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 explore the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children.Methods:A prospective non-randomized controlled study was conducted. From January 2022 to April 2023, 40 children with severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital. According to the willingness of the children or their families, the children were assigned to conventional rehabilitation group and combined rehabilitation group. During the study, 8 children dropped out of the study, 17 children were finally included in the conventional rehabilitation group with 6 males and 11 females, aged (8.5±2.4) years, and 15 children were included in the combined rehabilitation group with 5 males and 10 females, aged (9.6±2.5) years. The children in the 2 groups received conventional burn rehabilitation treatment in the hospital, including active and passive activity training, scar massage, and pressure therapy. The children in combined rehabilitation group received resistance training with elastic band of 3 to 5 times per week after discharge, and the children in conventional rehabilitation group received daily activity ability training after discharge. Before home rehabilitation training (1 week before discharge) and 12 weeks after home rehabilitation training, the grip strength was measured using a handheld grip dynamometer, the muscle strengths of the upper and lower limbs were measured using a portable dynamometer for muscle strength, lean body mass was measured by bioelectrical impedance measuring instrument, and the 6-min walking distance was measured. Data were statistically analyzed with independent sample t test, paired sample t test, Mann-Whitney U test, or Fisher's exact probability test. Results:After 12 weeks of home rehabilitation training, the grip strengths of children in combined rehabilitation group and conventional rehabilitation group were (15±4) and (11±4) kg, respectively, which were significantly higher than (10±4) and (9±4) kg before home rehabilitation training (with t values of -9.99 and -11.89, respectively, P values all <0.05); the grip strength of children in combined rehabilitation group was significantly higher than that in conventional rehabilitation group ( t=3.24, P<0.05). After 12 weeks of home rehabilitation training, the muscle strengths of upper and lower limbs of children in combined rehabilitation group (with t values of -11.39 and -3.40, respectively, P<0.05) and the muscle strengths of upper and lower limbs of children in conventional rehabilitation group (with t values of -7.59 and -6.69, respectively, P<0.05) were significantly higher than those before home rehabilitation training, and the muscle strengths of upper and lower limbs of children in combined rehabilitation group were significantly higher than those in conventional rehabilitation group (with t values of 3.80 and 7.87, respectively, P<0.05). After 12 weeks of home rehabilitation training, the lean body mass of children in combined rehabilitation group was significantly higher than that before home rehabilitation training ( t=0.21, P<0.05). After 12 weeks of home rehabilitation training, the 6-min walking distances of children in conventional rehabilitation group and combined rehabilitation group were significantly longer than those before home rehabilitation training (with t values of -5.33 and -3.40, respectively, P<0.05), and the 6-min walking distance of children in combined rehabilitation group was significantly longer than that in conventional rehabilitation group ( t=3.81, P<0.05). Conclusions:Conventional burn rehabilitation treatment in hospital and home resistance training with elastic band for 12 weeks after discharge can significantly improve the muscle function and walking ability of severely burned children.

Objective:To explore the effect of perioperative aspirin administration on intraoperative and postoperative bleeding in patients undergoing video-assisted thoracoscopic (VATS) pulmonary wedge resection.Methods:Sixty-three patients scheduled for VATS pulmonary wedge resection in Shougang Hospital of Peking University from November 2020 to April 2022 were randomly assigned in 2 groups. All patients had a history of aspirin taking, patients in study group ( n=32) continued aspirin taking perioperatively, and patients in the control group ( n=31) stopped taking aspirin for 7 days before surgery and resumed taking 3 days after surgery. The volume of intraoperative blood lost, operation time, postoperative drainage volume, thoracic drainage tube placement time, postoperative hospital stay, postoperative thrombosis of lower extremity, perioperative cardiovascular and cerebrovascular events, and postoperative wound healing were documented and compared between the two groups. Results:There were no significant differences in age, gender, oral aspirin time, lesion location, lesion nature, localization, lesion size and underlying disease between the two groups (all P>0.05). All patients successfully completed the operation, and no patients switched to thoracotomy. The intraoperative blood loss in study group and control group was (27.72±12.86) ml and (31.35±13.81) ml ( t=1.08, P=0.283); the operation time was (61.16±10.24) minutes and (61.39±13.79) minutes, respectively ( t=0.08, P=0.940). There were no significant differences in postoperative thoracic drainage, drainage tube placement time, length of hospital stay, incidence of lower extremity thrombosis, incidence of cardiovascular and cerebrovascular events, and rate of poor wound healing between the two groups (all P>0.05). Conclusion:Perioperative administration of aspirin may not increase intraoperative and postoperative bleeding, and the incidence of operation-related complications in patients undergoing VATS pulmonary wedge resection.

