Table of Content

20 June 2018, Volume 18 Issue 03

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The development of a CPR device based on fuzzy PID closed?loop control

HE Zhijie1，DUAN Wenzhou2，ZHOU Qingan3，YUAN Hengxin4

2018, 18(03):  245-248.  DOI: 10.3969/j.issn.1009?976X.2018.03.001

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［Abstract］ Objective To develop a chest compression device for cardiopulmonary resuscitation with closed-loop control of compression depth and compression speed to improve the quality of chest compressions. Methods A chest compression device for cardiopulmonary resuscitation was constructed. High?pressure oxygen was used as the power. The cylinder motion was controlled by a solenoid valve and a proportional valve to achieve the pressing action. The control part adopts the structure of the upper and lower position machines. The lower machine generates the control waveform according to the parameters sent by the upper computer，collects the pressing parameters，and sends them to the upper computer through the CAN bus；the upper computer can set various pressing modes，and can analyze the parameters collected by the lower machine， generate new pressing parameters through fuzzy PID algorithm，thus realize closed-loop control of pressing depth and speed. Results The CPR chest compression device supports a variety of compression modes. Different compression frequencies ， compression/relaxation ratios，compression depths，and compression speeds can be set. The compression depth accuracy is 1 mm. Conclusion This CPR chest compression device achieves closed?loop control of compression depth and speed according to the set compression mode.

Advances in pathophysiology and non?surgical treatment of spinal cord injury

LIU Zhen，LONG Hao，ZHANG Huan，ZHONG Dong，YAO Aiming

2018, 18(03):  249-253.  DOI: 10.3969/j.issn.1009?976X.2018.03.002

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［Abstract］ Spinal cord injury（SCI）is a common type of trauma in transportation, labor and sportsaccident. It is a serious disabling injury, leading to physical dysfunction of the corresponding body innervated by the damage segmental spine. However, secondary injuries induced by SCI are the key in the treatment, so we should focus on therapies of secondary injuries. Traditionally, surgery or drugs are the main ways to alleviate the secondary injuries, but as the understanding of biological mechanism has become more and more profound, some drugs or stem cell therapies have shown great potential in the treatment. It will provide a new sight and hope to cue SCI. This article is underlying the pathophysiology of SCI and the developing drugs and therapeutic ways to treat SCI in recent years.

The research progress of pedicle screw at the fracture level in short-segment fixation for treatment of posterior kyphosis after thoracolumbar fracture

ZHANG Tianqi，FANG Qingmin，WANG Dawei，ZHANG Daijie，YE Weikang

2018, 18(03):  254-260.  DOI: 10.3969/j.issn.1009?976X.2018.03.003

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［Abstract］ In recent years, the incidence of thoracolumbar fractures has been increasing year by year. For patients with thoracolumbar fractures, short-segment posterior fixation represents a less invasive alternative to the traditional long-segment posterior fixation approach. This technique can restore the stability of the spine and help restore the spine height. With the development of spinal biomechanics and internal fixation materials, there have been significant breakthroughs in the technique of pedicle screw fixation, but postoperative patients with kyphosis are still the most common complications. In this paper, we review the current situation of surgical treatment of thoracolumbar fractures and the causes of postoperative kyphosis.

Expression and clinical significances of citrate synthase in breast cancer tissues

HE Guangning1，CAI Zhiduan2，DENG Runshu1，WEN Runyao1，DENG Dingmei1，ZHANG Ailing1

2018, 18(03):  257-260.  DOI: 10.3969/j.issn.1009?976X.2018.03.004

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［Abstract］ Objective To investigate the expression of citrate synthase in breast cancer tissues and non? cancerous tissues, and analyze the associations of its expression and clinical pathological features. Methods Western blot was used to detect the protein level of CS in breast cancer tissues and non-cancerous tissues. Immunohistochemistry was used to detect the expression of CS in breast cancer tissue microarrays. The associations of CS expression and clinical pathological features were analyzed. The relationship between CS expression and survival period of breast cancer patients in Cancer Genome Atlas （TCGA） database was analyzed. Results The expression level of CS protein was significantly up-regulated in breast cancer patients （P=0.028）. The expression of CS protein was correlated with histological grade（P=0.035）, clinical stage（P<0.001）, and lymph node metastasis（P<0.001）. The survival rate of breast cancer patients with high CS expression was significantly reduced （P=0.007）. Conclusion Our study showed that up?regulation of CS in breast cancer is related to the progression of breast cancer and its clinical prognosis. It is expected to be a new biomarker for breast cancer.

The influence of morphine on proliferation and vascular endothelial growth factor expression of MDA?MB?231 breast cancer cell

LIU Zhongqi，CAO Minghui

2018, 18(03):  261-264.  DOI: 10.3969/j.issn.1009-976X.2018.03.005

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［Abstract］ Objective To observe the influence of morphine on proliferation and vascular endothelial growth factor （VEGF） expression of triple-negative breast cancer cell （MDA-MB-231 breast cancer cell）, and to explore the effect of PI3K?AKT?c?Myc signal pathway on this process. Methods MDA?MB? 231 breast cancer cells were divided into negative control group（N group）, 1 μmol/L morphine group （1 μM group）, 10 μmol/L morphine group（10 μM group）and 100 μmol/L morphine group（100 μM group）randomly. The cells in N group were incubated with normal cultural medium without FPS , 1μM group were incubated with 1 μmol/L morphine, 10 μM group were incubated with 10 μmol/L morphine and 100 μM group were incubated with 100 μmol/L morphine. After the treatments, MTS was applied to detect the proliferation of MDA?MB?231 breast cancer cells, while the expression of vascular endothelial growth factor（VEGF）, c?Myc and the phosphorylation of AKT were detected by Western Blot. Results Compared with the N group, each concentration of morphine in our experiment could promote the prolifer? ation of MDA?MB?231 cells, increase the expression of VEGF, c?Myc and the phosphorylation of AKT. The 10 μM group increases most significant（P<0.05）. Conclusion Morphine in the concentration of 10 μmol/L could increase MDA?MB?231 breast cancer cell proliferation and VEGF expression, activation of the PI3K?AKT?c?Myc signal pathway may related to this process.

