RESUMO
Objective To evaluate risk factors for surgical site infection(SSI) in patients with thoracolumbar fracture,and provide basis for making prevention and control measures.Methods Patients with thoracolumbar fractures operation in the department of spinal surgery of a hospital between January 2010 and March 2015 were monitored through information monitoring system,on-site visit,and telephone follow-up,incidence of SSI was investigated,risk factors were performed univariate analysis.Results A total of 326 patients undergoing thoracolumbar fracture operation were monitored,15(4.60％) had SSI.SSI were high in patients≥60 years old,underwent operation at nonlaminar air flow operation room,didn't receive antimicrobial prophylaxis 30 minutes prior to operation,preoperative hospital stay ＞3 days,operation duration ＞3 hours,as well as with diabetes mellitus and chronic respiratory disease (all P＜ 0.01).Conclusion Risk factors for SSI in patients undergoing thoracolumbar fractures operation were patients with older age,receive operation at non-laminar air flow operation room,didn't receive antimicrobial prophylaxis,long length of preoperative hospital stay and operation duration,as well as combined with diabetes mellitus and chronic respiratory disease,preventive measures should be taken to reduce the incidence of infection.
RESUMO
Objective To investigate the regional cerebral stimulation after central analgesics nasal spray and its mechanism with pharmacological functional magnetic resonance imaging (phfMRI). Methods Eighteen healthy right-handed volunteers participated. Butorphanol tartrate nasal spray was used as the experiment agent. Ethological experiment was carried out to record the participants' subjective feeling and the onset time of the analgesics, followed by the functional MRI (fMRI) scan two weeks later. Block design was adopted. Two phases of fMRI scan were performed at 7 min and 25 min after the nasal spray, respectively. Participants were also given pain stimulation in the dorsum of hand during the fMRI scanning. The data were post-processed with Matlab 6.5 and SPM 2. Results ①Onset time of butorphanol tartrate was 15-35 min after nasal spray administration, which was consistent with its concentration-time curve. ②After nasal spray, activations were observed in the cerebral cortex, including frontal lobe (orbitofrontal gyrus, medial frontal gyrus, superior frontal gyrus), temporal lobe (insula, middle temporal gyrus, inferior temporal gyrus), parietal lobe (precuneal gyrus), limbic system (anterior cingulate gyrus, middle cingulate gyrus, hippocampus, parahippocampal gyrus);subcortical region (globus pallidus) and cerebellum (6-9 of cerebellar cortex, cerebellar peduncle, vermis). ③The number and activation intensity of the second phase were more obvious than those of the first phase (P<0.01). Conclusion The feasibility of phfMRI study on cerebral stimulation and the mechanism of nasal spray is demonstrated. The study of butorphanol tartrate further validates the main distribution of opioid receptors in the central nervous system and the possible mechanism of central analgesia.