Objective To investigate the effectiveness of sacroiliac screw implantation assisted by three-dimensional (3D) printed faceted honeycomb guide plate in the treatment of posterior pelvic ring fracture. Methods The clinical data of 40 patients with posterior pelvic ring fractures treated with sacroiliac screw implantation between December 2019 and December 2022 were retrospectively analyzed. Among them, 18 cases were treated with sacroiliac screws fixation assisted by 3D printed faceted honeycomb guide plate (guide plate group), and 22 cases were treated with sacroiliac screws percutaneously fixation under fluoroscopy (conventional group). There was no significant difference in baseline data (P>0.05) such as gender, age, time from injury to operation, and Dennis classification between the two groups. The implantation time, frequency of C-arm X-ray fluoroscopy, frequency of guide pin adjustment of each sacroiliac screw, and postoperative complications and bone healing were recorded. Majeed score was used to evaluate the functional recovery at 6 months after operation, and CT was used to observe whether the screw penetrated the bone cortex. The deviation between the virtual position and the actual position of the screw tip, the sacral foramen, and the screw entry point was measured on the sagittal CT images of the guide plate group. Results The number of screws implanted in S1 and S2 vertebral bodies was 14 and 16 respectively in the guide plate group, and 17 and 18 respectively in the conventional group. The implantation time of each sacroiliac screw, the frequency of C-arm X-ray fluoroscopy, and the frequency of guide pin adjustment in S1, S2, and all vertebrae in the guide plate group were significantly less than those in the conventional group (P<0.05). Patients in both groups were followed up 8-48 months, with an average of 19.7 months. There was no incision infection, screw displacement, or internal fixation loosening in both groups. Callus growth was observed in all patients at 12 weeks after operation, and bone healing was achieved in all patients. The healing time ranged from 12 to 24 weeks, with an average of 15.7 weeks. No sacroiliac screw penetrated the bone cortex in the guide plate group; 2 patients in the conventional group had sacroiliac screws penetrating the bone cortex without damaging blood vessels or nerves. In the guide plate group, the deviation between the virtual position and the actual position of the screw tip, the sacral foramen, and the screw entry point were (2.91±1.01), (2.10±0.74), and (1.67±0.70) mm, respectively, with an average deviation of (2.19±1.22) mm. There was no significant difference in Majeed function evaluation between the two groups at 6 months after operation (P>0.05). Conclusion The application of 3D printed faceted honeycomb guide plate in sacroiliac screw implantation for posterior pelvic ring fracture can shorten the screw implantation time, reduce the frequency of fluoroscopy and guide pin adjustment, and reduce the risk of screw penetration through the bone cortex.
Objective To investigate the current status of healthcare-associated infection (HAI) management in medical institutions in Shanghai, analyze the implementation of HAI surveillance indicators, and provide evidence to support the improvement of refined and scientific HAI management. Methods Using the Shanghai Three-Network Linkage Platform, a survey was conducted from April to May 2025 covering HAI management practices in the preceding year at medical institutions in Shanghai. Investigation and analysis were conducted on the HAI information systems, staffing of infection prevention and control (IPC) professionals, and implementation of HAI surveillance indicators. Results A total of 56 medical institutions in 16 administrative districts of Shanghai were surveyed. Among them, there were 45 tertiary medical institutions and 11 secondary medical institutions. There were 48 comprehensive medical institutions and 8 specialized medical institutions. All 56 medical institutions had established fully functional HAI information systems (100.0%). The structure and training compliance of IPC personnel were generally satisfactory; however, 4 institutions (7.1%) had insufficient IPC staffing levels. No statistically significant differences were observed between tertiary and secondary hospitals in the scores for implementation of HAI surveillance indicators (P>0.05). In contrast, significant differences were found between general and specialty hospitals in scores for rates of three types of device-associated infections (P=0.005) and hand hygiene compliance (P=0.041). After standardization of indicator implementation scores, the five lowest-scoring indicators requiring priority attention were, in descending order: blood culture submission rate for patients with pneumonia and fever ≥38.5°C; blood culture submission rate for patients with central venous catheters retained for ≥5 days; timing of perioperative prophylactic antimicrobial use for Class Ⅰ surgical incisions; catheter-related urinary tract infection incidence; and consumption of liquid soap and alcohol-based hand rub in wards. Conclusions Overall, HAI information system construction and management frameworks in Shanghai medical institutions are well established and functioning effectively. Nevertheless, gaps remain in IPC staffing allocation and in the clinical implementation of certain core HAI surveillance indicators. Continued efforts are required to advance the standardization and refinement of HAI management.
ObjectiveSham acupuncture control is a commonly employed method to assess the specific effects of acupuncture in clinical trials. However, due to the absence of specific reporting standards, the reporting quality of sham acupuncture in these trials is low. In order to standardize the reporting of sham acupuncture and improve the reporting quality of sham acupuncture, our project team has developed SHam Acupuncture REporting guidelines and a checklist in clinical trials (SHARE). MethodsThe development process included four parts: we conducted literature research to form initial items of sham acupuncture reporting; two rounds of Delphi surveys were carried out to evaluate the reporting necessity of these initial items; two expert consensus meetings were held to further discuss and agree upon the Delphi results and approve the SHARE checklist; a pilot testing was conducted to assess the feasibility and practicality of the list and make necessary revisions to generate the final SHARE checklist. ResultsThe SHARE checklist consisted of 10 categories with 19 items. The requirements for reporting sham acupuncture primarily focused on sham acupuncture detailed information as well as relevant background factors. ConclusionThe SHARE serves as specialized reporting guidelines for sham acupuncture that offers clear guidance on comprehensive and concise reporting of sham acupuncture.