The application value of mammography in 198 young patients with breast cancer

LI Peng，YANG Man，CHENG Ran，HAN Bin，WEI Wei

2018, 18(03):  269-272.  DOI: 10.3969/j.issn.1009?976X.2018.03.007

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［Abstract］ Objective To explore the value of mammography in young breast cancer. Methods The results of mammography from newly diagnosed young breast cancer patients at Peking University Shenzhen Hospital from January 2011 to December 2016，were read and reviewed by a specialist. All patients were divided in subgroups according to mammary gland density， TNM stage， and immunophenotype. Results A total of 198 eligible subjects were collected. According to the density of the breast，180 cases were C?type breast and 18 were D?type. The difference of positive rate of different density breast was statistically significant. The 0，I，II，II，III and IV cases were divided into 2 cases， 47 cases，103 cases，39 cases and 7 cases respectively. The positive rates of the cases in different TNM staging were statistically significant. According to the immunohistochemical results ，there were 17 cases， 106 cases，54 cases and 21 cases of luminal A，luminal B，triple?negative and HER? 2 overexpression types， respectively. There were no statistical differences between the positive rate of different immunophenotypic cases. Academic significance. There was no significant difference in the positive rate between 21 immunophenotyp cases. Conclusion Mammography examination has a high positive rate for young breast cancer. The positive rate of late clinical stage is high，and the positive rate of dense mammary gland is low. For dense breasts，digital breast tomosynthsis（DBT）can be added to improve the positive rate.

The clinical observation on the treatment of incarcerated femoral hernia by laparoscopic incisional lacunare ligamentum procedure

FAN Guoyong，ZHEN Zuojun，YAO Gan，ZHANG Qingfeng

2018, 18(03):  273-276.  DOI: 10.3969/j.issn.1009?976X.2018.03.008

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［Abstract］ Objective To investigate the clinical effect of laparoscopic incising lacunare ligament in the treatment of incarcerated femoral hernia. Methods The clinical data of patients with incarcerated femoral hernia were retrospectively analyzed in our hospital from March 2010 to March 2018. Results Twenty-three patients（5 males，18 females） with incarcerated femoral hernia underwent laparoscopic lacunare ligament dissection treatment （TAPP operation）. There was no transfer to laparotomy because the incarcerated contents could not be reset. Four cases of patients with intestinal necrosis were subjected to bowel resection, and one case with bladder injury underwent laparoscopic suture. The operation time ranged from 50 to 180 min（103.36±52.87）, the bleeding was 2?50 ml（13.7±10.2），and the length of hospital stay was 3 to 15 days （mean 5.80 ± 3.25）. The post-subcutaneous emphysema and seroma occurred in 15 and 7 cases respectively were cured by conservative treatment, and one case of wound infection was cured by dressing change. Postoperative adhesion intestinal obstruction occurred in one patient and got recovery after conservative treatment. All 23 cases were followed up for 1 to 48 months. No recurrence, patch infection were found. Conclusion The surgical procedure treated incarcerated femoral hernia by laparoscopic incising lacunare ligament can effectively avoid the secondary injury of the bowel and reduce the rate of laparotomy.

Diagnosis and treatment of pancreatic pseudocyst in children（an analysis of 36 cases）

WU Qiang, CHAI Chengwei，HE Xiaobing, ZHU Deli，LAN Menglong, LUO Yuanyuan

2018, 18(03):  277-279.  DOI: 10.3969/j.issn.1009?976X.2018.03.009

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［Abstract］ Objective To explore the diagnosis and treatment of pancreatic pseudocyst in children. Methods The clinical datum of 36 patients with pancreatic pseudocyst in recent five years were retrospectively analyzed, reviewing each case for age, sex, presenting symptoms, type of management and clinical outcome and so on. Results Of 36 cases, there were 8 males and 4 females, aged from 2 years 5 months old to 12 years and 9 months old with mean age of 8 years and 2 months old. Fifteen patients underwent with conservative treatment, among them 6 cases underwent with Roux-en-Y type cystojejunostomy and one with was choledochocyst and pancreatic pseudocyst underwent with choledochocystectomy and Roux?en?Y type hepaticojejunostomy. Fourteen cases underwent with Roux?en? Y type cystojejunostomy directly；6 cases underwent with cystoperitoneal space drainage；one case was multiple pancreatic pseudocyst underwent with cyst excision and cystoperitoneal space drainage. All cases were cured. Follow-up ranged from 6 months to 2 years, there was not cyst recurrence. Conclusion The treatment of pancreatic pseudocyst is diversified and should be individualized． The choice for treatment of the disease should be based on the course of disease, the size of cyst, the position of cyst, the relationship with the adjacent organs.

Preoperative enteral nutrition as an approach of bowel preparation for early postoperative rehabilitation of elderly patients with colorectal cancer

LU Lu1，TANG Wu1，DING Yujie1，WU Hui1，ZENG Yujie2，CHU Zhonghua2*

2018, 18(03):  280-282.  DOI: 10.3969/j.issn.1009?976X.2018.03.010

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［Abstract］ Objective To explore the preoperative application of enteral nutrition as intestinal preparation of perioperative period in elderly with colorectal cancer under the concept of enhanced recovery after surgery（ERAS）. Methods The clinical data of 56 elderly patients with colorectal cancer were retrospectively analyzed. The patients were divided into enteral nutrition group and control group according to different preoperative bowel preparation. In the enteral nutrition group, an oral enteral nutrient suspension were administered preoperatively, while traditional treatment methods were used in the control group. The efficacy and postoperative complications were observed and compared. Results The related indicators such as the operation time and total length of hospital stay were similar in the two groups, and no serious complications such as anastomotic leak and abdominal infection were found. The intestinal cleanliness and postoperative nutritional indicators in the enteral nutrition group were better than those in the control group（P<0.05）. There was no significant difference in adverse reactions during bowel preparation between these two groups. Conclusion Preoperative preparation by using enteral nutrition in elderly patients with colorectal cancer is safe and feasible, and avoids the shortcomings of traditional methods, and is good for the perioperation period.

Endocospic thyroidectomy in a small working space

GONG Jiaquan，LUO Jielong，LI Deliang，WANG Xiaogang

2018, 18(03):  283-289.  DOI: 10.3969/j.issn.1009?976X.2018.03.011

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［Abstract］ Objective To report the surgical experience of endoscopic thyroidectomy with a small working. Methods Endoscopic thyroidectomy was carried out between December 2015 and December 2017 for 118 patients in our hospital. The patients were assigned to two group, small space group（S group, n=60）, a small working space（L group, n=58）according to the operative field. Results The operation time was similar in S group and L group, and the difference was not statistically significant（P>0.05）. S group had less bleeding than the L group（P<0.05）. Two cases had chest wall discomfort in S group, and most of L group had chest wall discomfort, and the difference was statistically significant（P<0.05）. The difference was statistically significant（P<0.05）in the subcutaneous effusion. The hoarseness occurred in both groups, and no statistically significant difference （P>0.05）. Conclusion Small working space endocospic thyroidectomy is a real cosmetic and minimally invasive operation , is also the future trend of thyroid surgery. Endoscopic thyroidectomy in a small working field is feasible and beneficial to the recovery of neck skin after operation.

