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Wang Y, Jiang K, Xia Q, Kang X, Wang S, Yu JH, Ni WF, Qi XQ, Zhang YN, Han JB, Liu G, Hou L, Feng ZC, Huang LM. Exploration of pathogenic microorganism within the small intestine of necrotizing enterocolitis. World J Pediatr 2024; 20:165-172. [PMID: 37676611 DOI: 10.1007/s12519-023-00756-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency in neonates. We designed this study to identify the pathogenic microorganisms of NEC in the microbiota of the small intestine of neonates. METHODS Using the 16S ribosomal DNA (rDNA) sequencing method, we compared and analyzed the structure and diversity of microbiotas in the intestinal feces of different groups of neonates: patients undergoing jejunostomy to treat NEC (NP group), neonates undergoing jejunostomy to treat other conditions (NN group), and neonates with NEC undergoing conservative treatment (NC group). We took intestinal feces and saliva samples from patients at different time points. RESULTS The beta diversities of the NP, NN, and NC groups were all similar. When comparing the beta diversities between different time points in the NP group, we found similar beta diversities at time points E1 to E3 but significant differences between the E2-E3 and E4 time points: the abundances of Klebsiella and Enterococcus (Proteobacteria) were higher at the E1-E3 time points; the abundance of Escherichia-Shigella (Proteobacteria) increased at the E2 time point, and the abundance of Klebsiella decreased significantly, whereas that of Streptococcus increased significantly at the E4 time point. CONCLUSIONS Our results suggest that the pathological changes of intestinal necrosis in the small intestine of infants with NEC are not directly caused by excessive proliferation of pathogenic bacteria in the small intestine. The sources of microbiota in the small intestine of neonates, especially in premature infants, may be affected by multiple factors.
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Affiliation(s)
- Yan Wang
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Kun Jiang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiao Xia
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Xia Kang
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Shan Wang
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Ji-Hong Yu
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Wen-Feng Ni
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Xiao-Qin Qi
- Clinical Biobank Center, Medical Innovation Research Division of Chinese, PLA General Hospital, Beijing, China
| | - Ying-Na Zhang
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Jin-Bao Han
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Gang Liu
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Lei Hou
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Zhi-Chun Feng
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China.
| | - Liu-Ming Huang
- Senior Department of Pediatrics, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China.
- Department of Emergency Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
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Jin HM, Luo JT, Miao JS, Lu JJ, Wu AM, Sheng SR, Xu H, Ni WF, Lin Y, Wang XY. [Imaging study on the safety of axial pedicle screw placement by the position of the screw trajectory tip on the anteroposterior and lateral radiographs]. Zhonghua Yi Xue Za Zhi 2022; 102:3430-3436. [PMID: 36396358 DOI: 10.3760/cma.j.cn112137-20220512-01039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To propose a method to judge the safety of axial pedicle screw placement based on the position of the tip of the screw trajectory on the anteroposterior and lateral X-ray radiographs. Methods: The cervical CT data of 40 patients admitted to the Second Affiliated Hospital of Wenzhou Medical University from December 2020 to December 2021 were selected, including 24 males and 16 females, with a mean age of (47.6±13.2) years. Based on the three-dimensional model reconstruction of Mimics software and its function of X-ray, the transmission of the axial pedicle screw and its anteroposterior and lateral films was simulated. The position of the tip of the simulated screw trajectory was divided into 5 regions (regions Ⅰ-Ⅴ) from the inside to the outside on the anteroposterior virtual radiographs, and the upper and lower regions (regions a, b) on the lateral virtual radiographs. By adjusting the direction of the screw, the tip of the screw was located in the corresponding 10 regions (80 screws in each area) on the virtual projections of the anteroposterior and lateral virtual radiographs respectively, and its accuracy was analyzed by CT to determine whether each screw penetrated the medial wall of the pedicle or vertebral artery foramen. The