Approximately 60% of colorectal cancer (CRC) patients exhibit TP53 mutations, which are strongly associated with tumor progression, chemotherapy resistance, and an unfavorable prognosis. However, targeting p53 has historically been challenging, and currently, there are no approved p53-based therapeutics for clinical use worldwide. In this study, we discovered that ubiquitin carboxyl terminal hydrolase L3 (UCHL3) plays a crucial role in high-level glycolysis, enhanced stem-like properties, and 5-fluorouracil (5-FU) chemoresistance in TP53-mutant CRC by exerting its deubiquitinating enzyme activity to stabilize α-enolase (ENO1) protein. Notably, we identified a newly Food and Drug Administration (FDA)-approved drug, pacritinib, that potently suppresses UCHL3 expression by blocking the janus kinase 2 (JAK2)-signal transducer and activator of transcription 3 (STAT3) pathway in TP53-mutant CRC. Furthermore, Pacritinib was demonstrated to effectively inhibit glycolysis and improve the sensitivity to 5-FU chemotherapy in TP53-mutant CRC. Our findings suggest that targeting the JAK2-STAT3-UCHL3-ENO1 axis is a promising strategy to suppress glycolysis and enhance the efficacy of 5-FU chemotherapy in TP53-mutant CRC. Pacritinib shows potential for clinical application in the treatment of TP53-mutant CRC.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

OBJECTIVE: To review targeted muscle reinnervation (TMR) surgery for the construction of intelligent prosthetic human-machine interface, thus providing a new clinical intervention paradigm for the functional reconstruction of residual limbs in amputees. METHODS: Extensively consulted relevant literature domestically and abroad and systematically expounded the surgical requirements of intelligent prosthetics, TMR operation plan, target population, prognosis, as well as the development and future of TMR. RESULTS: TMR facilitates intuitive control of intelligent prostheses in amputees by reconstructing the "brain-spinal cord-peripheral nerve-skeletal muscle" neurotransmission pathway and increasing the surface electromyographic signals required for pattern recognition. TMR surgery for different purposes is suitable for different target populations. CONCLUSION TMR surgery has been certified abroad as a transformative technology for improving prosthetic manipulation, and is expected to become a new clinical paradigm for 2 million amputees in China.
Humans ; Artificial Limbs ; Muscle, Skeletal ; Neurosurgical Procedures ; Plastic Surgery Procedures ; Prosthesis Implantation

【Objective】 To explore the difference of demographics and influencing factors of motivations between whole blood donors and plasmapheresis donors, so as to provide scientific reference for effective recruitment strategy. 【Methods】 A total of 200 whole blood donors from Guangyuan Blood Center and 200 plasmapheresis donors from Jiange Plasmapheresis Station were selected in August 2021 for on-site questionnaire survey using the method of cross-sectional survey. Statistical analysis was performed by chi-square test, univariate and multivariate logistic regression. 【Results】 There were significant differences in gender, age, occupation, education level and annual family income between whole blood donors and plasmapheresis donors (P<0.05). Males accounted for a large proportion of whole blood donors(124/196, 63.3%), whereas females accounted for a large proportion of plasmapheresis donors(117/198, 59.1%). There was little difference in the number of whole blood donors in different age groups, while the age of plasmapheresis donors was concentrated in 40~59 years old (167/198, 84.3%). In terms of occupation, civil servants (including public institutions) accounted the highest proportion in whole blood donors (41/196, 20.9%), and farmers accounted the highest proportion (152/198, 76.8%) in plasmapheresis donors. The number of whole blood donors increased with the education level, and donors with college/university and above degree accounted the largest proportion (80/196, 40.8%). Plasmapheresis donors with junior middle school education and college/university and above accounted the largest and smallest proportion (49.5% vs 4.5%). The annual family income of whole blood donors ranged from 30 000 to 80 000 yuan accounted the largest proportion (109/196, 55.6%), and the annual family income of plasmapheresis donors less than 30 000 yuan accounted the largest proportion (132/198, 66.7%). 【Conclusion】 There were significant statistical differences in gender, age, education level, occupation and annual family income between whole blood and plasmapheresis donors. Therefore, targeted recruitment strategies should be formulated.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Objective:To explore the clinical efficacy of double traction-assisted reduction internal fixation and open reduction internal fixation in treating tibial plateau fractures.Methods:Data of patients with tibial plateau fracture admitted to West China Hospital of Sichuan University from January 2016 to December 2021 were retrospectively analyzed, and patients were divided into two groups according to treatment method: double traction-closed reduction internal fixation group (referred to as double traction group) and open reduction internal fixation group (referred to as open group). The double traction group included 21 patients, with 15 male and 6 female patients, with a mean age of 56.14±9.24 years (range, 45-72 years). Schatzker classification of fractures: 1 type I, 2 type II, 2 type III, 5 type IV, 6 type V, and 5 type VI. The open group included 29 patients, with 20 male and 9 female patients, with a mean age of 58.97±4.84 years (range, 47-70 years). Schatzker classification of fractures: 2 type I, 4 type II, 8 type III, 4 type IV, 5 type V, and 6 type VI. The surgical time, incision length, intraoperative blood loss, length of hospital stays, fracture healing time, postoperative time to full weight bearing, Rasmussen score, Hospital for Special Surgery (HSS) knee score, and complications were compared between the two groups of patients.Results:Both groups were followed up for 24 to 36 months, with an average of 30 months. There were significant differences in the operation time (92.61±6.22 min vs. 47.92±9.53 min), incision length (4.54±0.56 cm vs. 6.26±0.51 cm), and intraoperative blood loss (47.05±9.72 ml vs. 156.82±4.62 ml) between the group treated with closed reduction and double traction and the group treated with open reduction, with statistical significance ( t=18.83, 10.78, 53.24, P<0.001). There were also significant differences in the hospitalization time (5.35±0.41 d vs. 5.84±0.78 d), fracture healing time (3.72±0.74 months vs. 4.22±0.42 months), and time to full weight-bearing after surgery (11.29±1.10 weeks vs. 15.07±1.96 weeks) between the two groups, with statistical significance ( t=2.30, P=0.026; t=3.38, P<0.001; t=7.96, P<0.001). The HSS score at 6 months after surgery in the group treated with closed reduction and double traction was 81.61±2.32 points, which was higher than the score in the group treated with open reduction (77.66±4.01 points), with statistical significance ( t=4.07, P<0.001); at 12 months after surgery, the Rasmussen score in the group treated with closed reduction and double traction was 16.71±1.00 points, which was higher than the score in the group treated with open reduction (13.79±1.42 points), with statistical significance ( t=8.05, P<0.001). There was no fracture malunion or compartment syndrome occurred in both groups. The incidence of complications was 5% (1/21) in the group treated with closed reduction and double traction, and 10% (3/29) in the group treated with open reduction, with statistical significance (χ 2=0.52, P=0.473). Conclusion:The advantages of double traction-assisted reduction and internal fixation for tibial plateau fractures include minimal trauma, minimal bleeding, early mobilization, and shorter fracture healing time. It is a safe and reliable treatment method.