Research of influence of local injection of tranexamic acid on unilateral total knee arthroplasty for the first time in patients with postoperative blood loss

LIANG Chuanxing，HUANG Jian，GUO Weikang，WANG Jun

2018, 18(03):  286-289.  DOI: 10.3969/j.issn.1009?976X.2018.03.012

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［Abstract］ Objective To summarize the clinical data from local injection of tranexamic acid on unilateral total knee arthroplasty forthe first time in patients with postoperative blood loss. Methods Eighty cases of patients who underwent the unilateral total knee arthroplasty in our hospital were selected as the research objects，and all patients were admitted to the hospital for osteoarthritis，and all were performed the operation for the first time. The patients were divided into the observation group and the control group according to the principle of randomized control. The observation group were injected the 10 ml tranexamic acid in the capsule of the joint before closing the joint cavity ，while the control group were injected with 10 ml normal saline. Then，two groups were placed the high negative pressure drainage bottle after the injection，and the hemoglobin，flow rate，blood transfusion，and complications of deep venous thrombosis of the lower extremities after operation of two groups were compared. Results The flow rate and the condition of blood loss after operation for 24 h in the observation group was significantly lower than that in the control group （P<0.05）. The erythrocyte specific volume and hemoglobin index after operation in the observation group were higher than those in the control group ， and the difference between the two groups was statistically significant（P<0.05）. The blood transfusion rate and blood transfusion rate in the observation group were lower than that in the control group （P< 0.05）. There was no statistical difference in the probability of deep venous thrombosis after the operation between the two groups（P>0.05）. Conclusion The tranexamic acid injection on the basis of negative pressure drainage treatment for patients with total knee arthroplasty which can effectively reduce postoperative bleeding and reduce the demand for blood transfusion. At the same time，it does not promote the risk of deep venous thrombosis of the lower extremity，thus it is worth further promoting and applying in clinical practice.

The trend and clinical significance of blood coagulation state in patients with diabetes after TKA operation

LUAN Feifan, ZHANG Guangming, LIU Yongyi, WANG Xinliang, CHEN Ming

2018, 18(03):  290-294.  DOI: 10.3969/j.issn.1009?976X.2018.03.013

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［Abstract］ Objective To investigate the changes of blood coagulation status in patients with osteoarthritis of knee joint with diabetes after primary TKA. Methods A total of 60 patients with osteoarthritis were included in the research object in December 2014 to December 2016 from our hospital and underwent primary TKA surgery. According to fasting blood glucose level and history, patients were divided into two groups：diabetic group （30 cases） and normal group （30 cases）. The patients in diabetes group had average 69.70 ± 4.69 years old, 5 males and 25 females. In the normal group, the average age was 72.70±5.36 years, 4 males and 26 females. The two groups were given the same clinical intervention and treatment during the perioperative period. The blood specimens of the anterior elbow vein were collected on the fasting morning in the first, the third, and seventh days to detect the changes of prothrombin time （PT）, activated partial thromboplastin time （PTT）, thrombin time （TT）, fibrinogen （FIB）, and blood platelet （PLT）. Results The postoperative Fib change trend in two groups were are risen in the postoperative 1st day, 3rd day to the peak（diabetes group=5.25±0.82 g/L, normal group=4.44 ± 0.43 g/L）. While the Fib level in the postoperative day 7 were was less than postoperative 3rd day, but still more than preoperative level（P<0.05）. Blood Fib in diabetes group was high than the normal group in all time points（all P values <0.05）. The change trend of blood PLT counts in both groups was basically the same, and. The PLT level on the first postoperative day was significantly lower than before surgery, and dropped to the lowest value on the third postoperative day. At the seventh postoperative day, the PLT count of both groups was restored to the preoperative level. And there were no statistical differences at each time point of PLT count （all P values <0.05）. In both group, PLT, PT and APTT did not change significantly preoperative and postoperatively. Conclusion After primary unilateral TKA, hypercoagulability of blood in patients with knee osteoarthritis and diabetes is more severe than that in patients with normal fasting blood glucose. Fib is a sensitive index for detecting hypercoagulable state. Postoperative monitoring of changes in Fib index is helpful for evaluating the coagulation state of patients with knee osteoarthritis after TKA.

Application of absorbable Surgiflo haemostatic matrix in posterior lumbar interbody fusion

GUAN Zhiping，WU Zhenquan，WEN Jian，QIU Ruishan，WANG Wenhao，SHI Yan，YU Binsheng

2018, 18(03):  295-297.  DOI: 10.3969/j.issn.1009?976X.2018.03.014

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［Abstract］ Objective To observe the clinical hemostatic efficacy and safety of absorbable Surgiflo haemostatic matrix （Surgiflo） in posterior lumbar interbody fusion （PLIF）. Methods A total of 96 patients performed PLIF in our hospital from Oct. 2016 to Oct. 2017, were recruited in our study. Members were divided into two groups,experimental group（n=48）and control group（n=48）. Surgiflo were used in experimental group,but not in control group. The volume of blood loss,operative duration, the seroma volume of drainage at 24 h, 48 h, 72 h after operation,and wound infection were compared between two groups. Results Compared with control group,the volume of blood loss,operative duration,the seroma volume of drainage at 24 h,48 h,72 h after operation in experimental group was significantly less （P<0.05）. There was no significant difference between the two groups in the wound infection,wound and hospital stay after surgery（P>0.05）. Conclusion Surgiflo has good hemostatic effect in PLIF,and can reduce the volume of blood loss,operative duration, the seroma volume of drainage.

