Dry-Spinning of Artificial Spider Silk Ribbons From Regenerated Natural Spidroin in an Organic Medium.

Natural spider silks with striking performances achieve extensive investigations. Nonetheless, a lack of consensus over the mechanism of the natural spinning hinders the development of artificial spinning methods where the regenerated spider silks generally show poor performances compared with the natural fibers. As is known, the Plateau-Rayleigh instability tends to break solution column into droplets and is considered a main challenge during fiber-spinning. Here in this study, by harnessing the viscoelastic properties of the regenerated spidroin dope solution via organic salt-zinc acetate (ZA), this outcome can be avoided, and dry-spinning of long and mechanically robust regenerated spider silk ribbons can be successfully realized. The as-obtained dry-spun spider silk ribbons show an enhanced modulus up to 14 ± 4 GPa and a toughness of ≈51 ± 9 MJ m-3 after the post-stretching treatment, which is even better than that of the pristine spider silk fibers. This facile and flexible strategy enriches the spinning methodologies which bypass the bottleneck of precisely mimicking the complex natural environment of the glands in spiders, shining a light to the spider-silk-based textile industrial applications.

Comparison of the incidence of wound complications with preoperative and postoperative radiotherapy in patients with extremity soft tissue sarcoma resection: A meta-analysis.

We performed a meta-analysis to compare the effect of preoperative and postoperative radiotherapy on wound complications after resection of extremity soft tissue sarcoma (ESTS). A comprehensive computerised search of the PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases was conducted from their inception to August 2023 to identify studies comparing the effect of preoperative and postoperative radiotherapy on wound complications after ESTS resection. Two investigators independently screened the literature, extracted the data, and assessed the quality of the articles. The meta-analysis was performed using RevMan 5.4 software. Nine studies with 1271 patients were included, with 631 and 640 patients in the preoperative and postoperative radiotherapy groups, respectively. The results showed that the incidence of postoperative wound complications after ESTS resection was significantly higher with preoperative radiotherapy than with postoperative radiotherapy (27.26% vs. 12.03%, odds ratio [OR]: 2.88, 95% confidence interval [CI]: 2.12-3.91, p < 0.001). However, the rate of local recurrence of ESTS was significantly lower with preoperative radiotherapy than with postoperative radiotherapy (8.75% vs. 14.81%, OR: 0.57, 95% CI: 0.36-0.91, p = 0.02), and the 3-year overall survival was significantly higher in the preoperative radiotherapy group than in the postoperative radiotherapy group (82.24% vs. 70.04%, OR: 1.97, 95% CI: 1.05-3.71, p = 0.03). This pooled analysis suggests that although preoperative radiotherapy increases the rate of wound complications in ESTS compared with postoperative radiotherapy, it significantly reduces the rate of local recurrence after ESTS resection and improves the overall survival of patients. Owing to the limitations in the number and quality of the included studies, additional prospective cohort studies or randomised controlled trials are required to confirm these findings.

Reconstruction of Large Anterior Palatal Fistulae Using Anteriorly Based Dorsal Tongue Flaps.

BACKGROUND: An anterior palatal fistula in a bilateral cleft lip and palate is a challenging clinical dilemma. The authors evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae using anteriorly based dorsal tongue flaps. METHODS: Eight patients with anterior palatal fistulae after repair of a bilateral cleft lip and palate using anteriorly based dorsal tongue flaps. The defect size varied from 1.0 × 1.0 cm to 1.5 × 2.0 cm, and the tongue flap size varied from 1.5 × 3.5 cm to 2.0 × 3.5 cm. RESULTS: All patients underwent successful reconstruction of palatal defects using anteriorly based tongue flaps, and no case of spontaneous detachment of the tongue flap occurred. The patients with palatal fistulae were followed up for 10 to 30 months, and no recurrence was encountered. CONCLUSION: An anteriorly based dorsal tongue flap is a safe and feasible surgical technique for the closure of anterior palatal fistulae.

