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.

Molecular epidemiology of urogenital Chlamydia trachomatis infection in patients attending sexually transmitted diseases clinics / 中华皮肤科杂志

Objective To determine the prevalence and genotype profiles of urogenital Chlamydia trachomatis and their related factors in patients attending sexually transmitted diseases (STD) clinics in Guangxi Zhuang Autonomous Region. Methods C. trachomatis was screened by a plasmid PCR in 598 patients attending STD clinics. Then, positive specimens underwent nested-PCR to amplify the major outer membrane protein 1 (ompl) gene. The amplicons of ompl gene were digested by restriction endonucleases Alu I plus Hinf I and Cfol . C. trachomatis was differentiated according to the restriction fragment length polymorphism (RFLP) patterns. Results Out of the 598 samples, 83 were positive for plasmid-PCR. The prevalence of chlamydial infection was 13.9% with no significant difference between male and female patients. Nested-PCR based RFLP analysis showed that genotype E amounted to 27.7% (23/83), F 20.5% (17/83), D 13.2%(11/83), G 12.0%(10/83), K 7.2%(6/83), H 4.8%(4/83), I 3.6% (3/83), J 3.6%(3/83)and uncertain types 7.2% (6/83). Visible symptoms were observed less frequently in infections with C. trachomatis genotypes E and F compared with the other genotypes, while low abdominal pain occurred in 80% of infections with type G. Conclusions A certain proportion of out-patients attending STD clinic are infected with various types of C. trachomatis in Guangxi Zhuang Autonomous Region. The polymorphism of ompl gene may serve as a useful tool in molecular epidemiological studies of C. trachomatis.