Clinical efficacy of MIS? TLIF in the treatment of degenerative lumbar spinal stenosis in the elderly

LI Xiankun, WU Mingxin, ZHANG Yunfan

2018, 18(03):  298-301.  DOI: 10.3969/j.issn.1009?976X.2018.03.015

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［Abstract］ Objective To compare the clinical efficacy and safety of minimally invasive surgery transforaminal lumbar interbody fusion（MIS?TLIF）in Quadrant minimally invasive channel system and conventional posterior lumbar interbody fusion （PLIF） in the treatment of degenerative lumbar spinal stenosis in the elderly. Methods From June 2013 to January 2017 in our hospital for treatment of 90 cases of lumbar spinal stenosis in elderly patients as the research object. Among them , 54 patients were operated by MIS?TLIF procedure（MIS?TLIF group）, and 36 patients were treated with PLIF operation （PLIF group）. The surgical effects of two groups were compared. The operation time, the amount of bleeding, the bed time, the amount of blood transfusion and the flow rate after the operation were compared between the two groups. The clinical symptoms of two groups were compared , and the incidences of adverse reactions in the two groups were compared. Results The cure rate and total effective rate in the MIS-TLIF group were significantly higher than those in the PLIF group （P<0.05）. The operative time in the MIS?TLIF group was significantly higher than that in the PLIF group , and the intraoperative blood loss, bed rest time, postoperative blood transfusion volume and postoperative drainage volume were significantly lower than those in the control group（P<0.05）. The JOA score in 6 months after operation in two groups was both higher than that in 1day before preoperative, VAS score and ODI score were lower than these in one day before preoperative（P<0.05）. The JOA score in the MIS-TLIF group in 6 months after operation was higher than that in the PLIF group in 6 months after operation, and the VAS score and ODI score were lower than those in the control group in 6 months after operation （P<0.05）. The incidences of postoperative infection and hard capsule rupture and the total adverse reaction incidences in the MIS?TLIF group were significantly lower than those in the PLIF group（P<0.05）. Conclusion MIS-TLIF minimally invasive surgery under Quadrant minimally invasive channel system for degenerative lumbar spinal stenosis in elderly patients with significant effect , small trauma and rapid recovery.

Effects of anterior cervical corpectomy decompression and full?contact titanium mesh graft fusion on NDI in patients with cervical spondylotic myelopathy

XIAO Jianbin1, AI Fuzhi2, LI Shiping1, YAN Yuemao1, XIAO Jianyong1, LIAO Huanqing1

2018, 18(03):  302-305.  DOI: 10.3969/j.issn.1009?976X.2018.03.016

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［Abstract］ Objective To observe the effects of anterior cervical corpectomy decompression and titanium mesh-bone graft composite on neck disability index （NDI） score in patients with cervical spondylotic myelopathy. Methods Fifty-six cases of patients with cervical spondylotic myelopathy admitted to our hospital from February 2012 to October 2017 were selected and divided into the control group （n=28） and the observation group （n=28）. The control group was assigned to anterior cervical discectomy and bone grafting internal fixation, and the observation group was given anterior cervical corpectomy decompression and full-contact titanium mesh-bone graft composite, and the patienys were followed up for 6 months. The operative time, intraoperative blood loss, hospital stay and intervertebral height loss were compared between the two groups, and the scores of NDI and Japanese Orthopaedic Association（JOA）were recorded before operation and at 6 months after operation, and the bone grafting fusion rate and postoperative improvement rate were calculated. Results The operative time in the observation group was shorter than that in the control group（P<0.05）, and the intraoperative blood loss was less than that in the control group（P<0.05）, and there was no significant difference in hospital stay between the two groups（P>0.05）. There was no significant difference in the intervertebral height loss between the observation group and the control group （P>0.05）. The postoperative JOA score in the observation group was significantly higher than that in the control group （P<0.05）while the NDI was significantly lower than that in the control group（P<0.05）. There was no significant difference in bone grafting fusion rate between the observation group and the control group（P>0.05）, and the postoperative improvement rate in the observation group was higher than that in the control group （P<0.05）. Conclusion Anterior cervical corpectomy decompression and full?contact titanium mesh graft fusion can have good efficacy for cervical spondylotic myelopathy, and can significantly reduce the NDI.

Clinical outcome of invasive interbody fusion under Quadrant system for lumbar disc herniation

ZHANG Huicheng，CHEN Jiayu，LIU Zhanliang，YANG Zhifa，YANG Yongqian，LI Weilong

2018, 18(03):  306-308.  DOI: 10.3969/j.issn.1009?976X.2018.03.017

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［Abstract］ Objective To evaluate preliminary clinical efficacy of minimally invasive posterior lumbar spine interbody fusion under Quadrant system for lumbar disc herniation. Methods From January 2012 to December 2014, a total of 18 cases suffering from lumbar disc herniation were implemented surgery. These cases underwent interbody fusion via bilateral paramedian approach under Quadrant invasive system. ODI and VAS score was used to evaluate the pre?and post?revision operation outcome Lumbar CT scan and three?dimensional reconstruction was used to assess the lumbar interbody fusion. Results Thirty?six patients were followed up for 6?25 months（mean, 12.6 months）. The mean VAS score at preoperation was 7.31±1.6, the last follow?up after operation average VAS score was 3.15± 0.54, which showed statistical significance（P<0.05）. Preoperative averaged ODI score was 38.54±3.21, the last follow?up after operation averaged ODI score was 5.96±3.12, there are differences compared with preoperative statistical significance （P<0.05）. All cases got bony fusion in the last follow-up after operation. No breakage of pedicle screws and fusion device shift were noted. Conclusion The Quadrant channel of minimally invasive lumbar interbody fusion in the treatment of lumbar disc herniation is safe and effective.

Clinical analysis of pedicle bone graft and pedicle screw fixation for thoracolumbar burst fractures

DONG Zhihui，LUO Shaojian，WEI Jian

2018, 18(03):  309-312.  DOI: 10.3969/j.issn.1009?976X.2018.03.018

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［Abstract］ Objective To observe the clinical effect of pedicle bone graft and pedicle screw in the treatment of thoracolumbar burst fracture. Methods From January 2014 to January 2017，100 patients with thoracolumbar burst fracture were divided into two groups（50 cases per group）. The patients in the control group were treated with lateral bone grafting plus pedicle screw fixation，and the observation group were treated with pedicle bone graft and pedicle screw internal fixation. The operative time，intraoperative bleeding volume，pain score，kyphosis angle were compared between the two groups. The height of injured vertebrae and the grade of spinal cord nerve injury. Results There was no significant difference in intraoperative bleeding volume between the two groups（P>0.05）. The pain scores of the two groups were significantly lower than those before operation（P<0.05），and the anterior and posterior edge height of injured vertebrae were significantly higher than those before operation（P<0.05），and the kyphosis angle was significantly higher than that before operation（P<0.05）. The pain score of the observation group was lower than that of the control group（P<0.05），and the height of the injured vertebrae was higher than that of the control group（P<0.05），and the kyphotic angle was lower than that of the control group（P<0.05）. Conclusion In the treatment of thoracolumbar burst fracture，the treatment with pedicle bone graft and pedicle screw fixation can effectively reduce the pain and correct the height and kyphosis angle of injured vertebrae. It is beneficial to promote the effective recovery of spinal cord nerve injury.

