Objective To explore the efficacy of precise surface positioning method in percutaneous screw fixation for Jones fracture.Methods Data of 46 patients with Jones fractures admitted to our hospital from September 2021 to December 2023 were retrospectively analyzed.According to the different treatment methods,the patients were divided into screw groups(24 patients fixed by percutaneous screws)and tension band groups(22 patients fixed by incision and reset tension band).The general conditions,follow-up time,surgical time,hospitalization time,fracture reduction quality,postoperative complete weight-bearing time,fracture healing time,and complications in the two groups were recorded and compared.The American Association of Foot and Ankle Surgery(AOFAS)system was used to assess the recovery of foot function.Results There was no statistically significant difference in the general data before the operation between the two groups of patients(P＞0.05).The follow-up time of the two groups was 6 to 24 months.Compared with the tension band group,the screw group had shorter operation time[(32.96±5.35)min vs.(47.27±9.42)min],shorter hospitalization time[(5.75±1.18)d vs.(7.68±2.05)d],earlier postoperative complete weight-bearing time[(6.47±0.73)w vs.(7.29±1.66)w],faster fracture healing time[(3.31±0.68)months vs.(4.29±1.29)months],higher AOFAS score[(89.13±2.62)vs.(79.59±4.49)](all P＜0.05).The tension band group of fracture reduction quality was better than the screw group(P＜0.05).The quality of fracture reduction during the operation in the tension band group was better than that in the screw group(P＜0.05).In terms of complications:no complications occurred in the screw group,one patient in the tension band group developed infection,and one patient had a loose Kirchner needle.Conclusion Precise surface positioning method in percutaneous screw fixation for Jones fracture is a safe and effective method with precise positioning,simple operation,small trauma,and rapid rehabilitation,which is worthy of clinical promotion,but the indications need to be strictly controlled according to the type of fracture.

China's Medical Service Price(MSP)reform has entered a new phase,implementing management measures.The compilation,implementation,and coordination of MSP item guidelines and the existing contradictions and problems were reviewed.It proposes strengthening price item management in planning under the background of the new era,itemizing in the alignment particle size,and comparing prices in the same coordinate system.This can offer systematic approaches and innovative strategies for improving the quality and efficiency of deepening MSP reform.

China's Medical Service Price(MSP)reform has entered a new phase,implementing management measures.The compilation,implementation,and coordination of MSP item guidelines and the existing contradictions and problems were reviewed.It proposes strengthening price item management in planning under the background of the new era,itemizing in the alignment particle size,and comparing prices in the same coordinate system.This can offer systematic approaches and innovative strategies for improving the quality and efficiency of deepening MSP reform.

Objective To explore the efficacy of precise surface positioning method in percutaneous screw fixation for Jones fracture.Methods Data of 46 patients with Jones fractures admitted to our hospital from September 2021 to December 2023 were retrospectively analyzed.According to the different treatment methods,the patients were divided into screw groups(24 patients fixed by percutaneous screws)and tension band groups(22 patients fixed by incision and reset tension band).The general conditions,follow-up time,surgical time,hospitalization time,fracture reduction quality,postoperative complete weight-bearing time,fracture healing time,and complications in the two groups were recorded and compared.The American Association of Foot and Ankle Surgery(AOFAS)system was used to assess the recovery of foot function.Results There was no statistically significant difference in the general data before the operation between the two groups of patients(P＞0.05).The follow-up time of the two groups was 6 to 24 months.Compared with the tension band group,the screw group had shorter operation time[(32.96±5.35)min vs.(47.27±9.42)min],shorter hospitalization time[(5.75±1.18)d vs.(7.68±2.05)d],earlier postoperative complete weight-bearing time[(6.47±0.73)w vs.(7.29±1.66)w],faster fracture healing time[(3.31±0.68)months vs.(4.29±1.29)months],higher AOFAS score[(89.13±2.62)vs.(79.59±4.49)](all P＜0.05).The tension band group of fracture reduction quality was better than the screw group(P＜0.05).The quality of fracture reduction during the operation in the tension band group was better than that in the screw group(P＜0.05).In terms of complications:no complications occurred in the screw group,one patient in the tension band group developed infection,and one patient had a loose Kirchner needle.Conclusion Precise surface positioning method in percutaneous screw fixation for Jones fracture is a safe and effective method with precise positioning,simple operation,small trauma,and rapid rehabilitation,which is worthy of clinical promotion,but the indications need to be strictly controlled according to the type of fracture.

