An Investigation of Risk Factors and Inflammatory Factors in Nosocomial Infections Following Total Hip Arthroplasty: Implications for Prevention and Control Strategies.

Objective: This work explored the relationship between nosocomial infection-related factors and inflammatory factors after total hip replacement (THA). Methods: A total of 296 THA patients treated in the Zhejiang hospital from 2018 to 2022 were analyzed retrospectively. Clinical data of the patients were collected, and the nosocomial infection rate, infection site, infectious pathogen, related risk factors, and postoperative follow-up were statistically analyzed. Disease types included avascular necrosis of the femoral head, osteoarthritis, and femoral neck fracture. The troponin (Tn), blood routine, blood types, heparin-binding protein (HBP), thyroid function, thromboelastogram (TEG), brain natriuretic peptide (BNP), bone metabolism-related markers, glycosylated hemoglobin (GHb), and other indicators in three types of patients before and after surgery were analyzed. Results: 37 cases (12.5%) had necrosis of the femoral head, 105 cases had osteoarthritis (35.47%), and femoral neck fracture was observed in 154 cases (52.03%). The main infection sites were the respiratory tract, urinary tract, deep incision, and tissue infection. There were 8 pathogenic bacteria strains, including gram-positive and gram-negative bacteria. The BNP content in plasma was highly decreased after treatment [RR: 0.353 (95% CI: 0.234-0.533), P < .001]. HBP in patients with postoperative infection was notably higher than that in patients without infection [RR: 0.241 (95% CI: 0.161-0.361), P < .001]. The blood glucose of both the diabetic group and the non-diabetic group was remarkably decreased after surgery [RR: 0.367 (95% CI: 0.233-0.461), P < .001]. The level of triiodothyronine (T3) showed a downward trend, while both tetraiodothyronine (T4) and thyroid stimulating hormone (TSH) were at normal levels. There were 15 cases of postoperative loosening, 6 cases of femoral shaft loosening, and 9 cases of acetabulum loosening. Conclusion: THA can regulate and maintain the balance of inflammatory cytokines, and taking preventive measures against risk factors can effectively reduce nosocomial infection, which is of great significance in improving the quality of medical treatment.

Tandem Mass Tag-Based Proteomic Analysis of Normal and Degenerated Human Intervertebral Discs.

Background: Intervertebral disc degeneration (IVDD) is the main cause of low back pain (LBP), but the specific regulatory factors, pathways and specific molecular mechanisms remain unclear. Methods: We identified and quantitatively analyzed Pfirrmann Grade II (n=3) and Pfirrmann Grade IV (n=3) pulposus samples via MRI. The differential abundance of proteins in the samples was determined and quantitatively analyzed by relative and absolute quantitative analysis of the isotope marker levels combined with the liquid chromatography-tandem mass spectrometry (LC‒MSMS/MS). Results: A total of 70 proteins (30 significantly increased proteins (> 1.2-fold change) and 40 significantly decreased proteins (< 0.8-fold change)) showed different levels among the groups. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology (GO) enrichment analyses and Western blot analysis showed that CYCS, RAC1, and PSMD14 may play important roles in IVDD and that Epstein‒Barr virus infection, viral myocarditis, colorectal cancer, nonalcoholic fatty liver disease (NAFLD) and amyotrophic lateral sclerosis (ALS) are the main pathways involved in IVDD. Conclusion: CYCS, RAC1 and PSMD14 may play important roles in IVDD, and Epstein‒Barr virus infection, viral myocarditis, colorectal cancer, NAFLD and ALS may be the main pathways involved in IVDD.

Analgesic effect and safety of a half-dose transdermal buprenorphine patch after arthroscopic rotator cuff repair.

Objective: To retrospectively explore the effect of a half-dose buprenorphine transdermal patch for analgesia after arthroscopic rotator cuff repair (ARCR). Methods: This analysis was performed with clinical data from patients who received unilateral ARCR in our hospital between October 2017 and December 2020. The patients were divided into three groups (30 cases each). In group A (control group), 100 mg flurbiprofen axetil (FA) was administered twice a day for 5 days after surgery. In group B (experimental group), 100 mg FA was administered twice a day for 5 days and half (2.5 mg) of a buprenorphine transdermal patch was applied after surgery; an additional half (2.5 mg) patch was applied 3 days later. In group C (condition control group), 100 mg FA was administered twice a day for 5 days and a 5-mg patch was applied directly after surgery. The visual analog scale (VAS) was administered repeatedly 1 day before surgery and 1, 2, 3, 5, and 14 days after surgery in each group. The simple shoulder test (SST) score, range of shoulder forward elevation (FE), and external rotation (ER) were recorded preoperatively and 12 weeks postoperatively. Results: VAS scores on postoperative days 3 and 5 were significantly lower in groups B and C than in group A (p < 0.05). The VAS score on postoperative day 14 was significantly lower in group C than in group A (p < 0.05). The difference in VAS score between groups B and C was not significant (p > 0.05). All patients had significantly improved VAS scores, SST scores, FE, and ER at 12 weeks postoperatively. Conclusion: The half-dose buprenorphine transdermal patch had a good analgesic effect with minimal side effects after ARCR and did not delay the recovery of shoulder joint function.