【Objective】 To systematically evaluate the incidence of donation related vasovagal reactions (DRVR) in China by Meta-analysis method and discuss the risk factors of DRVR, so as to provide scientific basis for the prevention and control of DRVR. 【Methods】 Cochrane Library, PubMed, WanFang Data CNKI and other electronic databases were retrieved to collect research literature concerning the incidence and risk factors of DRVR among whole blood donors in mainland China, with the publishing duration setting from 1998 to 2020. Two reviewers independently screened the literature, extracted the data, and evaluated the methodological quality of the included studies according to the inclusion and exclusion criteria. Then Stata was used for Meta-analysis. 【Results】 A total of 63 studies involving 6 043 945 donors were included. The prevalence of DRVR was 1.0% (95% confidence interval [CI], 0.9%~1.1%, I²=99.7%, P<0.01). The prevalence of DRVR in females (1.4%, 95% CI: 1.0-1.8%, I²=99.6%, P<0.01) was higher than that in males (1.1%, 95 % CI: 0.8-1.4%, I²=99.6%, P<0.01). The incidence of DRVR was 1.3% (95%CI: 0.8-1.8, I²=97.9%, P<0.01), 0.8% (95%CI: 0.5-1.0, I²=95.0%, P<0.01), 0.4% (95%CI: 0.3-0.5, I²=88.5%, P<0.01) and 0.3% (95%CI: 0.1-0.6, I²=96.1%, P<0.01) in the age groups of 18-25, 26-35, 36-45 and 46-55, respectively, and the incidence of DRVR decreased with age(P<0.01). From 1998 to 2020, the incidence of DRVR decreased year by year (P<0.01). The prevalence in first-time donors (1.5%, 95% CI: 1.3-1.8, I²=98.6%, P<0.01) was higher than that of regular donors (0.6%, 95% CI: 0.5-0.7%, I²=97.2%, P<0.01). Anxiety was the major risk factor for DRVR. 【Conclusion】 Our results indicate that blood centers should strengthen the monitoring of DRVR. More attention should be paid to young women, more comfort given to first-time blood donors, and a more perfect system developed to reduce the occurrence of DRVR.

NKILA is a kind of newly-discovered lncRNA whose expression is aberrant in diverse malignant tumors. The existing researches have confirmed that NKILA participates in the occurrence and development of tumors mainly by regulating the NF-κB signaling pathway, and has significance to the cancer diagnosis, treatment and prognostic evaluation of patients. This article reviews the abnormal expressions and biological effects of NKILA, and the up- and down-stream mechanisms of NKILA regulating malignant biological behavior in different cancers.