Factors associated with joint function after plate fixation of unstable pelvic fractures / 中华创伤骨科杂志

Objective To analyze the factors that influence joint function after plate fixation of unstable pelvic fractures.Methods A retrospective study was conducted to analyze the 109 patients with unstable pelvic fracture who had been treated with plate fixation from January 2007 to September 2014.They were 69 men and 40 women,23 to 72 years of age (average,46.3 years).By the Tile classification,15 cases were type B1,37 type B2,14 type B3,19 type C1,16 type C2,and 8 type C3.Their postoperative joint function was evaluated according to the Majeed criteria for functional evaluation.There were 86 cases in the good-to-excellent group (78.9％) and 23 in the fair-to-poor group (21.1％).Their data were analyzed in terms of gender,age,preoperative injury severity scale (ISS),body mass index (BMI),operation time,fracture type,reduction quality,postoperative complications,bone density,and postoperative weight bearing time.The influential factors were determined using Logistic regression analysis.Results All the 109 patients obtained a mean follow-up of 18.7 months (from 12 to 53 months).Preoperative ISS (P =0.000),fracture type (P =0.008),reduction quality (P =0.009) and postoperative complications (P =0.000) were identified as the factors influencing joint function after plate fixation of unstable pelvic fractures.Conclusion Preoperative assessment by ISS,a clear understanding of the pelvic fracture type,anatomical reduction of the fracture and efforts to reduce postoperative complications can effectively improve functional recovery of the joint after plate fixation of unstable pelvic fractures.

The relevance of molecular epidemiological study between Extraintestinal pathological escherichis coli infection in the clinic and intestinal pathogenic escherichis coli / 重庆医科大学学报

sObjective:To investigate the epidemiological correlation of the Extraintestinal Pathogenic Escherichia coli(ExPEC)and the intestinal Pathogenic Escherichia coli.Methods:227 ExPEC strains isolated in the Department of Infectious Diseases of the First Affiliated Hospitial of Chongqing Medical University were studied to investigate their serotype by"OK"diagnostic serum.The virulence gene of the bacterium was analyzed by PCR.The homology of the intestinal Escherichia coli and ExPEC in some patients were analyzed by Pulsed field gel electrophoresis.Results:34 strains were selected in 227 ExPEC strains include 20(Enterotoxigenic escherichia coli,ETEC)strains,14(Enteropathogenic escherichia coli,EPEC)strains.The positive rate of virulence gene of ETEC were the heat labile enterotoxin gene (ltA)31.57%,heat stable enterotoxin gene(stI)47.36%and stI/ltA 21.05%.The positive rate of virulence gene of EPEC were the bundle-formingpilus gene(bfpA)66.66%,eeeA gene 60.0%and eaeA/bfpA 26.67%.Two cases of E.coli septicemia was found in patients with gut the same clone.Conclusion:Intestinal pathogenic E.coli serotype caused a relatively small proportion of the clinical ExPEC,and mainly ETEC and EPEC serotypes.ExPEC in patients with septemia,especially in serious ill patients,its intestinal translocation of E.coli may be the source of ExPEC.