Purpose Describe the prevalence of visual impairment/blindness among older adults in rural populations in China. Design Population-based, cross-sectional study. Participants We evaluated 45 747 adults ≥ 50 years of age. Methods Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants were enumerated through village registers followed by door-to-door household visits. Eligible persons were invited to local examination sites for visual acuity (VA) testing and eye examination. Main Outcome Measures Presenting and best-corrected distance VA. Results Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The prevalence of presenting visual impairment <20/63 to ≥20/400 in the better eye was 10.8% and blindness (<20/400) was 2.29%. Across the 9 provinces, presenting visual impairment ranged from 6.89% to 15.8%, and blindness from 1.27% to 5.40%. With best-corrected VA, the prevalence of visual impairment was 5.30%, and 1.93% for blindness. The ranges across the 9 provinces were 3.13% to 9.51% for visual impairment and 0.74% to 4.95% for blindness. Visual impairment and blindness were associated with older age, female gender, lack of education, and geographic area (province) with both presenting and best-corrected VA. Conclusions Visual impairment and blindness are important public health problems in rural China, with significant regional variations in prevalence. Blindness prevention programs targeting the rural elderly should be expanded, particularly in areas with limited access and affordability of eye care services. Special emphasis should be given to reaching women and those without education. Greater attention should also be given to correction of refractive error.

Purpose: To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in rural populations throughout China. Design: Population-based, cross-sectional study. Participants: Forty-five thousand seven hundred forty-seven adults 50 years of age and older. Methods: Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants underwent VA measurements, refraction, and a slit-lamp examination at local examination sites; those with previous cataract surgery were queried as to the year and type of surgical facility. Surgical procedure and evidence of surgery complications were noted during the examination. The principal cause of visual impairment was identified for eyes with VA of 20/40 or worse. Main Outcome Measures: Cataract surgery procedure, presenting and best-corrected distance VA, and causes of visual impairment. Results: Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The overall prevalence of cataract surgery was 2.09%. Surgical coverage among those with VA worse than 20/200 in both eyes because of cataract was 35.7%. Unoperated cataract was associated with older age, female gender, lack of education, and geographic area (province). Among the 1174 cataract-operated eyes, 31.1% had presenting VA of 20/32 or better, 15.4% had presenting VA of 20/40 to 20/63, 30.0% had presenting VA worse than 20/63 to 20/200, and 23.5% had presenting VA worse than 20/200. With best correction, the percentages were 57.6%, 6.2%, 18.5%, and 17.7%, respectively. Posterior capsule opacification, refractive error, and retinal disorders were the main causes in cataract-operated eyes with VA worse than 20/63. Conclusions: Two thirds of those with bilateral visual impairment or blindness because of cataract remain in need of sight-restoring surgery. Posterior capsule opacification and refractive error, both readily amenable to treatment, were common in cataract-operated eyes. Sustained government efforts to provide access to affordable modern cataract surgery with a greater emphasis on postoperative follow-up and the quality of VA outcomes are needed.

The study aimed to explore the epidemiology and clinical characteristics of chronic osteomyelitis observed in a northern China hospital. Clinical data of 255 patients with chronic osteomyelitis from January 2007 to January 2014 were collected and analyzed, including general information, disease data, treatment and follow-up data. Chronic osteomyelitis is more common in males and in the age group from 41–50 years of age. Common infection sites are the femur, tibiofibular, and hip joint. More g+ than g- bacterial infections were observed, with S. aureus the most commonly observed pathogenic organism. The positive detection rate from debridement bacterial culture is 75.6%. The detection rate when five samples are sent for bacterial culture is 90.6%, with pathogenic bacteria identified in 82.8% of cases. The two-stage debridement method (87.0%) has higher first curative rate than the one-stage debridement method (71.2%). To improve detection rate using bacterial culture, at least five samples are recommended. Treatment of chronic osteomyelitis with two-stage debridement, plus antibiotic-loaded polymethylmethacrylate (PMMA) beads provided good clinical results in this study and is therefore recommended.