Effect of virtual reality on balance and gait ability in patients with Parkinson's disease: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of virtual reality interventions for improving balance and gait in people with Parkinson's disease. DESIGN: This is a systematic review and meta-analysis of randomized controlled trials. METHODS: Databases of MEDLINE, Cochran Central Register of Controlled Trials, EMBASE, PEDro, Web of Science and China Biology Medicine disc were searched from their inception up to 1 March 2019. Two reviewers individually appraised literatures for inclusion, extracted data and evaluated trial quality. RESULTS: A total of 12 studies with a median PEDro score of 6.4 and involving 419 participants were included. This review first demonstrated significant improvements in Berg Balance Scale (mean difference = 2.69; 95% confidence interval = 1.37 to 4.02; p < 0.0001), Timed Up and Go Test (mean difference = -2.86; 95% confidence interval = -5.60 to -0.12; p = 0.04) and stride length (mean difference = 9.65; 95% confidence interval = 4.31 to 14.98; p = 0.0004) in Parkinson patients who received virtual reality compared with controls. However, there was no significant difference in gait velocity and walk distance. CONCLUSION: This systematic review and meta-analysis supports the use of virtual reality to enhance the balance of patients with Parkinson's disease. However, the review does not find any definite effect upon gait by the use of virtual reality.

Craniofacial Resection and Reconstruction in Patients With Recurrent Cancer Involving the Craniomaxillofacial Region.

PURPOSE: Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. PATIENTS AND METHODS: This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction. The χ2 test in SPSS was used to analyze the data. RESULTS: Twenty-four patients with recurrent malignant tumors involving the craniomaxillofacial region were identified who had undergone craniofacial resection at the Center of Craniomaxillofacial Surgery of Sun Yat-sen University (Guangzhou, Guangdong, China). The study population was comprised of 24 patients (15 men and 9 women; age range, 21 to 73 yr) with recurrent tumors (58.3% with squamous cell carcinoma [SCC], 41.7% with sarcoma [SA]) involving the craniomaxillofacial region who underwent craniofacial resection. Craniofacial resection consisted of orbital exenteration and maxillotomy; anterior skull base surgery, facial resection, and mandibulotomy; or ipsilateral radical neck dissection. The resultant craniomaxillofacial defects were reconstructed using extended vertical lower trapezius island myocutaneous flaps (TIMFs), temporalis myofascial flaps, or submental flaps. All patients with recurrent malignant tumor involving the craniomaxillofacial region underwent gross total resection of the tumor; 22 patients underwent craniofacial reconstruction. There were no major surgical complications. Minor flap failure and wound dehiscence in the donor site occurred in 4 patients. The follow-up period ranged from 8 to 36 months. Seven patients in the SCC group and 7 in the SA group were alive with no evidence of disease (AND), 3 in the SCC group and 2 in the SA group were alive with disease (AWD), and 4 in the SCC and 1 in the SA group died of the disease (DOD) after local recurrence or distant metastases at 8 to 18 months. There were no statistical differences among the AND, AWD, and DOD groups. CONCLUSIONS: Craniofacial resection remains an effective salvage treatment for patients with recurrent SCC and SA involving the craniomaxillofacial region. The extended vertical lower TIMF is a large, simple, and reliable flap for reconstructing major defects after a craniofacial resection.

Plasma Intermedin Level Indicates Severity and Treatment Efficacy of Septic Shock in Sprague-Dawley (SD) Rats.

