Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

OBJECTIVE: To improve diagnosis and treatment level of foreign body ingestion of button cell in children. METHOD: Among the 14 cases with foreign bodies ingestion of button cell, 6 cases in esophageal, 7 cases in stomach and lower gastrointestinal tract, 1 case with multiple foreign bodies both in esophagus and stomach. Seven cases in stomach and lower gastrointestinal tract were closely observed without special treatment, 6 cases in esophageal, underwent esophagoscopy and removal of foreign body under general anesthesia, 1 case with multiple foreign bodies in esophagus and stomach underwent esophagoscopy and electronic gastroscopy and then removal of foreign body. All patients had symptomatic treatments after removal of foreign body. The average age is 2 years and 1 month. RESULT: After the removal of button cell, Foreign bodies in stomach and lower gastrointestinal tract in 7 cases were all discharged spontaneously. For the 6 cases in esophagus, 4 cases were cured, 1 case had esophageal stricture, 1 cased died. 1 case with multiple foreign bodies in both esophagus and stomach was cured. CONCLUSION Esophageal foreign body has strong corrosiveness and would cause serious damages even to threaten children's life. It also may lead to esophageal stricture. The key point to cure this disease is to diagnose timely and to operate as soon as possible. Because neutralize of digestive juices and low probability of incarceration, with close observation, the foreign bodies of stomach and lower gastrointestinal tract can discharge spontaneously.
Child, Preschool ; Esophagus ; Female ; Foreign Bodies ; etiology ; Humans ; Infant ; Male ; Stomach

OBJECTIVE: To investigate the clinical value that surgical treatment with comprehensive treatment in treating early stage nasopharyngeal carcinoma. METHOD: Based on the case selection criteria, patients with early nasopharyngeal carcinoma were divided into surgery group and the conventional group according to patients' wishes. Surgery group were treated with surgery plus Radiochemotherapy as a comprehensive treatment while conventional group were treated with Radiochemotherapy. Outcome indices: (1) 5-year survival rate and 5-year disease-free survival rate; (2) Radiation dose to the nasopharynx; (3) Incidence of xerostomia. RESULT: (1) The overall 5-year follow-up rate was 97.12%; 1 patient was lost to follow-up in surgical group, the 5-year follow-up rate was 96.77%; 2 patients were lost in conventional Group with 5-year rate of 97.26%. (2) The 5-year survival rate of 104 patients was 83.65% (87/104). (3) The 5-year survival rate and 5-year tumor-free survival rate were 96.77% (30/31) and 93.55% (29/31) in surgical group, 78.08% (57/73) and 73.97% (54/73) in conventional group. There were significant differences between the two groups (P < 0.05). (4) The radiation dose to the nasopharynx in surgery group and conventional group were (63.90 +/- 5.56) Gy and (71.48 +/- 4.18)Gy, respectively; the dose in surgical group was significantly less than the conventional group, there were statistical significance between the two groups. (5) The incidence of xerostomia was significantly less in surgical group (22.58%) than conventional group (65.75%), the difference was statistically significant. CONCLUSION The surgery combined with concurrent chemoradiotherapy is a effective comprehensive therapeutic interchange program for early stage nasopharyngeal carcinoma. These program can increase the long-term survival rate, but also reduce the radiation dose to the nasopharynx and the occurrence of radiation complications. A further aspect is worth consideration.
Aged ; Carcinoma ; Chemoradiotherapy ; Combined Modality Therapy ; methods ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; mortality ; pathology ; surgery ; therapy ; Nasopharynx ; radiation effects ; Neoplasm Staging ; Prospective Studies ; Radiotherapy Dosage ; Survival Rate ; Xerostomia ; epidemiology ; etiology

To investigate the role of mitochondria in neuronal apoptosis, ischemia-reperfusion mediated neuronal cell injury model was established by depriving of glucose, serum and oxygen in media. DNA fragmentation, cell viability, cytochrome C releasing, caspase3 activity and mitochondrial transmembrane potential were observed after N2a cells suffered the insults. The results showed that N2a cells in ischemic territory exhibited survival damage, classical cell apoptosis change, DNA ladder and activation of caspase3. Apoptosis-related alterations in mitochondrial functions, including release of cytochrome C and depression of mitochondrial transmembrane potential (deltapsim) were testified in N2a cells after mimic ischemia-reperfusion. Moreover, activation of caspase3 occurred following the release of cytochrome C. However, the inhibitor of caspase3, Ac-DEVD-CHO, couldn't completely rescue N2a cells from apoptosis. Administration of cyclosporine A, an inhibitor of mitochondria permeability transition pore only partly inhibited caspase3 activity and reduced DNA damage. Interestingly, treatment of Z-IETD-FMK, an inhibitor of caspase8 could completely reverse DNA fragmentation, but can't completely inhibit caspase3 activity. It was concluded that there were caspase3 dependent and independent cellular apoptosis pathways in N2a cells suffering ischemia-reperfusion insults. Mitochondria dysfunction may early trigger apoptosis and amplify apoptosis signal.
Animals ; Apoptosis ; physiology ; Caspase 3 ; Caspases ; biosynthesis ; Cytochromes c ; biosynthesis ; Mice ; Mitochondria ; physiology ; Neuroblastoma ; pathology ; Neurons ; pathology ; Reperfusion Injury ; metabolism ; pathology ; Tumor Cells, Cultured

Objective:To investigate the combining therapy which not only have cured effect but also can uphold and improve the NPC patient′s immunity function after radiotherrapy and chemotherapy.Method:90 cases randomly divided into 3 groups ①Local group (local injected with IL-2 +radiotherapy+chemotherapy);②General group(ivdrip with IL-2+radiotherapy+chemotherapy);③convention group(radiotherapy+chemotherapy).Checked and observed the immunity function around the immunotherapy and after the radiotherapy and chemotherapy.Result:Cellular immunity of 3 groups are lower and humoral immunity are hypetuntion than normal person.After treated with IL-2 the cellular immunity improves but there′s no great change of the humoral immunity. The immune status of the immune groups have not obvious change than before radiotherapy,at the same time,the cellular immunity of the convention group cut down and the humoral immunity doesn′t change obviously.Conclusion:①It has some effect to uphold and improve the NPC patient′s immunity function to treat with small dosage of IL-2 before radiotherapy and chemotherapy,general treatment is better than local injection;②The three therapies have not great influence on the patient′s humoral immunity.