With the rapid development of modern society, high energy injury has greatly increase as compared with the past, and the number of trauma patients seeking medical treatments has risen year by year. Trauma emergency medicine has become the reflection of the service level and medical quality of medical institutions, as well as the hospital administrators' attention and concern to this discipline. This paper aims to elaborate the status and role of emergent medicine of trauma in the development of hospitals, to review the significant experience in the construction and reform of Tianjin Trauma Emergence Center, and put forward the prospect of future disciplines and center construction in combination with the practice.

Objective To explore the bioactive constituents of Shufeng Jiedu capsule and its potential mechanism in the treatment of acute lung injury(ALI)via network pharmacology,bioinformatics analysis and molecular docking methods.Methods The bioactive constituents of Shufeng Jiedu capsule were searched from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)database.The putative targets of Shufeng Jiedu capsule were obtained from TCMSP and Swiss Targets Predicion website.Targets associated with ALI were obtained from 5 disease target prediction databases,including DisGeNET,GeneCard,Online Mendelian Inheritance in Man(OMIM),Therapeutic Target Database(TTD),and National Center for Biotechnology Information(NCBI).The intersecting targets between drug-related targets and disease-related targets were defined as potential therapeutic targets of Shufeng Jiedu capsules in the treatment of ALI.A regulative network among drug,ingredients and potential therapeutic targets was explored,and it was further visualized by Cytoscape 2.6.1 software.The key bioactive ingredients and core therapeutic targets were speculated according to the topological parameters.Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis was applied to the potential therapeutic targets.AutoDock Vina 1.1.2 was used to perform molecular docking and the docking results were visualized by PyMol software.Results A total of 170 bioactive constituents of Shufeng Jiedu capsule were obtained from TCMSP database,and 104 potential therapeutic targets of ALI were obtained in the present study.Quercetin,Luteolin,Wogonin,Kaempferol,and Acacetin were taken as putatively key constituents via the drug-ingredients-targets network.Prostaglandin endoperoxidase 2(PTGS2),nitric oxide synthase 2(NOS2),glycogen synthase kinase-3β(GSK-3β),PIM1 kinase and peroxisome proliferator-activated receptor gene(PPARG)were identified as the hub targets and hypoxia-inducible factor-1(HIF-1)pathway et al was considered as the key pathway of Shufeng Jiedu capsule through KEGG analysis.Molecular docking showed a stable affinity between the key compounds and the hub targets,confirming the accuracy of the network pharmacology screening results.Conclusion The mechanism of Shufeng Jiedu capsule in treating ALI involves multiple active ingredients,therapeutic targets,and signaling pathways,which can provide new ideas for the clinical treatment of ALI.

Orthopedic robots, as intelligent medical devices, have achieved good outcomes in clinical application in some orthopedic surgeries. Artificial intelligence (AI) has played an important role in the development of orthopedic robots due to its powerful capabilities of information processing and decision-making. The developing trends of orthopedic robotics are automation and intelligentization. Since AI has demonstrated great advantages in preoperative planning, an increasing number of researchers have been devoted to AI application in intraoperative navigation by an orthopedic robot. This paper outlines the exploratory efforts in applying AI technology to the intraoperative navigation assisted by an orthopedic robot, describes the advantages of AI in improving accuracy and reducing radiation, and forecasts research prospects in application of AI technology to orthopedic robots based on the current situation.

Periprosthetic fracture of femur is the most common postoperative complication after total knee arthroplasty (TKA). Risk factors for periprosthetic fractures include female sex, osteoporosis/osteopenia, rheumatoid arthritis, osteoarthritis, neuromuscular disease, cognitive disorder, chronic use of corticosteroids, obesity, advanced age, infection, osteolysis around the prosthesis, knee joint ankyloses, notching of the anterior femoral cortex, etc. According to epidemiological research, the incidence of femoral periprosthetic fractures following TKA ranges from 0.3% to 2.5%. Lewis and Rorabeck classifications, the most commonly used classification of periprosthetic fractures of the femur, introduce the concept of prosthesis loosening and emphasize the ecessity of revision surgery. Other classifications include Su typing, Universal Typing System, and Rhee typing, the latest of which is the Kim typing proposed in 2022. Treatment strategies for periprosthetic femoral fractures after TKA include nonsurgical treatment, external fixation techniques, single-plate fixation, double-plate fixation, intramedullary nail fixation, and revision TKA and distal femur replacement. The purpose of this paper is to better guide the prevention and treatment of periprosthetic fractures after TKA by searching and analyzing relevant literature on periprosthetic fractures after TKA.