BACKGROUND The aim of this study was to investigate the value of plasma intermedin (IMD) in assessing severity and treatment efficacy of septic shock. MATERIAL AND METHODS Healthy male Sprague-Dawley (SD) rats were chosen and divided into a normal control group (n=15) and a shock model group (n=27) that received intravenous injection of lipopolysaccharide (LPS). Then, 3 specimens were taken from each group. The shock model group rats were divided into an LPS group and a treatment group with 12 rats each. The treatment group received intravenous injection of compound sodium lactate solution. Plasma IMD and IMD1-47 mRNA expressions were compared and analyzed. RESULTS Mean arterial pressure (MAP) was lower while white blood cell count and TNF-α were higher in the shock model group than in the normal control group (P<0.05). After 10 h and 20 h, the treatment group had lower plasma IMD and IMD1-47 mRNA expressions compared with the LPS group (P<0.05). Plasma IMD and IMD1-47 mRNA expressions in the LPS group after 20 h were significantly higher than after 10 h (P<0.05). IMD was positively correlated with interleukins (IL-3, IL-6, and IL-8), white blood cell count, and body temperature (all P<0.05), but were negatively correlated with systolic pressure (r=-0.8474, P=0.0040). CONCLUSIONS Plasma IMD level can effectively reflect the severity of septic shock and can be used as an important indicator of septic shock treatment effectiveness.

Dysphagia in Tongue Cancer Patients Before and After Surgery.

PURPOSE: To define factors influencing postoperative aspiration in tongue cancer patients and to analyze the characteristics of dysphagia before and after surgery. MATERIALS AND METHODS: A total of 112 tongue cancer patients participated in this work. Videofluoroscopic swallowing studies were performed in all patients before and after surgery. A Penetration-Aspiration Scale score of 3 or greater was defined as an aspiration risk. Qualitative data were collected on a frame-by-frame basis from each videofluoroscopic swallowing study and analyzed. RESULTS: Smoking (58.14%, P < .01), tongue resection greater than 50% (38.71%, P < .05), and advanced tumor stage (49.18%, P < .01) were strong risk factors for aspiration. High incidences of inadequate tongue movement, delayed oral transit time, reduced hyoid bone elevation, poor aspiration or penetration, vallecula epiglottica, and residual material in the pyriform sinuses were evident after surgery (all P < .001). The Penetration-Aspiration Scale score was significantly higher after surgery than before surgery. The incidence of silent aspiration increased to 6.25% postoperatively. CONCLUSIONS: Smoking, larger tongue resection, and advanced tumor stage were strong risk factors for postoperative aspiration and dysphagia complications in tongue cancer patients. The aspiration rate was higher after surgery. Further studies should focus on the prevention and early treatment of dysphagia, especially postoperative aspiration, in tongue cancer patients.

Role of Negative-Pressure Wound Therapy in the Management of Submandibular Fistula After Reconstruction for Osteoradionecrosis.

PURPOSE: Although negative-pressure wound therapy (NPWT) for complicated wounds has been extensively studied, it is rarely used in cases involving a submandibular fistula due to radiation-induced osteoradionecrosis of the mandible. This study aimed to investigate the efficacy of NPWT for submandibular fistulas after reconstruction for osteoradionecrosis. PATIENTS AND METHODS: Nine patients with submandibular fistulas after reconstruction for osteoradionecrosis treated with NPWT between 2011 and 2014 were included in the study. The wound healing was documented. RESULTS: The NPWT device was removed postoperatively between days 7 and 12 (mean duration, 9.6 days). The wound bed was filled with healthy granulation tissue, and successful healing by second intention was observed in all patients within 2 weeks. No complications were observed. The follow-up ranged from 4 to 27 months (mean, 18 months); the fistulas exhibited excellent healing, and no recurrence or infection was observed. CONCLUSIONS: NPWT is a safe, effective technique for managing submandibular fistulas after reconstruction for osteoradionecrosis.

Salvage Surgery for Patients With Recurrent Oral and Oropharyngeal Squamous Cell Carcinoma Involving the Carotid Artery.

PURPOSE: Outcomes of salvage surgery and carotid artery (CA) management were evaluated in patients with oral and oropharyngeal cancer. PATIENTS AND METHODS: Eighteen patients with recurrent oral and oropharyngeal squamous cell carcinoma involving the CA underwent salvage surgeries consisting of wide resection of the tumor, CA resection without and with reconstruction, and CA subadventitial dissection without and with encapsulation. Major tissue defects were reconstructed using a flap. RESULTS: One patient showed postoperative transient hemiplegia, and wound dehiscence occurred at the recipient site in 2 patients. Two patients had carotid blowout. One patient who underwent CA resection and reconstruction had a carotid embolism. After 5 to 42 months of follow-up, 12 patients were free of disease, 2 remained ill, and 4 died of local recurrence or distant metastases. CONCLUSIONS: Salvage surgery remains an effective treatment modality. CA sacrifice offers a viable treatment strategy. Major defects can be reconstructed with a trapezius flap.

