Meta-analysis of risk factors of the surgical site infection through lumbar posterior approach / 中国组织工程研究

BACKGROUND: Surgical site infection is the main complication after posterior lumbar surgery, which not only increases the patient's hospitalization time, financial burden and physical pain, but also increases the difficulty for the clinical medical staff, delays the recovery of postoperative patients, even leads to deaths. Therefore, it is important to analyze the factors related to the infection of the surgical site after posterior lumbar surgery. OBJECTIVE: To analyze the risk factors of the surgical site infection after lumbar posterior approach in China. METHODS: Studies about the surgical site infection after lumbar posterior approach were retrieved by computer. The quality of the studies was evaluated by reading the full text. Heterogeneity was analyzed using RevMan 5.3 software. Meta analysis was used to analyze the combined effect. RESULTS AND CONCLUSION: (1) Totally 20 studies with 423 cases of surgical site infection and 13 995 cases of non-infection were included. (2)Meta-analysis univariate analysis results:body mass index ≥ 27 kg/m2[OR=3.82,95%CI(2.47,5.91),P<0.000 01],age ≥ 60 years [OR=1.99,95%CI(1.44,2.76),P<0.000 1],intraoperative blood loss ≥ 300 mL[OR=3.98,95%CI(2.50,6.33),P<0.000 01],subcutaneous fat thickness[MD=5.35,95%CI(3.58,7.12),P<0.000 01],number of segments ≥ 3[OR=3.83,95%CI(2.02,7.26),P<0.000 1],operation time ≥180 minutes[OR=2.96,95%CI(2.06,4.27),P<0.000 01],preoperative serum protein<35 g/L[OR=2.37,95%CI(1.63,3.46),P<0.000 01],and diabetes[OR=2.88,95%CI(2.22,3.74),P<0.000 01]were risk factors for surgical site infection after lumbar posterior approach.(3)Multivariate analysis results:body mass index ≥ 27 kg/m2[OR=3.21,95%CI(1.97,5.22),P<0.000 01],subcutaneous fat thickness[MD=5.35,95%CI(3.58, 7.12),P<0.000 01],preoperative serum protein<35 g/L[OR=3.73,95%CI(2.30,6.04),P<0.000 01],and diabetes[OR=3.35,95%CI(1.75,6.42), P=0.003]were independent risk factors for surgical site infection after lumbar posterior surgery.(4)Results showed that body mass index ≥27 kg/m2, subcutaneous fat thickness, preoperative serum protein < 35 g/L, and diabetes are independent risk factors for surgical site infection after lumbar posterior approach in China. Due to the number of cases of surgical site infection and its methodological quality during the study, the above conclusions still need to be confirmed by more large-scale, high-quality studies to provide reliable evidence for perioperative management.

Gut microbiota and osteoporosis / 南方医科大学学报

The rapidly evolving aging society in China is associated with increased incidences of osteoporosis and fractures, which have become common health problems that threaten the quality of life of the elderly. Gut microbiota colonizing in the human intestinal tract form a mutual symbiotic relationship with the host and play an important role in the metabolism and immune regulation of the host. In recent years increasing studies have demonstrated that gut microbiota not only affect the digestive system but also contribute to the disease conditions involving the immune system, and have a close relationship with the occurrence and progression of osteoporosis. This review summarizes the progress and hotspots in recent researches of the associations among gut microbiota, the immune system, osteoporosis.

A case-control study on risk factors for nosocomial infection of epilepsy in hospitalized children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the incidence and risk factors for nosocomial infection in child epilepsy.</p><p><b>METHODS</b>A retrospective study was conducted among all (292 cases) hospitalized children epilepsy patients in First Affiliated Hospital of Fujian Medical University from 1996 to 2000 in Fuzhou city. With all patients with nosocomial infection as cases and all patients without nosocomial infection as controls, a case-control study on risk factors for nosocomial infection was carried out. Available data were analyzed by one-way Chi-square test and unconditional logistic multiple regression model.</p><p><b>RESULTS</b>One hundred fourteen cases of nosocomial infection were identified among 292 cases with epilepsy with an incidence of 39.0% (114/292). The one-way Chi-square test showed that nosocomial infection was significantly associated with age below 3 years (OR = 2.55, P < 0.01), length of hospitalization over 14 days (OR = 4.75, P < 0.01), low intelligence (OR = 3.13, P < 0.01), receiving antibiotic unreasonably (OR = 3.51, P < 0.01), using gastrogarage (OR = 3.12, P < 0.01), other invasive operation (OR = 1.85, P < 0.05) dyskinesia or palsy (OR = 3.51, P < 0.01), and urinary nitrogen beyond normal range (OR = 5.00, P < 0.05), etc. Unconditional logistic multiple regression analysis revealed that the length of hospitalization over 14 days (OR = 4.30, OR 95% CI: 2.48 - 7.46, P < 0.01), taking antibiotic unreasonably (OR = 2.74, OR 95% CI: 1.30 - 5.77, P < 0.01), using gastrogarage (OR = 3.04, OR 95% CI: 1.28 - 7.18, P < 0.05), and low intelligence (OR = 2.32, OR 95% CI: 1.34 - 4.01, P < 0.01) were independent risk factors for nosocomial infection. The tendency chi-square test showed that the longer stay in the hospital with more kinds of antibiotic used and more gastrogarage they used, the greater the risk of nosocomial infection was.</p><p><b>CONCLUSION</b>Data suggested that occurrence of the nosocomial infection of children epilepsy patients was correlated with the length of hospitalization over 14 days, unreasonable using antibiotic, using gastrogarage and low intelligence.</p>