Objective To investigate the predictive values of serum complement C3, C4 and cholesterol levels in the prognosis of patients with sepsis. Methods The clinical data of all the patients with sepsis admitted to the Department of Critical Care Medicine of the General Hospital of Xinjiang Military Command from January 2015 to January 2017 were retrospectively analyzed. The levels of serum complement C3, C4, cholesterol, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure score (SOFA), etc. were recorded within 24 hours after admission, the patients were divided into survival group and death group according to the 28-day prognosis, and the differences in various indexes between the two groups were compared respectively;the predictive efficacies of C3, C4 and cholesterol levels in the prognosis of sepsis patients were evaluated by plotting receiver operating characteristic curves (ROC). Results Finally, 120 patients with sepsis were enrolled, including 57 patients in the survival group and 63 patients in the death group. Compared with the survival group, the APACHE Ⅱscore and the SOFA score of the death group were increased significantly (APACHE Ⅱ score: 20.29±5.90 vs. 15.32±5.98, SOFA score: 7.62±3.11 vs. 5.16±2.50, both P < 0.01), however, serum C3, C4 and cholesterol levels were obviously decreased [C3 (g/L): 0.67±0.22 vs. 0.82±0.24, C4 (g/L): 0.17±0.05 vs. 0.20±0.06, cholesterol (mmol/L): 2.77±1.23 vs. 3.46±1.02, all P < 0.01]. ROC curve analyses showed: each of the following items, complement C3, C4, and cholesterol, alone predicting the prognosis of sepsis patients, the area under ROC curve (AUC) and 95% confidence interval (95%CI) were as follows: AUC = 0.680 (95%CI = 0.583-0.777, P = 0.001), AUC =0.657 (95%CI = 0.560-0.754, P = 0.003), and AUC = 0.711 (95%CI = 0.619-0.804, P < 0.001) respectively; when complement C3, C4 and cholesterol combination to predict the prognosis of patients with sepsis, the resulting predictive value was better than the predictive value results obtained by each one of the items or each combination of any two of them (the AUC of C3+C4+cholesterol was 0.725, 95%CI = 0.633-0.817, P < 0.001; the AUC of C3+C4 was 0.697,95%CI = 0.603-0.791, P < 0.001; the AUC of C3 + cholesterol was 0.718, 95%CI = 0.626-0.811, P < 0.001; the AUC of C4+cholesterol was 0.722, 95%CI = 0.629-0.815, P < 0.001). Conclusion Using combination of serum complement C3, C4 and cholesterol levels to predict the prognosis of patients with sepsis may obtain important predicting value, that can provide a reference to clinical doctors.

Traumatic spinopelvic dissociation is trauma-induced complete separation of the pelvis and spine anatomy. It is characterized by longitudinal fracture lines on both sides of the sacral bone with transverse fractures, multiplane unstable fractures, more common in high-energy violent injury, more combined injuries, high incidence of sacral nerve injury, improper treatment can easily lead to fracture re-displacement, painful deformity healing, secondary nerve injury, dysfunction and other adverse consequences. The difficulty in the surgical treatment of traumatic spinopelvic dissociation lies in the reduction and fixation of fractures. Among them, it is still controversial whether the reduction method of fracture should be open reduction or closed minimally invasive reduction, the internal fixation should be simple sacroiliac screw or plate, iliolumbar fixation or triangular fixation, and whether the sacral nerve injury needs direct decompression. With the improvement of the understanding of spinopelvic dissociation injuries and clinical application of closed minimally invasive reduction technology, minimally invasive sacroiliac screws, iliolumbar fixation, and triangular fixation are increasingly used in clinical treatment, postoperative wound complications are significantly reduced, patient function prognosis is good, indirect decompression of the injured sacral nerve after fracture reduction helps to restore nerve function, but when the fracture displacement is large with a narrow sacral canal and the nerve is compressed by the fracture or free bone mass, direct decompression by laminectomy is recommended.

The development of modern science and technology continues to promote the advancement of surgical methods, the era of surgical surgery led by robots has arrived. Orthopaedic positioning robot is a kind of auxiliary treatment equipment to realize surgical planning by means of spatial mapping of target images. It is composed of movable robotic arm, optical tracking device and surgical planning navigation system. During the operation, the path navigation of surgical instruments can be planned and implemented according to the predetermined procedure, and the precise placement of orthopedic internal fixation can be completed with the participation of the surgeon. It is mainly used in trauma orthopaedics, joint replacement and spine surgery fields. It has clinical advantages such as accurate operation, stable performance and good repeatability. Robot assisted minimally invasive pelvic acetabular fracture surgery is mainly realized by assisted placement of the LC-II screw, sacral iliac screw, iliac lumbar triangular fixation, iliac lumbar fixation, acetabular anterior column screw, acetabular posterior column screw, Magic screw and other osseous fixation pathway screws. It has the advantages of relatively simple operation, small systematic error, accurate spatial positioning and safe screw insertion. The clinical introduction of robot-assisted surgery provides effective solutions and advanced technical supports for optimizing the surgical treatment of pelvic acetabular fractures and promoting the enhanced recovery after surgery. The continuous improvement of the application level of robots has created favorable conditions and technical support for promoting the development of intelligent, individualized, minimally invasive and precise treatment of pelvic and acetabular fractures.