Bacterial community structure of autotrophic denitrification biocathode by 454 pyrosequencing of the 16S rRNA gene.

Few studies have been conducted to explore the community composition in denitrifying biocathode. Herein, the microbial communities of denitrifying biocathodes yielding current of 1 mA (reactor C1) and 1.5 mA (reactor C2) were characterized by 454 pyrosequencing. The nitrate removal efficiencies in C1 and C2 were about 93 and 85%, respectively. The optimization of data generated high-quality sequences of 18509 in C1 and 14857 in C2. Proteobacteria was the predominant phylum, and Bacteroidetes, Chloroflexi, and Planctomycetes were the subdominant groups. Classes of Alphaproteobacteria, Anaerolineae, and Phycisphaerae may benefit the performance of current production and nitrate removal. Twenty-nine dominant operational taxonomic units (OTUs) accounted for 64 and 65% of sequences in C1 and C2, respectively. A denitrifying pathway was constructed based on the phylogenetic analysis and function inferring of the dominant OTUs. Obviously, the 454 pyrosequencing provided a high-resolution profile of bacteria community in denitrifying biocathode.

Liquid nitrogen cryotherapy for lip mucous membrane venous malformation in infants.

OBJECTIVE: Lip mucous membrane venous malformations are common benign lesions in infants. This clinical study evaluates the efficacy and safety of liquid nitrogen cryotherapy used to treat this condition. METHODS: A total of 84 pediatric patients undergoing liquid nitrogen cryotherapy for venous malformations involving the lips were reviewed, with 45 males and 39 females treated. The overall median age at mucous membrane venous malformation diagnosis was 5.6 months (range 2-18 months). The venous malformations involved the vermilion of the lower lip in 44 cases, the vermilion of the upper lip in 31 cases, and both vermilions in 9 cases. RESULTS: No complications due to anesthesia occurred. After a follow-up period of 2-38 months (mean 25 months), 65 lesions (77.4 %) were completely involuted, 14 lesions (16.7 %) were mostly involuted, and 5 lesions (5.9 %) were partially involuted; no lesions showed a minor amount of involution. CONCLUSIONS: Liquid nitrogen cryotherapy is an effective, simple, and safe management tool for mucous membrane venous malformations of the lip in infants.

Human CD133-positive hematopoietic progenitor cells initiate growth and metastasis of colorectal cancer cells.

The tumour-specific 'pre-metastatic niche' has emerged as a potential driving force for tumour metastasis and has been confirmed using mouse models of cancer metastasis. Vascular endothelial growth factor receptor-1(+) hematopoietic progenitor cells (HPCs) have been shown to play an important role in metastasis, forming a 'pre-metastatic niche' at designated sites for distant tumour progression. Here, CD133+ human umbilical hematopoietic progenitor cells (HUHPCs) were purified from human umbilical cord blood and expanded in vitro. We studied the effects of CD133+ HUHPCs on the growth and metastasis of four colorectal cancer (CRC) cell lines by using cell-to-cell co-culture. Our results revealed that CD133+ HUHPCs promoted the proliferation and invasion of CRC cells in vitro and enhanced tumour growth and metastasis in vivo. Moreover, CD133+ HUHPCs were observed in the pre-metastatic liver tissue using immunohistochemical analysis after co-injection of SW480/EGFP(+) cells and HUHPCs. Further experiments were therefore conducted to uncover the molecular mechanisms by which CD133+ HUHPCs influenced colon carcinogenesis and cancer progression. Extracted proteins were separated using the two-dimensional difference in gel electrophoresis technology. Among the differentially expressed proteins, mitogen-activated protein 4 kinase 4, stromal cell-derived factor-1, matrix metallopeptidase 9, calumenin, peripherin, leucine zipper, putative tumour suppressor 1 and guanidinoacetate methyltransferase attracted our attention. Western blot analysis further confirmed the differential expression of these proteins. Altogether, these results suggest that CD133+ HUHPCs may induce proliferation or metastasis of CRC cells and impact their derived proteins by providing a pre-metastatic microenvironment.

