Objective:To evaluate the clinical efficacy of a novel surgical approach of debridement, antibiotics, and implant retention (DAIR) with flap transfer, for treating chronic implant infections in bone tumor patients.Methods:A retrospective review was conducted on nine consecutive patients [6 males, 3 females; median age 35(27, 51) years, range 9-71] who underwent a modified procedure of DAIR plus flap transfer between November 2022 and January 2024. The cohort included six cases of chronic periprosthetic joint infection and three cases of chronic plate and screw infection. Tumor diagnoses included seven primary malignant tumors (osteosarcoma=5, undifferentiated pleomorphic sarcoma of bone=1, synovial sarcoma=1) and two bone metastasis of renal cell carcinoma. The procedure involved wide, radical debridement, meticulous removal of biofilm from implants and surrounding soft tissue, followed by the transfer of a well vascularized musculocutaneous flap to fully envelope the contaminated interface. Pre-operative clinicopathological data, surgical details, postoperative complications and infection recurrence were analyzed.Results:The median interval between initial implantation and debridement was 10.0(3.3, 14.8) months. Median follow-up after debridement was 15.9(15.4, 18.2) months. All nine surgeries were completed as planned: six musculocutaneous flaps, two fasciocutaneous flaps and one muscle-only flap. Implants were preserved in six patients; two required subsequent removal for recurrent infection, and one patient later underwent amputation for tumor recurrence. Infection-free implant survival at 3, 6 and 12 months was 88.9%, 87.5% and 87.5%, respectively. Major complications included one donor-site hematoma, one donor-site sensory deficit and one wound healing delay. All the complications were well management. Both reinfections occurred in proximal tibial prostheses, likely due to limited flap coverage options and local anatomical constraints.Conclusion:Although reinfections happened in two cases DAIR with flap transfer provides promising short-term infection control in patients with chronic implant-associated infections following bone tumor surgery.

Objective:To evaluate the clinical efficacy of a novel surgical approach of debridement, antibiotics, and implant retention (DAIR) with flap transfer, for treating chronic implant infections in bone tumor patients.Methods:A retrospective review was conducted on nine consecutive patients [6 males, 3 females; median age 35(27, 51) years, range 9-71] who underwent a modified procedure of DAIR plus flap transfer between November 2022 and January 2024. The cohort included six cases of chronic periprosthetic joint infection and three cases of chronic plate and screw infection. Tumor diagnoses included seven primary malignant tumors (osteosarcoma=5, undifferentiated pleomorphic sarcoma of bone=1, synovial sarcoma=1) and two bone metastasis of renal cell carcinoma. The procedure involved wide, radical debridement, meticulous removal of biofilm from implants and surrounding soft tissue, followed by the transfer of a well vascularized musculocutaneous flap to fully envelope the contaminated interface. Pre-operative clinicopathological data, surgical details, postoperative complications and infection recurrence were analyzed.Results:The median interval between initial implantation and debridement was 10.0(3.3, 14.8) months. Median follow-up after debridement was 15.9(15.4, 18.2) months. All nine surgeries were completed as planned: six musculocutaneous flaps, two fasciocutaneous flaps and one muscle-only flap. Implants were preserved in six patients; two required subsequent removal for recurrent infection, and one patient later underwent amputation for tumor recurrence. Infection-free implant survival at 3, 6 and 12 months was 88.9%, 87.5% and 87.5%, respectively. Major complications included one donor-site hematoma, one donor-site sensory deficit and one wound healing delay. All the complications were well management. Both reinfections occurred in proximal tibial prostheses, likely due to limited flap coverage options and local anatomical constraints.Conclusion:Although reinfections happened in two cases DAIR with flap transfer provides promising short-term infection control in patients with chronic implant-associated infections following bone tumor surgery.