Clinical effect of external fixation combined with vacuum sealing drainage in patients with Gusti? lo type Ⅲ fracture of lower limb

HUANG Jianbin1，YAN Chaoyi2，CHEN Yuanzhuang1，HUANG Yuanqiao1

2018, 18(03):  313-316.  DOI: 10.3969/j.issn.1009?976X.2018.03.019

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［Abstract］ Objective To analyze and evaluate the effect of external fixation combined with vacuum sealing drainage in the treatment of Gustilo type Ⅲ fracture of lower limb. Methods Eighty cases of pa? tients with Gustilo type Ⅲ fracture of lower limb in our hospital were selected as the research objects. All the patients were randomly divided into group A and B，with 40 cases in each group. Patients in the group A received external external fixation combined with vacuum sealing drainage ，while patients in the group B received external fixation. The clinical effects of the two groups were compared. Results The operation time，hospital stay，fracture healing time and would healing time were shorter than those of the group B（P<0.05）. The excellent rate of fracture healing of the group A was 87.50% ，which was higher than 62.50% of group B（P<0.05）. The incidence rate of complications of group A was 12.5% ，which was lower than 45% of group B（P<0.05）. Conclusion External fixation combined with vacuum sealing drainage is effective in the treatment of Gustilo type Ⅲ fracture of lower limb. It can not only shorten the hospitalization time and accelerate the fracture healing，but also has less complication. It is worthy of wide promotion.

Correlation between prostatic urethra length，prostatic volume and bladder outlet obstruction in patients with lower urinary tract symptoms

FAN Jianfeng1，LIAO Haixing2，LI Zhijie1，WU Zhanghai1

2018, 18(03):  317-322.  DOI: 10.3969/j.issn.1009?976X.2018.03.020

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［Abstract］ Objective To evaluate the predictable effect of prostatic urethra length（PU）on bladder outlet obstruction（BOO）in patients with low urinary tract symptoms（LUTS）basing on investigating the correlation between PU segmental length，prostatic volume （PV），residual urine （RU） and BOO. Methods Clinical data of 168 outpatients or hospitalized males with LUTS were collected from January 2014 to June 2017. PU，superior prostatic urethra length （SPU），inferior prostatic urethra length （IPU），ratio of SPU and IPU（SIR），PV were measured and calculated by transrectal ultrasonography. The residual urine（RU）was measured and calculated by transabdominal ultrasonography. Bladder outlet obstruction index（BOOI）was recorded by uroflowmetry. BOO was defined by a BOOI above 40. Firstly， the data were divided into two groups accordingly BOOI≥40 and BOOI<40. Statistical significance of mean value was compared between two groups. Correlation was analyzed between BOOI and PU ，SPU， IPU，SIR，PV，RU and age. Univariate analysis was used to screen the risk factors of BOO. Receiver operating characteristic curves （ROC） were used to evaluate PU， SPU， IPU， SIR， PV， RU in predicting BOO in patients with LTUS. Results The proportion of BOO was 58.9%（99/168）in our study. BOO in LUTS patients correlated positively with SIR，SPU，RU，PU，PV（r=0.427，P=0.001；r= 0.387，P=0.027；r=0.313，P=0.019；r=0.308，P=0.032；r=0.269，P=0.038），whereas uncorrelated with IPU and age（r=0.159，P=0.147；r=0.118，P=0.063，respectively）. The positive predictive value of SIR took up the highest percentage amongst these parameters（75.2%，76/101）. Significant difference of SIR was found between the groups of BOOI≥40 and BOOI<40 in LTUS patients（t=3.856，P=0.002）. The incidence rate of the BOO was higher in group of SIR≥1.5 than that of SIR<1.5（?2=20.563，P< 0.001）. The area under curve（AUC）of the ROC of SIR in predicting BOO in LTUS patients was 0.729± 0.061（P=0.002），and optimal cut-off value was SIR≥1.5. The parameter of SIR≥1.5 could predict presence of BOO in LUTS patients with a sensitivity of 66.8% and specificity of 90.1% . Conclusion SIR，SPU，PU，RU，PV positively correlate with the incidence of BOO in patients with LUTS.SIR manifests a better predictor over these parameters. Patients with SIR≥1.5 are at a higher risk for BOO than those with SIR<1.5 with a favorite specificity and fairly sensitivity.

Comparative analysis of clinical methods for endometrial carcinoma screening

QU Xiao，WANG Xuelai，TAN Yan，ZHANG Xuefang，FANG Guangguang

2018, 18(03):  323-326.  DOI: 10.3969/j.issn.1009?976X.2018.03.021

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［Abstract］ Objectives To compare the diagnostic value of Pipelle endometrial sampler and Tao brush endometrial sampler in endometrial cancer screening. Method 200 patients with abnormal uterine bleeding had endometrial sampling with randomly either Pipelle，or Tao brush sampler，were compared with D&C as gold standard，in the department of Obstetrics and Gynecology Unit，the Second Hospital of Shen Zhen，China，during the period of July 2015?July，2017. Pain score（VAS），bleeding volume，adequacy of samples and patient s compliance were also compared between the two groups. Results There was no significantly difference in the diagnostic accuracy between two groups（P>0.05）， with a correlations of both 98% compared with D&C； and the patients factors in bleeding volume， VAS， sample adequacy and complications were matched with no statistic significance （P>0.05）. Respectively，the sensitivity and specificity of two groups was 95.0% ，93.1% ，96.0% and 93.9% respectively；and the positive predictive value and the negative predictive value was 96.0% ，93.0% ， 95.0% and 93.0% ，respectively in each group. It s indicated that there is no significant difference in accuracy between Tao brush and Pipelle biopsy compared with D&G as gold standard in diagnosing（P> 0.05）. Conclusion It is concluded that both Tao brush and Pipelle biopsy are useful and cost?effective sampler methods compared with D&C，whist Tao brush perhaps has higher accuracy by taking biopsy for the patient thereby for early diagnosis of malignancy.