Minimally invasive selective neck dissection: a prospective study of endoscopically assisted dissection via a small submandibular approach in cT(1-2_N(0) oral squamous cell carcinoma.

BACKGROUND: Selective neck dissection (SND) in clinical N0 (cN0) cases of oral squamous cell carcinoma (SCC) has been performed by surgeons using a retroauricular or modified facelift approach with robotic or endoscopic assistance. However, these procedures provide cosmetic satisfaction at the cost of possible maximal invasiveness. In this prospective study, we introduced and evaluated the feasibility as well as surgical invasiveness and cosmetic outcome of endoscopically-assisted SND via a small submandibular approach. METHODS: Forty-four patients with cT1-2N0 oral SCC (OSCC) were randomly divided into two groups of endoscopically-assisted SND and conventional SND. Perioperative and postoperative outcomes of patients were evaluated, including the length of the incision, operating time for neck dissection, estimated blood loss during the operation, amount and duration of drainage, total hospitalization period, total number of lymph nodes retrieved, satisfaction scores based on the cosmetic results, perioperative local complications, shoulder syndrome, and follow-up information. RESULTS: The mean operation time in the endoscopically-assisted group (126.04 ± 12.67 min) was longer than that in the conventional group (75.67 ± 16.67 min). However, the mean length of the incision was 4.33 ± 0.76 cm in the endoscopically-assisted SND group, and the amount and duration of drainage, total hospital stay, postoperative shoulder pain score, and cosmetic outcomes were superior in the endoscopically-assisted SND group. Additionally, the retrieved lymph nodes and complications were comparable. CONCLUSIONS: Endoscopically-assisted SND via a small submandibular approach had a longer operation time than the conventional approach. However, endoscopically-assisted SND was feasible and reliable while providing minimal invasiveness and satisfactory appearance.

The thin-layer drying characteristics of sewage sludge by the appropriate foaming pretreatment.

As dewatered sludge is highly viscous and sticky, the combination of foaming pretreatment and drying process seems to be an alternative method to improve the drying performance of dewatered sludge. In this study, CaO addition followed by mechanical whipping was employed for foaming the dewatered sludge. It was found that the foams were stable and the diameters of bubbles mainly ranged from 0.1 to 0.3 mm. The drying experiments were carried out in a drying oven in the convective mode. The results indicated that foamed sludge at 0.70 g/cm(3) had the best drying performance at each level of temperature, which could save 35-45% drying time to reach 20% moisture content compared with the non-foamed sludge. The drying rate of foamed sludge at 0.70 g/cm(3) was improved with the increasing of drying temperature. The impact of sample thickness on drying rate was not obvious when the sample thickness increased from 2 to 8 mm. Different mathematical models were used for the simulation of foamed sludge drying curves. The Wang and Singh model represented the drying characteristics better than other models with coefficient of determination values over 0.99.

Electroacupuncture alleviates ciliary muscle cell apoptosis in lens-induced myopic guinea pigs through inhibiting the mitochondrial signaling pathway.

