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 analyze the characteristics of perioperative mortality (POM) in oral maxillofacial head and neck cancer patients. Methods: A retrospective study was adapted for head and neck cancer patients who were treated and had POM in the department of oral maxillofacial & head and neck oncology in Shanghai Ninth People′s Hospital from Jan 1999 to Dec 2019. Demographic information, disease characteristic and clinical records were collected. The factors of POM were classified into surgical complication, medical complication, mixed complication (surgical and medical) and personal complication. SPSS 17.0 software was used to analyze the cause composition for POM under different condition. Results : 55 patients were included: 39 were male, and 16 were female. A total of 12 patients had a smoking history. Furthermore, 28 patients had general comorbidities. 20 underwent preoperative radiotherapy and 9 received preoperative chemotherapy. Squamous cell carcinoma was the most frequent pathological diagnosis in 37 patients. A total of 9 patients had tumors in the maxilla and skull base. In addtition, 4 patients had POM preoperatively, 1 patient had POM within the operation, and 50 patients had POM postoperatively. The leading causes of death were as follows: rupture of the carotid artery was the most frequent (8), and the surgical complication of pulmonary infection was the main medical complication (6). Pulmonary infection and hemorrhage were regarded as the main mixed complication (4). Two patients had POM due to personal complications. The higher the American Society of Anesthesiologists (ASA) score, the higher the proportion of medical factors in POM (P=0.039). Conclusion The composition of POM in oral maxillofacial- head and neck cancer (OMHNC) patients was complicated. Carotid artery rupture was the most common and fatal surgical complication, especially for those who underwent preoperative radiotherapy. Pulmonary infection was the most frequent medical complication, and those who had a higher ASA grade tended to have more complication.

A 61-year-old patient with type I diabetes, diabetic nephropathy, thyroid hypofunction, chronic renal insufficiency anemia period, class IV heart function. During kidney dialysis, a little bleeding when puncture needle punctured the right common carotid artery, bleeding stopped after compression hemostasis. One week later, the patient complained of swollen neck, pain and difficult breathing. Ultrasonic examination suggested that local eminence beside the right common carotid artery, echoless and vascular interlinked; CDFI blood flow signal appeared the artery frequency spectrum, eddy current. Enhanced CT prompted right common carotid artery pseudoaneurysm, the contrast medium extravasated. The patient was diagnosed right common carotid artery pseudoaneurysm.
Aneurysm, False ; surgery ; Carotid Artery, Common ; Humans ; Iatrogenic Disease ; Male ; Middle Aged

BACKGROUND: Bone marrow stromal stem cells (BMSCs) are characterized by rapid amplification and wide differentiation.Thus, to establish in vitro BMSC induction models contributes to the study of tissue engineering.OBJECTIVE: To investigate the possibility of inducing the differentiation of rat BMSCs into cardiomyocytes by 5-azacitidine in vitro.OESING, TIME AND SETTING: The cytological in vitro study was performed at the Central Laboratory of First Affiliated Hospital of Liaoning Medical University from June 2005 to June 2008.MATERIALS: A total of 20 Sprague Dawley rats were supplied by the Experimental Animal Center, Liaoning Medical University.5-azacitidine (Sigma, USA) was used.MHEHODS: Following anesthesia, the rats were used to isolate the femur and tibia. BMSCs were isolated and cultured by the whole bone marrow method + adherent method. When 90% BMSCs were confluence, BMSCs were passaged. BMSCs at the third passage were incubated in a 24-well plate at 2×10~4/well, with 5,10, 15, 20 μmol/L 5-azacitidine. Simultaneously, a blank control group (without inductor) was set. Following 24 hours of induction, BMSCs were incubated in normal medium for 3 weeks.MAIN OUTCOME MEASURES: The following parameters were measured: cell appearance and growth curve, morphological changes following induction, and expression of connexin-43 and a-striated muscle actin.RESULTS: Cultured BMSCs were spindle-shape, with some cell confluence. P3 cells following incubation entered static phase at 1 and 2 days, and entered logarithmic phase at 3 days, reached a peak at 9 days, and then entered platform stage. Cell number became decreased at 12 days. Following induction of 5 μmol/L 5-azacitidine, no significant difference was found in BMSCs.Following induction of 10 μmol/L 5-azacitidine, BMSCs became long and big, extended towards a direction, with the property of myotube formation cells. Following induction of 15 umol/L 5-azacitidine, a few cells survived surrounding the 24-well plate.Following induction of 20 μmol/L 5-azacitidine, cells died. Following induction of 10 μmol/L 5-azacitidine for 3 weeks, expression of connexin-43 and a-striated muscle actin was determined in BMSCs. However, a negative expression was detected in the blank control group.CONCLUSION: BMSCs cannot differentiate into cardiomyocytes by itself. Following in vitro induction, BMSCs can differentiate into cardiomyocytes. Low-dose 5-azacitidine concentration cannot induce the differentiation, but high-dose 5-azacitidine concentration will induce death in a large number of cells. Thus, 10 μmol/L is an optimal concentration.

0.01). There was a significant difference in TIMP-1,-2 expressions between saccule injury group and control group (P

OBJECTIVE To investigate the surgical methods for the lesions involved the common carotid artery.METHODS The clinical data of 11 cases with lesions involved the common carotid artery who underwent operations were retrospectively studied.The lesions were 1 case with recurrence tumor after 3/4 partial laryngectomy,1 case with bleeding of the carotid aneurysm caused by tuberculosis,1 case with iatrogenic carotid aneurysm,3 cases with carotid body tumor,1 case with thyroid gland cancer,2 cases with neck tumor,1 case with injury of the carotid artery and 1 case with gas gangrene.RESULTS Common carotid artery was reconstructed in 2 cases after removal of the tumors.The tumors were resected using the carotid shunt in 2 cases.Common carotid artery was sutured in 1 case with neck injury.The common carotid artery was repaired in 1 case with iatrogenic carotid aneurysm after removal of the tumor.The carotid artery was dissected out from the thyroid gland cancer in 1 case.The common carotid artery was reserved in 2 cases after resection of the neck tumors. Neck drainage was performed in the case with gas gangrene.CONCLUSION The surgical methods for lesions involved the carotid artery after removal of the tumors include the reconstruction of the carotid artery, resection and suture the carotid artery,and free of the carotid artery from the tumors.