Closed reduction percutaneous screw fixation offers significant biological and biomechanical advantages and can be employed independently for the surgical treatment of pelvic acetabular fractures, as well as serving as a complementary method to open reduction internal fixation. The osseous fixation pathway (OFP) constitutes the anatomical foundation for the minimally invasive approach to pelvic and acetabular fracture management. The pelvis's OFP can be categorized into anterior, middle, and posterior parts. The anterior OFP encompasses both the superior pubic/anterior column and inferior pubic OFPs. The former is primarily utilized for addressing transverse and T-shaped acetabular fractures, as well as anterior column and superior pubic fractures. The latter is predominantly applied to inferior pubic fractures. The middle OFP includes the anterior inferior iliac spine to the posterior iliac crest (LC-II) OFP, the gluteus medius column OFP, and the iliac crest OFP. The LC-II OFP is primarily designated for pelvic crescent, iliac wing, and select high anterior column acetabular fractures. The gluteus medius column OFP is used for the treatment of some iliac fractures or acetabular fractures. And the iliac crest OFP is used for the treatment of simple iliac wing fractures or acetabular fractures involving the iliac crest. The posterior OFP includes the posterior column of the acetabulum OFP, sacroiliac OFP, and sacral OFP. The posterior column of the acetabulum OFP is used for the treatment of acetabular fractures involving the posterior column; the sacroiliac OFP is mainly utilized for a range of pelvic injuries, including pelvic rotational or vertical unstable pelvic injury, sacroiliac dislocation or fracture dislocation; open injury of the posterior ring of the pelvis with relatively mild contamination; elderly sacral (incomplete) fractures; residual gap at the end of sacral fracture after pubic symphysis and plate internal fixation; certain traumatic spinopelvic dissociation ; in combination with lumbopelvic fixation for the treatment of pelvic fractures with lumbosacral junction injury. Sacral OFP is advised for treating bilateral sacroiliac dislocation and certain crescent-like pelvic fractures; bilateral sacral fractures; sacral fractures involving Denis III zone, osteoporotic sacral incomplete fractures. The pursuit of minimally invasive treatment modalities for pelvic and acetabular fractures comes with challenges. A comprehensive understanding of OFP morphology and intraoperative imaging, coupled with a commitment to enhancing fracture reduction quality and surgical proficiency, is imperative for the precise management of such injuries.

BACKGROUND:With the increase of the incidence of cervical spondylosis,it is particularly important to control the postoperative bleeding and related inflammatory reaction of cervical vertebra. OBJECTIVE:A prospective study was conducted to investigate the combined effect of intravenous and topical tranexamic acid of different concentrations on postoperative blood loss and inflammatory response during posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion. METHODS:From January 2020 to December 2022,150 patients who were scheduled to undergo posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion for cervical spondylotic myelopathy in Tianjin People's Hospital were enrolled in the study.Patients were divided into A,B,and C groups(n=50)by randomized double-blind lottery.The patients in the A,B,and C groups were treated with 1%,3%,and 5%intravenous and topical tranexamic acid solution,respectively.Postoperative blood loss and inflammation-related indicators were compared among three groups.The occurrence of venous thromboembolism and hematoma was observed after operation. RESULTS AND CONCLUSION:(1)There were significant differences in blood loss-related indexes,such as intraoperative blood loss,overall blood loss,and occult blood loss among the three groups(P<0.01).The above indexes were significantly lower in groups B and C than that in group A.There was no significant difference between groups B and C(P>0.05).(2)On days 1 and 3 after surgery,the levels of inflammatory indicators including serum C-reactive protein and interleukin-6 were increased to varying degrees in the three groups compared to before surgery(P<0.05).As the drug concentration increased,its expression decreased,and there was a significant difference among the three groups(P<0.001).(3)Two cases of intramuscular venous thrombosis appeared in each of the three groups after surgery.No hematoma or pulmonary embolism occurred in all three groups.(4)It is concluded that in posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion,intravenous combined with topical application of different concentrations of tranexamic acid is effective in reducing perioperative blood loss and inflammatory response.3%tranexamic acid achieves the same effect without significantly increasing the risk of postoperative venous thromboembolism.

Objective:To investigate the effect of using multi-functional torticollis orthosis with manipulation in pediatric congenital myotonic torticollis. Method:In this study,60 children with congenital myotonic torticollis were randomly divided into a test group and a control group.The test group was treated with a multi-torticollis orthosis on the basis of tradition-al corrective manual therapy,while the control group was only treated with manual correction.After three months of treatment,the corrective effect of the orthosis in different neck positions of the children was ob-served.Surface electromyography(sEMG)data analysis was conducted by collecting sEMG signals of the stern-ocleidomastoid muscle in two neck positions:lateral flexion and rotation.The sEMG signal characteristics of each child's sternocleidomastoid muscle were then analyzed.Subsequently,an overall assessment of the treat-ment for the children with torticollis was performed. Result:The root mean square(RMS)values of the sternocleidomastoid surface EMG signals were significantly higher in the test group than those in the control group,with a significant difference(P＜0.05).There were sig-nificant differences between the two groups before and after treatment(P＜0.01).Overall,the total effective treatment rate in the test group was 96.67％,which was significantly higher than that in the control group,showing a significant difference(P＜0.01). Conclusion:In children with early-stage congenital muscular torticollis,the orthosis is precise,reliable,com-fortable and adjustable,and the combination of manual correction makes significant clinical outcomes and im-provements of torticollis in children.