches for preventing and treating RA complicated by sarcopenia.

Objective:To explore the relationship between the prognostic nutritional index(PNI)and the prevalence of coronary heart disease(CHD)in adults.Methods:A cross-sectional analysis was conducted based on the 2017-2020 National Health and Nutrition Examination Survey(NHANES)database.A total of 12,141 adult participants were initially included and divided into CHD group and control group according to the disease status questionnaire.PNI was calculated using serum albumin level and lymphocyte count.Multivariable logistic regression was applied to explore the association between PNI and the prevalence of CHD in adults.Subgroup analysis was conducted to assess whether this association remained consistent across different populations.A restricted cubic spline model was con-structed to clarify the dose-response relationship between PNI and CHD prevalence in adults.Results:Among the 3,894 adult participants,200(5.14％)had CHD.The PNI level in CHD patients was significantly lower than that of the control group[(49.20±8.59)vs.(51.57±4.80),P＜0.001].Multivariable logistic regression analysis showed that,after adjustment for sex,age,race,marital status,body mass index(BMI),hypertension,diabetes and family history of cardiovascular disease,an increase in PNI was still independently associated with a lower prev-alence of CHD(odds ratio[OR]=0.92,95％CI 0.89～0.94,P＜0.001).The dose-response relationship indica-ted a negative linear correlation between PNI and CHD prevalence(P＜0.001).Subgroup analysis showed that the association between PNI and CHD differed significantly across BMI,hypertension and diabetes subgroups(P for in-teraction＜0.05 or＜0.01).Conclusion:Increasing PNI was significantly associated with a lower prevalence of CHD in adults,and this association was more pronounced in specific high-risk populations,such as those with obe-sity,hypertension,and diabetes.Our findings suggest that maintaining good nutritional status is of great significance in reducing the risk of CHD.

Humans ; SARS-CoV-2 ; COVID-19 ; Antibodies ; Antibodies, Viral/therapeutic use* ; Antibodies, Neutralizing/therapeutic use*

Objective: To identify the feasibility and efficacy of indocyanine green (ICG) used in laparoscopic gastrectomy for advanced gastric cancer patients. Methods: From December 2018 to August 2019, the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed. These patients were divided into ICG group(n=38) and a historical control group (non-ICG group, n=44). The number of retrieved lymph nodes, operation time, blood loss, hospital stay, fever time, evacuation time and complications were compared between these two groups. Results: The operation time [(172.8±45.8) min vs (162.6±45.7) min], blood loss [(80.1±91.9) ml vs (78.6±89.8) ml], hospital stay [(7.0±2.0) d vs (7.5±2.4) d], fever time [(2.3±1.2) d vs (2.9±1.9) d], evacuation time [(3.4±0.8) d vs (3.4±1.1) d] and incidence of complications (5.3% vs 9.1%) were not significantly different between the ICG and historical control groups (P>0.05). The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group (46.5 vs 33.0, P=0.005). Conclusions The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe. Moreover, ICG might elevate the efficiency of regional lymph node dissection.

Wolfberry has important unique medical values as well as edible and commerce values. In this paper,we analyze the characteristics and problems of international trade of wolfberry based on the customs data between 2008 and 2017. During periods of these ten years,the wolfberry was mainly exported with a small proportions of imports. The total export volume increased steadily,reached 82 182. 08 tons and 696. 622 million dollars respectively. Wolfberry came from 31 provinces/autonomous regions and exported to 105 countries and regions through 21 ports. Most of the total exports of wolfberry flew to markets of Asia and Europe,the Ningxia autonomous region was the major export province. Large amount of wolfberry exported through Tianjin port. Compared with the export volume,the import is almost negligible,mainly coming from North Korea,almost all through Changchun port,Jilin province to enter the domestic market. There is a situation of"import of domestic goods". To enhance the international competitiveness of wolf berry industry,we must rely on the fundamental research of wolfberry,speed up the standardization process,strengthen the scientific and technological innovation in wolfberry products,improve the added value and profit of wolfberry.
Asia ; China ; Commerce ; Europe ; Lycium

This study reported two women with extreme obesity who underwent metabolic surgery due to their mutations in leptin receptor (LEPR).Genomic DNA was extracted from the anticoagulant blood samples of the two patients and their parents.A panel of genes related to metabolic diseases or whole exon sequencing was screened and the results were confirmed by Sanger sequencing.This is the first time that these three mutations in LEPR were reported.Two patients complained insatiety and early-onset obesity since childhood at clinics.Patient 1 was a 39-year-old woman with height 150 cm,weight 130 kg,and BMI 57.8 kg/m2.Serum leptin level was 156.4 μg/L.A homozygous mutation of c.2317G＞T was found in exon 15 of LEPR gene in patient 1,which was descended from her father and mother respectively.Patient 2 was a 37-year-old woman with height 158 cm,weight 167 kg,and BMI 67 kg/m2.Serum leptin level was 193.4 μg/L.Genetic analysis showed compound heterozygous mutations of c.1482delT and c.1892C ＞ A.Her father showed heterozygous c.1482delT mutation,and her mother carried heterozygous c.1892C ＞ A mutation.Two patients all underwent metabolic surgery with body weight reduction of about 22 kg and 40 kg respectively after first six months.However,the follow-up studies showed that the body weight of patient 1 rebounded to pre-surgery level in two years and patient 2 did not further lose weight in the following six months.

Objective To identify the feasibility and efficacy of indocyanine green ( ICG) used in laparoscopic gastrectomy for advanced gastric cancer patients. Methods From December 2018 to August 2019, the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed. These patients were divided into ICG group (n＝38) and a historical control group (non?ICG group, n＝44). The number of retrieved lymph nodes, operation time, blood loss, hospital stay, fever time, evacuation time and complications were compared between these two groups. Results The operation time [(172.8±45.8) min vs (162.6±45.7) min], blood loss [(80.1±91.9) ml vs (78.6±89.8) ml], hospital stay [(7.0±2.0) d vs (7.5±2.4) d], fever time [(2.3± 1.2) d vs (2.9±1.9) d], evacuation time [(3.4±0.8) d vs (3.4±1.1) d] and incidence of complications (5.3%vs 9.1%) were not significantly different between the ICG and historical control groups (P＞0.05).The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group (46.5 vs 33.0, P＝0.005). Conclusions The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe.Moreover, ICG might elevate the efficiency of regional lymph node dissection.

Objective To identify the feasibility and efficacy of indocyanine green ( ICG) used in laparoscopic gastrectomy for advanced gastric cancer patients. Methods From December 2018 to August 2019, the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed. These patients were divided into ICG group (n＝38) and a historical control group (non?ICG group, n＝44). The number of retrieved lymph nodes, operation time, blood loss, hospital stay, fever time, evacuation time and complications were compared between these two groups. Results The operation time [(172.8±45.8) min vs (162.6±45.7) min], blood loss [(80.1±91.9) ml vs (78.6±89.8) ml], hospital stay [(7.0±2.0) d vs (7.5±2.4) d], fever time [(2.3± 1.2) d vs (2.9±1.9) d], evacuation time [(3.4±0.8) d vs (3.4±1.1) d] and incidence of complications (5.3%vs 9.1%) were not significantly different between the ICG and historical control groups (P＞0.05).The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group (46.5 vs 33.0, P＝0.005). Conclusions The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe.Moreover, ICG might elevate the efficiency of regional lymph node dissection.