Objective:To investigate the relationship between preoperative serum thyroglobulin (Tg) and clinical data with the risk of cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC) .Methods:Data of 395 PTC patients who underwent surgery from Feb. 2016 to Jun. 2019 at the Second Affiliated Hospital of Soochow University were retrospectively analyzed. Based on whether cervical lymph nodes had metastasis, patients were classified into central lymph node metastasis positive group ( n=195 cases) , central lymph node metastasis negative group ( n=200 cases) , lateral lymph node metastasis positive group ( n=72 cases) , and lateral lymph node metastasis negative group ( n=323 cases) .Then the relationship between age, sex, multifocality, tumor diameter, capsular invasion, preoperative TSH and preoperative Tg with lymph node metastasis were analyzed by SPSS. Comparisons between groups were performed by χ2 test and rank sum test. Prediction efficiency of the preoperative Tg and Logistic regression model was estimated by receiver operating characteristic (ROC) curve. A total of 100 PTC patients confirmed by pathological results in the Second Affiliated Hospital of Soochow University from Jul. 2019 to Apr. 2020 were selected as the validation data. Results:Multi-factor Logistic regression showed that age, tumor diameter, capsular invasion and preoperative Tg were independent risk factors of central cervical lymphatic metastasis ( P<0.05) ; Tumor diameter, capsular invasion, central cervical lymphatic metastasis and preoperative Tg were independent risk factors of lateral cervical lymphatic metastasis ( P<0.05) . The area under the ROC curve (AUC) for diagnosing central lymph node metastasis by preoperative Tg was 0.710, with a sensitivity of 49.2%, and specificity of 88.5%. The AUC for diagnosing lateral lymph node metastasis by preoperative Tg was 0.728, with a sensitivity of 59.7%, and specificity of 89.5%. The AUC for diagnosing central lymph node metastasis by the prediction model was 0.773, with a sensitivity of 78.5%, and specificity of 64.5%.The AUC for diagnosing lateral lymph node metastasis by the prediction model was 0.869, with a sensitivity of 84.7%, and specificity of 70.3%. Conclusions:The preoperative serum Tg level is correlated with cervical lymph node metastasis in PTC patients. But the Logistic regression model based on preoperative Tg and other independent risk factors shows a better predictive value.

Translationally controlled tumor proteins (TCTP) and SNF1- related protein kinase (SnRK1) are conserved and widely present in eukaryotic cells. TCTP regulates cell division, plant growth and development, and mediates plant resistance against pathogen infection. SnRK1 participates in a range of physiological processes including sugar metabolism and resistance to abiotic and biotic stresses. Previous work in our laboratory demonstrated that wheat TCTP can respond to Puccinia triticina infection and induce host defense responses. In order to further investigate the mechanism of TaTCTP in wheat resistance to Puccinia triticina infection, we used TAP (tandem affinity purification) and mass spectrometry to screen the potential interactants of TaTCTP. A SNF1- related protein kinase (SnRK1) was identified as a potential interacting protein of TaTCTP. The results of yeast two-hybrid assay showed that TCTP could interact with SnRK1 in yeast, and the yeast carrying TCTP and SnRK1 could grow on SD/-Leu/-Trp/-His/-Ade (SD/-LWHA) medium. The fluorescence signal of the interaction between TCTP and SnRK1 was found to be distributed in the cytoplasm in the Bi-fluorescense complementation experiment. Co-IP experiments further showed that TCTP and SnRK1 could interact in plant cells. This study lays an important foundation for further studying the mechanism of TaTCTP in the interaction between wheat and Puccinia triticina, and it play a great influence on further improving the molecular mechanism of wheat resistant to Puccinia triticina.
Basidiomycota ; Humans ; Neoplasms ; Protein Biosynthesis ; Protein-Serine-Threonine Kinases ; Triticum