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5The study aimed to explore the epidemiology and clinical characteristics of chronic 6 osteomyelitis observed in a northern China hospital. Clinical data of 255 patients with 7 chronic osteomyelitis from January 2007 to January 2014 were collected and analyzed, 8including general information, disease data, treatment and follow-up data. Chronic 9 osteomyelitis is more common in males and in the age group from 41-50 years of age. 10Common infection sites are the femur, tibiofibular, and hip joint. More g+ than g-bacterial 11infections were observed, with S. aureus the most commonly observed pathogenic organism. 12The positive detection rate from debridement bacterial culture is 75.6%. was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which . http://dx.doi.org/10.1101/316836 doi: bioRxiv preprint first posted online May. 9, 2018; 2 Chronic osteomyelitis is a common clinical disease and a challenging disorder, characterized 21 by its long disease course, difficult early diagnosis and high disability rate. The clinical 22 characteristics of chronic osteomyelitis are varied, and may be affected by geography, time, 23 and pathogenetic differences. Geographically, developing countries have a higher incidence 24 of the disease than developed ones, likely caused by differences in economic foundation, 25 lifestyle and healthcare level [1][2]. Over time, a shift has occurred from predominately 26 hematogenous osteomyelitis several decades ago, to a predominance of chronic osteomyelitis 27 that results from trauma, implant infection, and diabetes [3][4][5][6]. 28In recent years, the number of patients with open wounds and multiple fractures from road 29 and industrial accidents has sharply increased in China, as the Chinese economy undergoes 30 rapid development. Multiple injuries are difficult to treat and frequently lead to infection; 31 thus, treatment exerts great pressures on patients, both economically and psychologically. It 32 also poses great challenges for orthopedists [7]. Wang [8] and Jiang et al. [9] provide recent 33 data on the epidemiology of chronic osteomyelitis in southwest and southern China, which 34 can be used by local government policy-makers and by clinicians. However, China is a 35 country of great diversity in its population, climate and culture. Currently, data and relevant 36 research are lacking for northern China on the epidemiology of chronic osteomyelitis. To 37 address this, we conduct an epidemiological statistical analysis on 255 patients at a 38 prominent hospital and explore the clinical characteristics of chronic osteomyelitis in 39 . CC-BY 4.0 International license It is made available under a was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which . http://dx.doi.org/10.1101/316836 doi: bioRxiv preprint first posted online May. 9, 2018; (1) acute osteomyelitis ...

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Background: The study aims to use five common pathogenic bacteria in Fracture-related infection (FRI) to establish a simple and fast multiplex qPCR method for initially clinical FRI detection. Methods: A total of 66 patients with FRI and 24 noninfectious volunteers were enrolled. Results from tissue culture and multiplex qPCR were analyzed and compared. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden Index and area under the ROC curve (AUC) of the two methods were calculated respectively. Results: For 66 FRI cases, tissue culture detected 63 cases (95.5%) and multiplex qPCR detected 56 cases (84.8%). Among the 24 control cases, 12.5% and 16.7% were detected positive by tissue culture and multiplex qPCR, respectively. The sensitivity and specificity of multiplex qPCR were 84.8% and 66.7%, while those of tissue culture were 95.4% and 87.5%, respectively. To 51 cases within the detection profile, five common pathogens of FRI, the sensitivity and specificity of PCR changed to 92.2% and 90.9%, respectively. Conclusion: The advantage of multiplex qPCR is short processing time (< 5h) and simple steps. The multiplex qPCR may provide a complemental method for clinical FRI detection due to the simplicity and rapidity.

Objective: To compare the perioperative hidden blood loss (HBL) and analyze its risk factors in elderly patients undergoing intramedullary fixation after intertrochanteric fractures at different altitudes. Materials and methods: This prospective study collected the perioperative clinical data of 120 elderly femoral intertrochanteric fractures from February 2020 to February 2021 at different altitudes. Twenty-nine cases were from Nanjing, where an average altitude is 10 m (group A); 73 patients were from Xining, where an average altitude is 2300 m (group B); and 20 cases were from Yushu where an average altitude is 3600 m (group C). Demographic data of the included patients, preoperative and postoperative hemoglobin, hematocrit, prothrombin time (PT), activated partial thromboplastin time (APTT), preoperative and postoperative HBL, intraoperative visible blood loss, and perioperative blood transfusion rate, and other relevant indicators were recorded and the clinical data of the 3 groups were summarized. Results: The total HBL, preoperative HBL, and postoperative HBL of group C were greater than those of groups A and B, that is, total HBL: 740±380 mL in group A versus 850±530 mL in group B versus 1090±180 mL in group C, F=3.551, P=0.032; preoperative HBL: 460±320 mL in group A versus 410±300 mL in group B versus 590±120 mL in group C, F=9.086, P=0.011; Postoperative HBL: 270±220 mL in group A versus 440±420 mL in group B versus 500±140 mL in group C, F=13.138, P=0.001. Multiple linear regression analysis found that admission PT and APTT, fracture classification AO/OTA 31-A2.2–A3.3, male, body mass index, intraoperative blood transfusion, injury to operation time >5 days, longer operation time, and high altitude all were independent risk factors for perioperative HBL increase. There was a negative correlation between low altitude and hemoglobin on the first postoperative day and HBL. Conclusion: Elderly patients undergoing intramedullary fixation after intertrochanteric fractures develop massive HBL during the perioperative period, especially in patients in high altitude areas. Regular blood tests, PT, APTT during the perioperative period are vital to avoid perioperative anemia. Shortening the perioperative period and operation time will significantly reduce HBL.