Objective To investigate the antimicrobial resistance profile of clinical isolates in Dongguan Tungwah Hospital during 2016.Methods Antimicrobial susceptibility testing was carded out for the clinical isolates collected from Dongguan Tungwah Hospital according to a unified protocol using Kirby-Bauer method or automated systems.Result were analyzed according to CLSI 2016 breakpoints.Results Of the 3 482 clinical isolates,gram positive cocci and gram negative bacilli accounted for 34.4％ (1 199/3 482) and 65.6％ (2 283/3 482),respectively.The prevalence of methicillin-resistant strains was in 28.7％ (86/300) in S.aureus and 77.7％ (300/386) in coagulase-negative Staphylococcus isolates.No staphylococcal strains were found resistant to vancomycin or linezolid.Overall,one E.faecium strain was identified as resistant to vancomycin by instrument method and confirmed by vancomycin E test.The prevalence of ESBLs-producing strains was 59.6％ (337/565) in E.coli and 29.8％ (115/386) in Klebsiella spp.(K.pneumoniae and K.oxytoca).Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,0.4％ and 0.2％ of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.About 38.3％ and 36.9％ of Acinetobacter strains were resistant to imipenem and meropenem,respectively.Conclusions Surveillance of antimicrobial resistance is most important and valuable for understanding the changing resistant pattern in local hospital and rational selection of antimicrobial agents.More attention should be paid to surveillance of antimicrobial resistance to avoid the spread of drug resistant strains.

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan,Guangdong Province during 2015.Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to CLSI 2015 breakpoints.The susceptibility data were analyzed using WHONET 5.6 software.Results A total of 29 665 strains of microorganisms were isolated,of which gram positive cocci accounted for 32.1％ (9 509/29 665) and gram negative bacilli accounted for 67.9％ (20 156/29 665),respectively.The prevalence of methicillinresistant Staphylococcus was 23.3％ (705/3 024) in S.aureus and 43.6％ (1 054/2 419) in coagulase-negative Staphylococcus.No vancomycin-resistant staphylococcal strain was found.ESBLs-producing strains accounted for 36.4％ (2 554/7 020) in E.coli and 24.5％(792/3 227) in Klebsiella isolates.The prevalence of carbapenem-resistant Enterobacteriaceae was 0.2％ (30/13 077).The prevalence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) was 16.0％ (500/3 116) and 53.9％ (827/1 533),respectively.The prevalence of penicillin-resistant S.pneumoniae (PRSP) strains was 10.1％ (142/1 404).Beta-lactamase was produced in 30.6％ (276/902) of the H.influenzae strains.The prevalence of vancomycin-resistant Enterococcus (VRE) strains was 0.7％ (10/1 441).Conclusions Periodic surveillance of antimicrobial resistance is valuable for rational antimicrobial therapy,formulation of treatment guidelines and infection control and prevention measures,as well as preventing the spread of drug-resistant strains.

Objective To analyze the serotypes and antimicrobial susceptibility profile of Group B Streptococcus (GBS) in perinatal pregnant women.Methods The vaginal and rectal specimens were collected from pregnant women at 35 to 37 weeks of pregnancy for culture and identification.The serotypes were analyzed using agglutination assay.Antimicrobial susceptibility testing was conducted by using Kirby-Bauer method,and interpreted according to 2009 CLSI breakpoints.The data were analyzed via WHONET 5.6 software.Results The prevalence of GBS was 10.4％ (264/2 533) in the 2 533 perinatal pregnant women.Serotype Ⅲ,Ⅰa and Ⅰb was identified in 54.9％ (84/153),17.6％ (27/153) and 13.1％ (20/153) of the GBS,respectively.All the GBS isolates were susceptible to penicillin,cefiriaxone and vancomycin.But 32.9％,68.1％ and 62.1％ of the isolates were resistant to levofloxacin,erythromycin and clindamycin,respectively.The antibiotic resistance rate of serotype Ⅲ isolates to the above three antibiotics was significantly higher than the other serotypes.Conclusions GBS may colonize both vagina and rectum of pregnant women.Vaginal and rectal secretions should be sampled simultaneously for better screening GBS.GBS serotype Ⅲ was the predominant serotype.Penicillin can be used as the first-choice treatment for GBS infections in pregnant women and newborns.GBS-positive pregnant women should be given the intervention treatment immediately to ensure the health of perinatal infants.