Comparison of electromagnetic extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy in the treatment of ureteral calculi

YAO Shiwu，LI Hanrong，HUANG Diandong，JIANG Huiming

2018, 18(03):  327-330.  DOI: 10.3969/j.issn.1009?976X.2018.03.022

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［Abstract］ Objective To compare the efficacy of electromagnetic extracorporeal shock wave lithotripsy（ESWL）and ureteroscopic lithotripsy in the treatment of ureteral calculi. Methods 150 cases of ureteral calculi were treated in our department from July 2015 to October 2017，and divided into two groups，75 cases were treated by extracorporeal shock wave electromagnetic extracorporeal shock wave lithotripsy（ESWL group），and 75 cases（ureteroscopy group）were treated with ureteroscopic lithotripsy treatment. The clinical effects，stone size，operation time and complications were compared between the two groups. Results For stone size <1.0 cm，success rate in ESWL group and ureteroscopic group were 95.24% and 73.33% respectively，and the difference was statistically significant （P<0.05）. The total success rate in ESWL group and ureteroscopic group were 88.00% and 72.00% ，the difference between the two groups has statistical significance（P<0.05）. The operation time in in ESWL group was shorter than in ureteroscopic group （P<0.05）. The incidence of postoperative complications was 9.33% in the extracorporeal shock wave group and 21.33% in the ureteroscopy group， and the difference was statistically significant（P<0.05）. Conclusion Electromagnetic extracorporeal shock wave lithotripsy is effective for ureteral calculi less than 1.0 cm and can reduces complications.

Treatment of high-risk patients with benign prostatic hyperplasia by transurethral plasma bipolar resection

ZHANG Heyuan，HUANG Minzhi，DENG Limin，HUANG Yuqing

2018, 18(03):  331-333.  DOI: 10.3969/j.issn.1009?976X.2018.03.023

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［Abstract］ Objective To summarize the experience and record the clinical efficacy of transurethral plasma bipolar resection in the treatment of elderly patients with high risk of benign prostatic hyperplasia. Methods From January 2015 to June 2017，60 consecutive patients with symptomatic obstructive BPH were treated with transurethral plasmakinetic resection prostate. Preoperative and postoperative parameters were recorded and evaluated including International Prostate Symptom Score questionnaire（IPSS），maximum urinary flow rates（Qmax），prostate volume（assessed by transrectal ultrasound），postvoid residual urine volume（PRV）measurement and Quality of life score（QoL）. The operation time and complications were also recorded. Results Median follow-up was 15.68 ± 7.32 months. There were statistically significant differences between baseline and postoperative parameters. Mean Qmax increased from 5.6±4.2 ml/s to 23.2±1.7 ml/s（P<0.001）. Their mean IPSS improved from 22.3 ± 5.6 to 11.6 ± 2.5（P<0.001）and mean QOL improved from 5.01 ± 0.43 to 1.26 ± 0.78（P<0.001）. Urethral stricture developed in 1.6% of patients，respectively. No patient had recurrent BPH symptoms except one case of urethral stricture associated surgery needed further treatment. Conclusion Transurethral plasma bipolar resection of the prostate is a safe and effective treatment for patients with high risk of benign prostatic hyperplasia.

The effectiveness of 1% Mepivacaine and 0.5% ropivacaine used for brachial plexus nerve block in clavicle fracture surgery

HONG Yu1，LIU Jiayu1，WANG Shouping2，ZHANG Lei3

2018, 18(03):  334-337.  DOI: 10.3969/j.issn.1009?976X.2018.03.024

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［Abstract］ Objective To compare the efficacy of 1% Mepivacaine with 0.5% ropivacaine on brachial plexus nerve block in clavicle fracture surgery. Methods Thirty adult patients（ASAI~II）undergoing clavicle fracture surgery were randomly divided into two groups（n=15），1% mepivacaine group（group M）and 0.5% ropivacaine group（group R）. Patients in two groups both acceptted brachial plexus nerve block guided by nerve stimulator，and patients in group M and group R were injected 1% mepivacaine or 0.5% ropivacaine 25 ml separately. The hemodynamic，sensory and motor block onset and recovery time， postoperative VAS score，adverse reactions and anesthesia satisfaction were observed in the two groups. Results Compared with group R，the onset time of sensory and motor block was shortened in group M， the time of block recovery was shortened（P<0.05），and the scores of 6 h and 12 h were increased（P< 0.05）after operation（VAS < 0）. Conclusion Brachial plexus nerve block with 1% mepivacaine and 0.5% ropivacaine both can satisfy clavicle fracture surgery. The use of 1% mepivacaine was faster than the 0.5% ropivacaine，and the sensory and motor recovery was earlier in group M，which was beneficial to the early stage of operation，but the analgesic effect was less than 0.5% ropivacaine.

Comparison between the sciatic nerve block and periarticular local infiltration anesthesia in postoperative analgesic effects after total knee replacement

LIN Yibin1，WU Guiyun2，ZENG Zhiwen1，LIN Weixiong1，LV Weiming

2018, 18(03):  338-341.  DOI: 10.3969/j.issn.1009?976X.2018.03.025

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［Abstract］ Objective To compare the difference of postoperative analgesic effects after total knee replacement between the sciatic nerve block and the periarticular local infiltration anesthesia around the joint. Methods Thirty-three patients with total knee surgery，ASA class Ⅰ or Ⅱ，were divided into sciatic nerve block groups（SNB group，n=16，the patients were given 20 ml of 0.375% ropivacaine for sciatic nerve block）；local infiltration anesthesia group （LIA group，n=17，the patients were given mixed local anesthetics including 150 ml of 0.2% of ropivacaine，100 mg of tramadol and 0.5 mg of epinephrine for periarticular local infiltration anesthesia. The VAS scores in the static state and the active state were recorded and evaluated at 2，8，16，24，36 and 48 hours postoperatively. Postoperative nausea and vomiting，the symptoms of local anaesthesia poisoning，the occurrence of rashes，and the status of KSS scores in the two groups were observed. Results Compared with the SNB group，static VAS scores of LIA group was higher at postoperative 2，8，16 hours，with statistically significant differences （P<0.01），but the scores were reduced at postoperative 24，36 and 48 hours，with statistically significant differences （P<0.01）. Compared with the SNB group，motional VAS scores of LIA group was higher at postoperative 2 and 8 hours，with statistically significant differences（P<0.01）， but the scores were reduced at postoperative 16，24，36 and 48 hours，with statistically significant differences（P<0.01）. The two groups of patients were similar in postoperative nausea and vomiting，the symptoms of anesthetic poisoning，rash occurrence，and KSS score，without statistically significant differences. Conclusion SNB or LIA can provide good postoperative analgesic effect for total knee surgery，but the latter is more suitable for such operations from the perspective of convenient procedures.