AIM: To investigate the effect of electroacupuncture (EA) on the mitochondria-dependent apoptotic signaling pathway in the ciliary muscle of guinea pigs with negative lens-induced myopia (LIM). METHODS: Guinea pigs were randomly divided into normal control (NC) group, LIM group, LIM+SHAM acupoint (LIM+SHAM) group, and LIM+EA group. Animals in the NC group received no intervention, while those in other three groups were covered with -6.0 diopter (D) lenses on right eyes. Meanwhile, animals in the LIM+EA group received EA at Hegu (LI4) combined with Taiyang (EX-HN5) acupoints, while those in the LIM+SHAM group were treated at sham points. After treatments for 1, 2, and 4wk, morphological changes in ciliary muscles were observed with hematoxylin and eosin (H&E) staining and nick end labeling (TUNEL), and the expression of the mitochondrial apoptotic signaling pathway-related molecules in ciliary muscles was measured by real-time quantitative polymerase chain reaction (qPCR) and Western blot. Additionally, the adenosine triphosphate (ATP) contents were also determined in ciliary muscles. RESULTS: Axial length increased significantly in the LIM and LIM+SHAM groups and decreased in the LIM+EA group. The ciliary muscle fibers were broken and destroyed in both LIM and LIM+SHAM groups, whereas those in the LIM+EA group improved significantly. TUNEL assay showed the number of apoptotic cells increased in the LIM and LIM+SHAM groups, whereas reduced in the LIM+EA group. ATP contents showed a significant decrease in the LIM and LIM+SHAM groups, whereas increased after EA treatment. Compared with the NC group, the dynamin-related protein 1 (DRP1), Caspase3, and apoptotic protease activator 1 (APAF1) levels were significantly increased in the LIM group and decreased in the LIM+EA group. CONCLUSION: The results provide evidence of EA inhibiting the development of myopia by regulating the mitochondrial apoptotic signaling pathway.

Reconstruction of major full cheek defects with combined extensive pedicled supraclavicular fasciocutaneous island flaps and extended vertical lower trapezius island myocutaneous flaps after ablation of advanced oral cancer.

PURPOSE: The present clinical study assessed the feasibility of extensive pedicled supraclavicular fasciocutaneous island flaps combined with extended vertical lower trapezius island myocutaneous flaps for large, full-thickness cheek defect reconstruction after ablative oral cancer surgery. PATIENTS AND METHODS: A retrospective review of data from consecutive patients requiring extensive pedicled supraclavicular fasciocutaneous island flaps and the extended vertical lower trapezius island myocutaneous flap to provide both an inner and an outer lining for major full-thickness cheek defects after oncologic resection. RESULTS: Eight patients had advanced oral squamous cell carcinoma. All patients had combined bone and extensive soft-tissue defects. The extensive pedicled supraclavicular fasciocutaneous island flap with a skin paddle measuring 10 × 8 cm to 14 × 10 cm and the extended vertical lower trapezius island myocutaneous flap with a skin paddle measuring 25 × 10 cm to 15 × 8 cm were used to reconstruct the major through-and-through defects. No major complications occurred in any patient. The patients were followed up for 6 to 20 months; 6 patients were living with no evidence of disease, 1 was living with disease, and 1 had died of local recurrence. CONCLUSIONS: The combined use of the extensive pedicled supraclavicular fasciocutaneous island flap with an extended vertical lower trapezius island myocutaneous flap to reconstruct major through-and-through cheek soft defects is reliable and an excellent alternative to other pedicles, even microsurgical free flaps, for patients who have previously undergone radiotherapy and surgery of the head and neck.

Functional reconstruction with an extended supraclavicular fasciocutaneous island flap following ablation of advanced oropharyngeal cancer.

The aim of the present study was to evaluate the functional outcome of an extended supraclavicular fasciocutaneous island flap for reconstructing oropharyngeal defects.The 15 patients with oropharyngeal cancers ranged in age from 54 to 73 years. Primary tumor excisions via a transmandibular approach and neck dissection were performed in all patients. An extended supraclavicular fasciocutaneous island flap with a flap skin paddle ranging in size between 4 × 10 and 6 × 12 cm was used to reconstruct the defects.All of the flaps survived. Minor flap failure occurred in 2 cases, and 1 of these developed a minor orocutaneous fistula. All patients could eat soft foods and had normal speech. The extended supraclavicular fasciocutaneous island flap is a simple, reliable flap that can be used for functional reconstruction of oropharyngeal defects.

Double mental neurovascular V-Y island advancement flaps combined with tongue flaps for functionally reconstructing total lower-lip defects.