Objective To explore the effect of therapeutic hypothermia on the activation of inflammasome in the lung tissue of rats with hemorrhagic shock (HS).Methods Twenty-four male Sprague-Dawley rats were randomly (random number) divided into three groups:sham group,normothermia resuscitation (NR) group and hypothermia resuscitation (HR) group.Rats of each group were subjected to pressure-controlled (MAP 40 mmHg) HS for 1 h,then the NR group and the HR group were resuscitated with lactated Ringer and MAP was maintained at 90 mmHg for 1 h.Four hours later,the rats in each group were sacrificed by exsanguination.Hematoxylin eosin staining was used to observe the injury of lung tissue.The desiccation method was used to detect the edema of lung tissue.RT-PCR and western blot were employed to evaluate the mRNA and protein expression of NLRP-3,IL-1β,caspase-1.Analysis of variance was used for comparison among groups,and SNK-q test was used for comparison between two groups.Results (1) The injury of lung tissue in HR group was significantly milder than that in NR group;(2) Wet/dry (W/D) weight ratio of lung in HR group decrease compared with NR group [HR group 5.85 ± 0.102;NR group 6.471 ± 0.165 8 (t =3.14,P ＜ 0.05)];(3) NLRP-3 and of Caspase-1 protein expression in the HR group were lower than those in NR group.(4) The NLRP-3 mRNA expression in HR group was lower compared with NR group [(HR group 1.027 ± 0.143;NR group 1.3487 ± 0.163 (t =4.36,P ＜ 0.05)] and IL-1 mRNA expression in HR group was lower compared with NR group [HR group 162.3 ± 0.125;NR group 2.388 ± 0.229 (t =7.72,P ＜ 0.05)].Conclusions Therapeutic hypothermia attenuated ALI induced by HS in rats by modulation of signal way of inflammasome.

Objective To evaluate the test-retest reliability and validity of the 3-dimensional Digital Goniometer for Cervical (3DDGC) in measurement of cervical range of motion. Methods 39 healthy participants were measured of cervical range of motion 2 times in 1 hour with 3DDGC by one observer, and with cervical range of motion (CROM) device once. The intraclass correlation coefficient (ICC) of test-retest and the Pearson correlation coefficient between devices were caculated. The measurement errors were evaluated with standard er-ror of mean (SEM). Results The ICC was 0.89 of 3DDGC as the cervical rotation to the left, and it was 0.90-0.98 of the other directions, with the SEM of 2.07-3.85° . The Pearson correlation coefficient was 0.73-0.92, with the SEM of 1.66-3.17° . Conclusion 3DDGC is valid and reliable in test-retest in measuring cervical range of motion, which need more research clinically.

BACKGROUND:After entering the aging society, improving the balance function to prevent fals and reduce incidence of fractures in the elderly has received widespread attentions in al aspects. OBJECTIVE: To design a training program for the elderly, involving static stretching and strength exercise of lower limb, in order to study the combined effect on the balance function of the elderly. METHODS: Static stretching and strength training of the lower limbs were carried out in 28 elderly persons who met the inclusion criteria for 3 months, three times a week, once for 60 minutes. Before and after exercise training, the static balance ability with foot standing, eyes open and eyes closed was evaluated using the PRO-KIN balance instrument; the dynamic balance ability and lower limb strength were evaluated using treadmil test with eyes closed and chair-stand test. Evaluation results before and after exercise were compared and anayzed. RESULTS AND CONCLUSION:In the eyes open state, the average X-axis coordinate and exercise-induced elipse area at the center of pressure were significant different before and after exercise (P < 0.01); the mean velocities at the left and right direction were of significant difference before and after exercise (P < 0.05); the results of treadmil test with eyes closed and chair-stand test also presented very significant differences before and after exercise (P < 0.01). Static stretching combined with lower limb strength exercise can effectively improve the balance function and lower limb strength of the elderly, which can be used as an effective exercise way to prevent the fals in the elderly.

Objective To compare finger tapping of stroke patients' unaffected hands to the same hands of healthy people. Methods 40 stroke patients with left hemiplegia (25 males and 15 females), including 11 cases of cerebral hemorrhage and 29 cases of cerebral infarction, and other 40 healthy people were tested the finger tapping of right hand. Results The finger tapping was significantly lower in the stroke patients than in the healthy people (P<0.01). There was no difference in finger tapping between patients with cerebral hemorrhage and cerebral infarction (P<0.05). Conclusion Motor function of fingers in unaffected hands is injured in stroke patients.

OBJECTIVE: To investigate the correct diagnosis for styloid process syndrome. METHOD: CT scan and 3D reconstruction was undertaken in 301 cases with foreign body sensation in submandibular angle, pain in pharyngeal, tension feeling and unhealing feeling after tonsillectomy. 263 cases were diagnosed as styloid process syndrome. RESULT: Seventy-two cases were performed with tonsillar styloidectomy. The follow up showed no pre-operative symptoms. CONCLUSION CT scan 3D reconstruction is the best method in diagnosing styloid process syndrome.
Adult ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Temporomandibular Joint Dysfunction Syndrome ; diagnosis ; Tomography, X-Ray Computed ; Young Adult