Effect of palonosetron on intraoperative shivering in patients undergoing caesarean section LIN

Zonghang,YANG Chunhe,LI Heng,FU Baojun,YANG Xiuhuan,CHEN Qingmei,LU Wenmin，JIANG Jingjing

2018, 18(03):  342-344.  DOI: 10.3969/j.issn.1009?976X.2018.03.026

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［Abstract］ Objective To investigate the effect of palonosetron for cesarean section perioperative shivering. Methods Eighty cases of cesarean section patients were divided into palonosetron group（P group）and control group（C group），40 cases in each group. The incidence of shivering，nausea and vomiting during the operation of the patients was recorded，and the vital signs of the patients and the Apgar score after the birth of the neonates were recorded. Results The incidence of shivering and nausea and vomiting in group P was significantly lower than that in group C（P<0.05）. There was no significant difference in vital signs and Apgar scores of the neonates between the 2 groups（P>0.05）. Conclusion Palonosetron can safely and effectively reduce the incidence of cesarean section in patients with perioperative shivering.

Comparison of intranasal dexmedetomidine and intravenous dexmedetomidine for prevention of emergence agitation after ambulatory orthognathic surgery in children

LEI Dongxu，PAN Yongying，CHEN Liumei，WANG Huaizhen，ZHAO Qing，SONG Xingrong

2018, 18(03):  345-348.  DOI: 10.3969/j.issn.1009?976X.2018.03.027

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［Abstract］ Objective To compare the effects of intranasal dexmedetomidine and intravenous dexmedetomidine on emergence agitation （EA） after sevoflurane anaesthesia in pediatric ambulatory orthognathic surgery. Methods In this study，135 children，1-6 years of age，undergoing sevoflurane anaesthesia were assigned to three groups which receiving either intravenous dexmedetomidine 1 μg/kg after induction （Group VD），intranasal dexmedetomidine 1 μg/kg 15 min before induction （Group ND）， or saline （Group C）. The severity of EA were evaluated with the Paediatric Anaesthesia Emergence Delirium （PAED） scale and pain were evaluated with FLACC scale every 5 min after surgery. The HR and BP were record at time points：before induction （T0），after induction （T1）， beginning of surgery （T2），being operated （T3） and woke up （T4）. And the time to recovery and PACU stays，incidence of nausea/vomiting，breath depression and bradycardia were assessed. Results The incidence of EA in Group VD and Group ND were lower than Group C（P<0.01）. The HR at time T2 and T3 in Group ND was significantly lower than that in Group VD and Group C（P<0.01），and the HR at time T3 was lower in Group ND than Group C（P<0.05）. Recovery time in Group ND and Group VD weres longer than in Group C（P<0.01）. The differences in time of PACU stays and the highest pain score between the 3 groups were considered clinically insignificant. Four children in Group VD required atropine treatment for bradycardia. Conclusion Both intranasal dexmedetomidine and intravenous dexmedetomidine comparably reduced EA after sevoflurane anaesthesia in pediatric pediatric ambulatory orthognathic surgery. Intranasal dexmedetomidine provide more acceptable heart rate during the surgery.

Revival effects of flumazenil in patients undergoing hepatic lobectomy under general anesthesia and the influence on convalescent bispectral index and cognitive function

YU Zhaoying1，XU Shan2

2018, 18(03):  349-352.  DOI: 10.3969/j.issn.1009?976X.2018.03.028

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［Abstract］ Objective To observe the revival effects of flumazenil in patients undergoing hepatic lobectomy under general anesthesia and the influence on convalescent bispectral index （BIS） and cognitive function. Methods Fifty patients undergoing hepatic lobectomy under general anesthesia were selected. They were divided into flumazenil group（n=25）and non flumazenil group（n=25）according to the use of flumazenil. Both groups were given remifentanil combined with propofol target-controlled infusion（TCI）general anesthesia，and BIS was maintained between 40 to 60. At the end of the operation， the flumazenil group was given intravenous infusion of flumazenil，and the non flumazenil group was given intravenous injection of equal volume of normal saline. Postoperative recovery time and changes of BIS values at different time points after recovery in the two groups were recorded. The cognitive function of patients was evaluated by the mini mental state examination（MMSE）before operation and at 1 d，3 d and 5 d after operation. Results The postoperative spontaneous breathing recovery time，eye opening time under the instruction，fist making time under the instruction，extubation time and time of recalling the birth date of the flumazenil group were significantly shorter than those of the non flumazenil group （P< 0.05）. The BIS value of the flumazenil group increased significantly at 4 min after entering the anesthesia recovery room（P<0.05），while the BIS value of the non flumazenil group increased significantly at 6 min after entering the anesthesia recovery room（P<0.05）. The BIS values the flumazenil group at 4 min，6 min，8 min，10 min，12 min，14 min and 16 min after entering the anesthesia recovery room were significantly higher than those of the non flumazenil group（P<0.05）. MMSE scores of the flumazenil group at 1 d，3 d and 5 d after operation were significantly higher than those of the non flumazenil group（P< 0.05）. Conclusion Flumazenil can promote the recovery of patients undergoing hepatic lobectomy from general anesthesia and improve their cognitive function.

The clinical experience in using duramater tension?reduced suture pericranium in decompressive hemicraniectomy of acute transtentorial herniation

CHEN Qinbiao1，GUO Yongtong2，HU Zhi1，ZHAO Yiying1，LIU Zhenghao1，ZHOU Zhiwei1，HUANG Yutao1，DENG Yuefei1，LEI Bingxi1

2018, 18(03):  353-356.  DOI: 10.3969/j.issn.1009?976X.2018.03.029

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［Abstract］ Objective To compare the clinical effects of two surgical procedures between duramater tension-reduced suture using pericranium and traditional dura mater suture in decompressive hemicraniectomy of acute transtentorial herniation. Methods From January 2016 to June 2017，a retrospective analysis was performed on the prognosis of patients with decompressive hemicraniectomy of acute transtentorial herniation. Mann-Whitney U test was used to analyze the GOS difference between dura mater tension?reduced suture using pericranium and traditional dura mater suture. Results When compared with traditional dura mater suture（control group，n=24），the patients underwent dura mater tension-reduced suture using pericranium （observation group，n=26） showed lower GOS scores （P< 0.05）. Conclusion Dura mater tension?reduced suture was superior to traditional dura mater suture in prognosis and reducing the occurrence of complications and should be generalized.

