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Objective To evaluate the occurrence of surgical site infection (SSI) after cesarean section in secondary and above medical institutions in China since 2009,and provide data support for monitoring healthcare-associated infection(HAI).Methods Literatures on SSI following cesarean section published after 2009 were retrieved from China National Knowledge Infrastructure (CNKI),Chinese Science&Technology Journal Database (VIP),Wanfang Database,and PubMed,quality of literatures was evaluated by referring to disease incidence or morbidity quality evaluation criteria,combined incidence of SSI was estimated by Meta analysis,subgroup analysis was performed according to the levels of the medical institutions.Results A total of 61 literatures were included in the study,19,36,and 6 literatures were with quality scores of 7,6,and 5 respectively,the overall quality of literatures was better.The total sample size was 173 319 cases,2 860 cases occurred SSI,incidence of SSI after cesarean section was 1.8％(95％CI[1.6％,2.0％]).Subgroup analysis showed that incidence of HAI in secondary medical institutions was 2.3％(95％ CI[1.8％,2.7％]),which was higher than 1.4％ (95％CI[1.2％,1.7％])of tertiary medical institutions.Conclusion Incidence of SSI after cesarean section in secondary and above medical institutions in China is high,and is different among different levels of medical institutions.Different monitoring baselines should be established according to actual condition,so as to guide HAI control work scientifically.
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<p><b>BACKGROUND</b>Insulin-like growth factor-binding protein-3 (IGFBP-3) is suggested to predict the radiosensitivity and/or prognosis of patients with esophageal squamous cell carcinoma (ESCC). The present study was designed to investigate the clinical and prognostic effects of IGFBP-3 on ESCC.</p><p><b>METHODS</b>IGFBP-3 was detected by immunohistochemistry in paraffin-embedded tissues from 70 ESCC patients treated with radiotherapy alone and further examined by western blotting analysis in 10 pairs of fresh ESCC tissues and adjacent non-malignant esophageal specimens. Receiver operating characteristic (ROC) analysis was used to determine cut-off scores for tumor positivity and to evaluate patient survival status. The χ(2) test was performed to analyze the association of IGFBP-3 expression with clinical characteristics and radiotherapy response. Associations between prognostic outcomes and IGFBP-3 expression were investigated using Kaplan-Meier analysis and the Cox proportional hazards model.</p><p><b>RESULTS</b>The threshold for IGFBP-3 positivity was set to greater than 65% [area under the ROC curve (AUC)=0.690, P<0.019]. Of the 70 ESCC patient tissues tested, 32 (45.7%) were defined as having high IGFBP-3 expression. The levels of IGFBP-3 protein expression were decreased in 70.0% (7 of 10) of ESCC tissues compared with adjacent non-malignant esophageal tissue. In addition, IGFBP-3 expression was associated with pathologic classification (P<0.05 for T, N, and M categories and clinical stage). Patients with elevated protein level of IGFBP-3 in the tumor had an improved radiotherapy response and prolonged overall survival (P<0.001).</p><p><b>CONCLUSIONS</b>High level of IGFBP-3 expression in ESCC associates with early clinical stages and are predictive for favorable survival of the patients treated with radiotherapy.</p>