anteroposterior and lateral X-rays and postoperative CT data of 34 patients who underwent axial pedicle screw placement (67 axial pedicle screws were placed in total) from January 2014 to December 2021 were collected, including 18 males and 16 females, with a mean age of (45.8±14.1) years. The position of the tip of the screw trajectory on the anteroposterior and lateral films was divided in the same way. The number of screws in the corresponding 10 positions was counted, and CT analysis was used to determine whether each screw penetrated the medial wall of the axial pedicle or the vertebral artery foreman. Results: The results of the imaging simulation screw placement study showed that the perforation rate of the vertebral artery foramen in region Ⅳ and Ⅴ was 75.0% (120/160) and 100% (160/160), respectively, while the perforation rate of the medial wall of the axial pedicle in the region Ⅰ was 85.6%(137/160). The failure rate in regions Ⅱ and Ⅲ was relatively lower, and the performance of simulated screws located in the region a was better than those in region b. The perforation rates of the medial wall in regions (a-Ⅱ) and (a-Ⅲ) was 7.5% (6/80) and 0 (0/80), respectively, and the perforation rates of the vertebral foramen was 0 (0/80) and 21.3% (17/80), respectively. The retrospective imaging study also showed a higher rate of placement failure in regions Ⅰ, Ⅳ and Ⅴ, and relatively lower in regions Ⅱ and Ⅲ. There were total of 15 screws in region a-Ⅱ and a-Ⅲ, and no destruction of the medial wall of the axial pedicle and the vertebral artery foreman occurred there. Conclusions: Regions a-Ⅱ and a-Ⅲ are the "safety areas" of the tip of the pedicle screw trajectory in the axial vertebra. By analyzing the tip of the pedicle screw trajectory on the anteroposterior and lateral radiographs, the operator can determine the reasonable trajectory of axial pedicle screw placement, prevent the injury of the cervical spinal cord and vertebral artery, and reduce the risk of operation.
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Affiliation(s)
- H M Jin
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - J T Luo
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - J S Miao
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - J J Lu
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - A M Wu
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - S R Sheng
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - H Xu
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - W F Ni
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - Y Lin
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
| | - X Y Wang
- Department of Spine Surgery, the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University, Wenzhou 325000, China
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Wu AM, Wang XY, Chi YL, Xu HZ, Weng W, Huang QS, Ni WF. Management of acute combination atlas-axis fractures with percutaneous triple anterior screw fixation in elderly patients. Orthop Traumatol Surg Res 2012; 98:894-9. [PMID: 23158783 DOI: 10.1016/j.otsr.2012.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/22/2012] [Accepted: 09/07/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Patients with combined C1-2 fractures were often treated by posterior arthrodesis. However, elderly patients with multiple injuries (such as brain injury), the large surgical trauma of posterior arthrodesis will increase the risk of perioperative mortality. A minimally invasive technique may be better for them, and decrease the risk of perioperative mortality. MATERIALS AND METHODS Seven patients with combined C1-2 fractures underwent percutaneous anterior odontoid screw and anterior C1-2 transarticular screws (percutaneous triple anterior screws fixation). The surgical technique of percutaneous triple anterior screws fixation is described. RESULTS The operation performed on all patients successfully without technical difficulties, and no intra-operative surgery-related complications such as vertebral artery, nerve injury and soft tissue complications occurred. No pullout, loosening, or breakage of internal screws was observed. C1/2 stable was found in all cases and radiographic union achieved in all odontoid fractures. CONCLUSION Using the appropriate instruments allied to intra-operative image-intensification, we suggest that percutaneous triple anterior screw fixation is reliable, effective and minimally invasive procedure for elderly and brain injured patients suffering of combined atlas-axis fractures. LEVEL OF EVIDENCE Level IV. Retrospective study.
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Affiliation(s)
- A M Wu
- Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, #109 XueYuan Western Road, WenZhou, ZheJiang, China.
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