Adverse reactions and nursing methods in patients undergoing chemotherapy after radical esophageal

WANG Yucui，LIU Yu

2018, 18(03):  357-359.  DOI: 10.3969/j.issn.1009?976X.2018.03.030

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［Abstract］ Objective To comprehend the side effects of postoperative adjuvant chemotherapy for esophageal cancer and provide basis for the next new care response. Methods An investigation was conducted on 85 cases of undergoing neoadjuvant chemotherapy after radical esophageal. Results The incidence of adverse reactions in postoperative adjuvant chemotherapy for esophageal cancer was 100.00% as followed，weight loss（100.0%），poor appetite（100.0%），hair loss（98.8%），swallowing discomfort（97.7%），nausea（97.7%），and weary（97.7%）. The highest degree of symptom severity were poor sleep，hair loss，nausea and swallowing discomfort. And different chemotherapy courses occur with different adverse reactions. Conclusion The nursing care should make individualized nursing response plan according to the characteristics of the patients，and the dynamic evaluation impact the patients symptoms. The standardized nursing should be recommended for improvement of nursing quality.

Effect of whole nursing combined with low molecular weight heparin on postoperative coagulation in patients with cervical malignant tumor and its preventive effect of venous thrombosis

OUYANG Zhongxia1，CHEN Shaozhen2

2018, 18(03):  360-363.  DOI: 10.3969/j.issn.1009?976X.2018.03.031

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［Abstract］ Objective To explore the effect of whole nursing combined with low molecular weight heparin on postoperative coagulation in patients with cervical malignant tumor and preventive effect of venous thrombosis. Methods A total of 110 patients were enrolled in our hospital from April 2014 to December 2016. The patients were divided into control group and observation group. Two groups of patients were the same group of medical staff to complete the project. The patients in the control group were given routine nursing mode，and the patients in the observation group the whole nursing mode. The effects of nursing care and number of hypercoagulability and the incidence of postoperative thrombotic disease in two groups were recorded and analyzed. The indexes of coagulation at different time between two groups were analyzed. Results A total of 38 surgical nurses were chosen to participate in this study，with an average age 32（21?55）. Patients compliance rate was 42.3% in the control group while it was 95.0% in the observation group. In the control group，only one patient in 5 patients with mild swelling legs was detected. Evidence of warmth or increasing heat of 6 patients was not recorded in the nursing record. In the observation group，four patients with mild swelling legs were detected，and evidence of high skin temperature of only 3 patients was not recorded in the nursing record. There was no significant difference in the proportion of blood coagulation between the two groups（P>0.05）. There was no significant difference between PLT，PT APTT（all P values >0.05）except for D?Dimer between two groups. Conclusion Whole?course nursing integral nursing care for postoperative observation of patients with thoracic malignant tumor using low molecular weight heparin helps prevent postoperative VTE.

Clinical observation of preventive nursing procedure in reducing the occurrence of inhalation pneumonia

HUANG Lixia1，LAN Jing1，CHEN Yanshan1，PENG Caijin1，LI Li2

2018, 18(03):  364-366.  DOI: 10.3969/j.issn.1009?976X.2018.03.032

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［Abstract］ Objective To investigate the effect of preventive nursing on the incidence of inhalation pneumonia in bedridden patients. Methods A prospective study was conducted to collect 75 inpatients with long?term bed rest（>2 months admission）from May 2016 to November 2016. The patients were di? vided into preventive care group （38 cases） and routine care group （38 cases）. The preventive care group adopted more active care for routine care，mainly including supervised hand nursing supervision to increase compliance，prevention of cough in the diet，and strengthening oral care. Results A total of 35 patients in the preventive care group completed the study and 34 patients in the conventional care group completed the study. 5 cases（14.29%）in the preventive care group and 8 cases（23.53%）in the regular care group had inhalation pneumonia. There was no statistically significant difference between the two groups （P=0.05）；compliance with the preventive care group Higher than the regular care group（71.8% vs 52.4%，P=0.05）；satisfaction of the preventive care group was significantly better than that of the conventional care group（92.0% vs 69.9%，P=0.022）. Conclusion Preventive nursing improves the work compliance of the nurses and increases patient satisfaction. However，whether to reduce the inci? dence of inhalation pneumonia in bedridden patients requires more observations.

Analysis on risk factors for clean wound orthopedic surgical site infection

2018, 18(03):  367-371. 

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Objective To analyze the risk factors for surgical site infection (SSI) in clean wound orthopedics surgery, and to explore how to control it. . Methods SSI among patients receiving clean wound orthopedic surgery from June 2015 to December 2016 were monitored, Chi-square test was used to analyze the related influencing factors(age, ASA score, skin preparation modes, operation time, types of surgery , use of Antibacterials, drainage tube indwelling) of postoperative infection in clean wound orthopedics surgery, multiple Logistic regressions were used to analyze the positive risk factors. Results A total of 792 patients were monitored, 17 cases (2.15%) of SSI occurred. The results of chi-square test showed that elder age，ASA score ≥ grade Ⅱ,conventional skin preparation, long operation time, complicated operation type , irrational use of antibiotics might increase the risk of clean wound orthopedic surgical infection (all P values <0.05)，but patients’ gender, the surgeons’ level and operation skill , drainage tube indwelling did not. Multiple Logistic regressions results showed that ASA score ≥ grade Ⅱ,conventional skin preparation and long operation time might increase the risk the clean wound orthopedic surgical infection，and the highest risk factors was long operation time(＞3h), and then ASA score ≥ grade Ⅱ and conventional skin preparation. [OR (95%CI), 4.08(1.36-12.35),3.46(1.98-21.12),2.97 (1.08-14.71)]. Conclusion Elder age，ASA score ≥ grade Ⅱ and conventional skin preparation may increase the risk of clean wound orthopedic surgical infection. Medical staff should be fully aware of these risk factors, optimize the regulatory factors most in perioperative period and maximally reduce the incidence for SSI in clean wound orthopedics surgery.