Objective: Based on the theoretical framework of Risk Perception-Efficacy Appraisal-Behavioral Response, the study aims to explore the group heterogeneity in high temperature health risk perception and behavioral responses among college students in Chongqing, so as to provide a scientific basis for implementing differentiated health interventions. Methods: A multi stage cluster sampling method was used to select 856 students from five universities in Chongqing. Data were collected using a validated questionnaire. One way analysis of variance and independent samples t-test were used to analyze individual differences, Pearson correlation analysis was employed to examine relationships between variables, multiple linear regression was used to identify influencing factors, a structural equation model was constructed to validate the theoretical pathways, and the Bootstrap method was applied to test mediating effects. Results: In the risk perception dimension, the severity score of high temperature health hazards among college students (3.28±0.89) was higher than that of susceptibility score (2.94±0.93). Efficacy appraisal showed that the response efficacy score was the highest (3.91±0.81). In behavioral responses, adaptive behaviors were most prominent (5.43±2.75), while emergency preparedness behaviors were the lowest (2.71±1.33). The structural equation model validated the pathway of "threat appraisal → efficacy appraisal → behavioral response" ( χ 2/df=2.49, RMSEA =0.05). Self efficacy played a fully mediating role between threat appraisal and behavioral response, with a mediation effect value of 0.10 (95% CI =0.02-0.19). K means cluster analysis categorized the subjects into three groups, with the core barriers to behavior being economic constraints (22.3%), lack of motivation (34.8%), and insufficient cognition (34.1%), respectively. Conclusions Decision making regarding high temperature health behaviors among college students follows psychological pathway of "cognition-appraisal-action" with self efficacy serving as a key mediating variable driving behavioral change. Targeted interventions should be implemented for groups with different characteristics.

Objective To study the differences in living habit and blood biochemical indicators of male elderly people at different age groups in a"regional longevity"gathering area in Chongqing and the high fre-quency variation of mitochondrial DNA(mtDNA)in the elderly people(≥90 years old).Methods The male elderly people aged ≥60 years old in a"regional longevity"gathering area in Chongqing were randomly select-ed as the study subjects and divided into the group A(60-＜70 years old),group B(70-＜80 years old),group C(80-＜90 years old)and group D(≥90 years old).The differences of vegetable and fruit consump-tion,dairy bean consumption,outdoor activities,sleep time and blood biochemical indexes were compared a-mong different age groups.Then peripheral blood in the above subjects was collected for extracting mtDNA and sequencing.The meaningful mtDNA mutations between the various groups and group D were found out by the bioinformatics analysis.Results There were no statistically significant differences in consumption of vegetables and fruits,consumption of dairy beans,outdoor activities and sleep duration among different age groups(P＞0.05).There were statistically significant differences in erythrocyte and creatinine of blood bio-chemical indexes among the partial groups(P＜0.05).The mitochondria mutation analysis found 4 105 mtD-NA mutation sites,mainly single base mutation,the most common mutation was T＞C(22.57％),followed by C＞T(19.82％)and A＞G(19.36％).The average mutation rate of mtDNA in the group D was the high-est(8.392％),in which 3 mtDNA variants were found to have significant differences between different age groups and group D(P＜0.1),including mtDNA5396-5411CAACGTAAA＞C,mtDNA5414A＞T and mtD-NA5417G＞T.Conclusion There was no significant difference in the living habits of male elderly people of different ages.The mutation rate of mtDNA in the advanced age group was the highest.mtDNA5396-5411CAACGTAAA＞C,mtDNA5414A＞T and mtDNA5417G＞T variations may be related to"regional lon-gevity".

