简介：AbstractPeriprosthetic joint infection (PJI) is the most difficult complication following total joint arthroplasty. Most of the etiological strains, accounting for over 98% of PJI, are bacterial species, with Staphylococcus aureus and Coagulase-negative staphylococci present in between 50% and 60% of all PJIs. Fungi, though rare, can also cause PJI in 1%—2% of cases and can be challenging to manage. The management of this uncommon but complex condition is challenging due to the absence of a consistent algorithm. Diagnosis of fungal PJI is difficult as isolation of the organisms by traditional culture may take a long time, and some of the culture-negative PJI can be caused by fungal organisms. In recent years, the introduction of next-generation sequencing has provided opportunity for isolation of the infective organisms in culture-negative PJI cases. The suggested treatment is based on consensus and includes operative and non-operative measures. Two-stage revision surgery is the most reliable surgical option for chronic PJI caused by fungi. Pharmacological therapy with antifungal agents is required for a long period of time with antibiotics and included to cover superinfections with bacterial species. The aim of this review article is to report the most up-to-date information on the diagnosis and treatment of fungal PJI with the intention of providing clear guidance to clinicians, researchers and surgeons.

简介：AbstractBackground:The screening of periprosthetic joint infection (PJI) in patients with inflammatory diseases before revision arthroplasty remains uncertain. Serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen (FIB), monocyte/lymphocyte ratio, and neutrophil/lymphocyte ratio (NLR) can help screening PJI, but their values in patients with inflammatory diseases have not been determined.Methods:Patients with inflammatory diseases who underwent revision hip or knee arthroplasty at West China Hospital, Sichuan University, from January 2008 to September 2020 were divided into infected and non-infected groups based on the 2013 International Consensus Meeting criteria. Sensitivity and specificity of the tested biomarkers for diagnosing infection were determined based on receiver operating characteristic (ROC) curves, and optimal cutoffs were determined based on the Youden index. The diagnostic ability of these biomarkers was re-assessed after combining them with each other.Results:A total of 62 patients with inflammatory diseases were studied; of them 30 were infected. The area under the ROC curve was 0.813 for CRP, 0.638 for ESR, 0.795 for FIB, and 0.656 for NLR. The optimal predictive cutoff of CRP was 14.04 mg/L with a sensitivity of 86.2% and a specificity of 68.7%, while FIB had a sensitivity of 72.4% and a specificity of 81.2% with the optimal predictive cutoff of 4.04 g/L. The combinations of CRP with FIB produced a sensitivity of 86.2% and specificity of 78.1%.Conclusion:CRP with a slightly higher predictive cutoff and FIB are useful for screening PJI in patients with inflammatory diseases, and the combination of CRP and FIB may further improve the diagnostic values.Trial Registration:ChiCTR.org.cn, ChiCTR2000039989

简介：AbstractPurpose:Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC.Methods:The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching "total knee arthroplasty" , "antibiotic-loaded cement" , "antibiotic prophylaxis" , "antibiotic-impregnated cement" and "antibiotic-laden cement" in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles.Results:Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA.Conclusion:The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.

简介：Wolbachia是感染大量节肢动物和丝虫的线虫的细胞内部的共生者。蚜虫从事与他们的endosymbionts的多样、复杂的关系。Wolbachia的四超群(A，B，M和N)以前在蚜虫和超群M被检测，N仅仅在蚜虫被发现。在这研究，我们在中国在蚜虫的自然人口检测了并且描述Wolbachia感染。三超群(A，B和M)在检验蚜虫种类被发现。超群M是优势的，而超群A和B仅仅在某些种类被检测。超群N没在这研究被发现。也就是，有在蚜虫的Wolbachia的四个感染模式有超群M的感染独自一个，有超群A和M，有超群B和M的合作感染，和有超群A，B和M的合作感染的合作感染。仅仅有超群M的感染的模式是通用的并且在所有评估亚科被发现。仅仅二个亚科，Aphidinae和Lachninae，表明了介绍所有四个感染模式。三个模式在Calaphidinae被观察(M，A&M，B&M)并且Eriosomatinae(M，B&M，A&B&M)。二个模式在Anoeciinae被观察(M，A&M)并且Greenideinae(M，B&M)，并且一仅仅模式(M)在Aphidoidea的留下的家庭或亚科被观察。这些结果显示在中国蚜虫的Wolbachia感染是普遍的。种系发生的分析建议超群M在中国在蚜虫的所有主人种类之中很快并且最近散布了的那Wolbachia。为这传播和它的机制的原因在他们的蚜虫主人上与Wolbachia的可能的效果一起被讨论。

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简介：ShanghaiYuelongNonferrousMetalsCor-potationLtd.---ajointcorporationbetweenShanghaiYuelongChemicalPlant,ChinaNationalMinerals&MetalsImp.--Exp.Corporation(Minmetal),ShanghaiMineralsandMetalsImp.--Exp.Corpora-tionandQiRongCorporationofHongKongwasestablishedinlastNovember.Withadvancedtechnologyofseparating

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简介：AbstractIntraamniotic infection (IAI) or chorioamnionitis is a common cause of preterm birth and may cause adverse neonatal outcomes, including neonatal pneumonia, respiratory distress, meningitis, sepsis, and death. Maternal morbidities from intraamniotic infection include dysfunctional labor requiring increased intervention, cesarean birth, postpartum uterine atony with hemorrhage, endometritis, peritonitis, sepsis, adult respiratory distress syndrome and, rarely, death. Chorioamnionitis can result from an ascending infection, iatrogenic causes or transplacental passage from maternal blood-borne infections. The clinical findings of chorioamnionitis include maternal fever (≥38 °C), maternal (>100 beats per minute) and/or fetal tachycardia (>160 beats per minute), maternal leukocytosis on complete blood count (>15 000 cells/mm3), and uterine tenderness and/or purulent and/or foul-smelling amniotic fluid. The management of chorioamnionitis mainly includes antibiotic therapy and delivery. Women with previable preterm premature rupture of membranes should be offered realistic counseling from a multidisciplinary approach. The separation of the mother and the fetus to preserve the life of the mother should prioritize delivery methods that result in a living fetus if possible, with appropriate neonatal resuscitation available.