Although several techniques have been described for lower-lip reconstruction, functional reconstruction of total lower-lip defects remains a challenge. This study investigated a functional reconstruction technique for total lower-lip defects. Nine lower-lip defects were reconstructed after cancer ablation using double mental V-Y island advancement flaps, based on mental neurovascular bundle combined with tongue flaps. All flaps survived completely. The patients were followed up for 6 to 20 months. The lip function and sensation were normal, and aesthetic appearance was satisfactory. No patient developed local recurrence or lymphatic metastasis. The technique of combining a double mental neurovascular V-Y island advancement flap with a lingual mucosal membrane flap is ideal for the functional repair of total lower-lip defects after cancer ablation.

[The multiplex polymerase chain reaction for detection of ventilator-associated trachea-bronchitis and pneumonia in patients with common pathogens].

OBJECTIVE: To explore the clinical utility of multiple polymerase chain reaction (M-PCR) in the rapid detection of the common pathogens in ventilator-associated trachea - bronchitis (VAT) and ventilator-associated pneumonia (VAP). METHODS: Sputum samples of 75 patients complicated VAT or VAP in surgical intensive care unit (SICU), were examined by bacterial culture, ordinary PCR, the M-PCR detection. The pathogen detection rates among three methods were compared. RESULTS: The Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae of the positive detection rates were 50.7%, 45.3%, 30.7%, 41.3% and 58.7% by bacterial culture. By ordinary PCR, the positive detection rates were respectively 88.0%, 89.3%, 78.7%, 85.3% and 93.3%, and by M-PCR, the positive detection rates were respectively 92.1%, 90.7%, 82.7%, 89.3% and 96.0%. The positive rates of five common pathogens of ordinary PCR and M-PCR were higher than those of bacterial culture (all P < 0.05). The M-PCR had merit for rapid detection compared with ordinary PCR. CONCLUSION: Compared with bacterial culture, ordinary PCR and M-PCR yield higher positive rates in identifying five common pathogens of VAT and VAP, meanwhile, it also demonstrated the tendency that M-PCR may save cost and labor power.

[Intraoperative assisted O-arm navigation imaging for unstable pelvic fractures in INFIX].

OBJECTIVE: To investigate the effect of internal external fixator assisted O-arm navigation imaging in the treatment of unstable pelvic fractures. METHODS: From May 2019 to November 2019, 15 patients with unstable pelvic fractures were treated by intraoperative O-arm navigation imaging using INFIX technology. There were 6 males and 9 females. The age ranged from 24 to 66 years old. The course of disease ranged from 2 to 14 days. According to Tile classification, there were 1 case of B1 type, 8 cases of B2 type, 3 cases of C1 type, and 3 cases of C2 type. According to Young-Burgess classification, there were 8 cases of LC, 1 case of APC, 4 cases of VS, 2 cases of CM. Preoperative routine pelvic anteroposterior film, entrance position, exit position and pelvic CT three-dimensional reconstruction were performed. Intraoperative O-arm navigation system three-dimensional reconstruction and triplane scanning imaging were used to evaluate the effect of intraoperative reduction. The anterior pelvic ring was fixed with internal external fixator, and the posterior ring was fixed with sacroiliac screw, plate screw or lumbar iliac screw. The operation time, intraoperative bleeding and nail placement were observed and recorded. The quality of fracture reduction was evaluated by Matta standard, and the postoperative function was evaluated by Majeed function score. RESULTS: Wound healing was good in all patients without vascular, nerve and local irritation complications. All the 15 patients were followed up for 10 to 16 months. The fracture reduction was evaluated according to the Matta scoring standard, 9 cases were excellent results, 5 cases were good, and 1 case was medium. The Majeed functional score was 0 to 95 points. CONCLUSION: The built-in external fixator assisted O-arm navigation imaging system in the treatment of unstable pelvic fractures. The reduction effect is evaluated in advance, the operation time is shortened, and the accuracy of internal fixation is improved. The operation is simple, safe and less bleeding. The operation is in line with the principles of minimally invasive medical treatment and precision medical treatment in orthopedics, which is conducive to the recovery of patients' postoperative function and rapid recovery.