Objective To explore the effects of the down-regulating peroxiredoxin 2 (PRDX2) on invasion, migration and proliferation of human gastric cancer MGC803 cells by using RNA interference. Methods MGC803 cells were divided into 3 groups:blank control group,negative control group and PRDX2 siRNA group. Transwell assay was used to examine the invasive ability change of MGC803 cells after transfection. Scratch test was used to detect the change of MGC803 cells migration ability after transfection. Western blot was used to examine the expression changes of PRDX2, matrix metalloproteinase (MMP)-2 and MMP-9. The proliferation ability of MGC803 cells was assessed by using CCK-8 assay. Results The expressions of PRDX2(0.345±0.006,0.721±0.013,0.720±0.014),MMP-2(0.067±0.012, 0.391±0.015, 0.371± 0.016) and MMP-9 (0.073±0.013, 0.341±0.028, 0.346±0.024) in the PRDX2 siRNA group were lower than those in the blank control group and negative control group (all P < 0.05). The cell invasion, migration and proliferation were inhibited in MGC803 cells (all P < 0.05). Conclusion PRDX2 is overexpressed in MGC803 cells. Down-regulating the expression of PRDX2 could inhibit the invasion, migration and proliferation of MGC803 cells.

Objective To understand the infection status and gene types of Cryptosporidium among HIV/AIDS patients in Guangxi Zhuang Autonomous Region. Methods The fecal samples were collected from 285 HIV/AIDS cases in Nanning,Gui?lin,Qinzhou,Baise,Hechi cities of Guangxi and 150 HIV negative persons in Nanning City. The modified acid?fast staining and nested?PCR based on 18S rRNA were employed to detect the infection status of Cryptosporidium. The nested PCR products were sequenced,and the homology searches and identification for the gene types of Cryptosporidium were done by DNAStar soft?ware. Results The infection rate of Cryptosporidium in HIV/AIDS patients was 0.70%(2/285),and the rate of those with chronic diarrhea was 6.67%(2/30),the latter was significantly higher than that of the HIV negative persons(0,0/150)(P=0.002). Both the two HIV/AIDS patients infected with Cryptosporidium were from Guilin City. By molecular identification,the Cryptosporidium strains which the above 2 patients were infected with were Cryptosporidium andersoni and Cryptosporidium hominis respectively. Conclusions Cryptosporidium co?infection can be found in HIV/AIDS patients in Guangxi. The geno?types of the infection strains include Cryptosporidium andersoni and Cryptosporidium hominis.

Objective To evaluate musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation.Methods Sixty lung cancer surgery patients (ASA Ⅰ-Ⅱ grade) were selected and divided randomly into musical therapy (group M; n =30) and control (group C; n =30).In group M,patients accepted music relaxation training for fifteen minutes before surgery,and music intervention for one hour at 3,7,15,19 hour after surgery.Whereas,in Group C,patients did not listen to any music during the same period.In the intensive care unit,patients were connected to a patient controlled analgesia (PCA) device.The PCA device (sufentanil 2 μg/kg,100 ml saline) was set to deliver a bolus of 2 ml,with a lockout interval of 10 min and background infusion volume of 0.5 ml/h.Hemodynamic changes,the visual analog scale (VAS) and consumption of sufentanil were recorded at the 4th,8th,12th,16th,20th and 24th hour after operation.Results SBP,DBP,HR and VAS of group M were significantly decreased compared to the group C,respectively (P ＜0.05),and significant difference was found in the PCA delivery frequency [group C (30.96 ± 4.00),group M (19.06 ± 3.49),t =12.39,P ＜ 0.01] and postoperative sufentanil consumption[group C (82.65±6.19)μg,group M (52.68 ±7.07)μg,t =20.00,P ＜0.01].Conclusions Musical therapy combined with sufentanil postoperative intravenous analgesia was able to produce better analgesic effect in the treatment of patient accepted lung cancer operation,which decreased postoperative sufentanil consumption and effectively reduced SBP,DBP and HR,and relieved the patient's anxiety.

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.