简介：AbstractBackground:The ongoing COVID-19 pandemic hit South America badly with multiple waves. Different COVID-19 variants have been storming across the region, leading to more severe infections and deaths even in places with high vaccination coverage. This study aims to assess the spatiotemporal variability of the COVID-19 pandemic and estimate the infection fatality rate (IFR), infection attack rate (IAR) and reproduction number (R0) for twelve most affected South American countries.Methods:We fit a susceptible-exposed-infectious-recovered (SEIR)-based model with a time-varying transmission rate to the reported COVID-19 deaths for the twelve South American countries with the highest mortalities. Most of the epidemiological datasets analysed in this work are retrieved from the disease surveillance systems by the World Health Organization, Johns Hopkins Coronavirus Resource Center and Our World in Data. We investigate the COVID-19 mortalities in these countries, which could represent the situation for the overall South American region. We employ COVID-19 dynamic model with-and-without vaccination considering time-varying flexible transmission rate to estimate IFR, IAR and R0 of COVID-19 for the South American countries.Results:We simulate the model in each scenario under suitable parameter settings and yield biologically reasonable estimates for IFR (varies between 0.303% and 0.723%), IAR (varies between 0.03 and 0.784) and R0 (varies between 0.7 and 2.5) for the 12 South American countries. We observe that the severity, dynamical patterns of deaths and time-varying transmission rates among the countries are highly heterogeneous. Further analysis of the model with the effect of vaccination highlights that increasing the vaccination rate could help suppress the pandemic in South America.Conclusions:This study reveals possible reasons for the two waves of COVID-19 outbreaks in South America. We observed reductions in the transmission rate corresponding to each wave plausibly due to improvement in nonpharmaceutical interventions measures and human protective behavioral reaction to recent deaths. Thus, strategies coupling social distancing and vaccination could substantially suppress the mortality rate of COVID-19 in South America.

简介：<正>QUESTION:I’mtheCEOofaforeigncorporation,ourcompanywanttosetupaChinese-foreignjointventureinChinesethisyear.Buttothisday,wedon’tknowhowtohandletheproceduresoftheregistrationfortaxationofourjointventure.Pleasetellusthedetails;we’llbeextremelygratefultoyourhelp.

简介：UHMWPEcompositesreinforcedwithBovineBoneHydroxyapatite(BHA)indifferentcontentswerepreparedbyheatpressingformationmethod.AhipjointwearsimulatorwasusedtoinvestigatethebiotribologicalbehaviorofUHMWPE/BHAcompositeacetabularcupsagainstCoCrMoalloyfemoralheadsinbovinesynovialubricationat37±1℃.ItwasfoundthattheadditionofBHApowdertoUHMWPEcanimprovethehardnessandcreepmodulusofUHMWPE/BHAcomposites,anddecreasetheirwearratesunderbovinesynovialubrication.WhenthecontentofBHAfillerparticleswasupto30wt%,UHMWPE/BHAcompositesdemonstratedthewelldesignperformancesofthesurfaceandbiotribologicalproperties.Fatigue,ploughingandslightadhesivewearwerethemainwearmechanismsforUHMWPEanditscomposites.Inaddition,thesizesofwearparticlesbecamelargerwithanincreaseinBHApowderaddition.TheseresultssuggestthatBHAfillerisadesirablecomponenttoincreasethewearresistanceofUHMWPE/BHAcompositesforbiomedicalapplications.

简介：AbstractChronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.

简介：AbstractBismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.

简介：ThisarticleisageneralreviewoftheevolvementofHIV/AIDS-relatedpublicpoliciesinChinasince1980's.Ittrackstheimportantlaws,regulationsandothergovernmentaldocumentsinregardtoHIV/AIDSpreventionmainlyatcentrallevel.

简介：新闻事件：2016年2月24日。26名在陕西省镇安县医院进行血液透析的患者被确认感染丙肝病毒。据有关部门初步调查，此次感染为医院医务人员违规操作所致。据了解，对26名已确诊的丙肝病毒感染者，医院将制订诊疗方案，对他们实行免费治疗。陕西省卫计委事件调查组已作出决定，对镇安县医院院长给予党内聱告，分管副院长给予行政记过处分，并免去二人职务。目前共有15人受到党纪政纪处分。

简介：ProteomicshasbeenwidelyusedinthelastfewyearstolookfornewbiomarkersanddecipherthemechanismofHIV-hostinteraction.Herein,wereviewtherecentdevelopmentsofHIV/AIDSproteomicresearch,includingthesamplesusedinHIV/AIDSrelatedresearch,thetechnologiesusedforproteomicstudy,thediagnosisbiomarkersofHIV-associateddiseaseespeciallyHIV-associatedneurocognitiveimpairment,themechanismsofHIV-hostinteraction,HIV-associateddementia,substanceabuse,andsoon.Intheendofthisreview,wealsogivesomeprospectsaboutthelimitationandfutureimprovementofHIV/AIDSproteomicresearch.