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 therapeutic efficacy of type B3 distal radius fractures treated with modified locking plate implantation through single minimally invasive volar approach of 15 mm.Methods:A retrospective case series study was conducted to analyze the clinical data of 14 patients with type B3 distal radius fractures admitted to Wuxi Ninth People′s Hospital from February 2021 to January 2024, including 6 males and 8 females, aged 21-78 years [(50.9±15.5)years]. The steel plate was inserted first through single minimally invasive volar approach of 15 mm, followed by reduction and temporary fixation of the fractures. Further adjustment of the reduction and final fixation were performed under fluoroscopy. The length of the incision was observed at the end of the surgery and at the last follow-up. The reduction quality of the articular surface was evaluated by CT at postoperative 3 days. The bone healing was observed and the healing time was recorded. The visual analogue scale (VAS) scores before surgery and at 7, 14 days after surgery and at the last follow-up were compared. The grip strengths, range of motions of the wrist joint (flexion-extension, pronation-supination and ulnar-radial deviation), and Gartland-Werley wrist scores at 3, 6 months after surgery and at the last follow-up were detected. The occurence of postoperative complications was observed.Results:All the patients were followed up for 6-34 months [(17.1±5.2)months]. The incision length was (20.3±6.9)mm at the end of the surgery and was (19.1±6.3)mm at the last follow-up. As shown in CT scan at postoperative 3 days, excellent reduction of the articular surface was observed in 9 patients, good in 4 and fair in 1, with an excellent and good rate of 92.9%. The fractures were all healed, with the healing time of 5-8 weeks [(5.9±0.6)weeks]. At 7, 14 days after surgery and at the last follow-up, the VAS scores were 3.0(3.0, 4.0)points, 3.0(2.0, 3.0)points and 0.0(0.0, 1.0)points respectively, significantly lower than 5.0(3.8, 6.0)points before surgery ( P<0.01), and the VAS scores significantly decreased over time after surgery ( P<0.05). At 3, 6 months after surgery and at the last follow-up, the grip strengths [(72.1±5.3)%, (78.9±4.0)% and (82.9±4.8)% respectively], ranges of wrist flexion-extension [(76.6±3.3)°, (80.9±3.6)° and (82.3±3.6)°respectively], ranges of pronation-supination [(159.4±5.7)°, (172.1±6.2)° and (173.9±3.7)° respectively], ranges of ulnar-radial deviation [(35.8±3.9)°, (37.6±4.0)° and (38.3±3.5)° respectively], and Gartland-Werley wrist scores [7.0(2.8, 8.0)points, 2.0(2.0, 4.5)points, 2.0(2.0, 2.0)points] were all significantly improved compared with the values preoperatively [(63.4±8.0)%, (74.9±5.4)°, (150.6±10.3)°, (32.7±4.9)° and 18.0(16.8, 20.0)points respectively] ( P<0.05). Moreover, the ranges of wrist motion were significantly improved over time after surgery ( P<0.05), while the grip strengths and Gartland-Werley wrist scores were significantly improved at postoperative 3 and 6 months ( P<0.05). According to their Gartland-Werley wrist scores at the last follow-up, 8 patients were rated excellent, 5 good, and 1 fair, with an excellent and good rate of 92.9%. There were 2 patients with delayed incision healing, one injury to the palmar cutaneous branch of the median nerve, and one with extensor tendon irritation because of the overlength of the screw. Conclusion:Modified locking plate implantation through single minimally invasive volar approach of 15 mm for type B3 distal radius fractures has advantages of small incision, fast bone healing, reduced pain, increased grip strengths and range of motions of the wrist joint, good wrist function recovery, and few complications.

Objective:To explore the therapeutic efficacy of type B3 distal radius fractures treated with modified locking plate implantation through single minimally invasive volar approach of 15 mm.Methods:A retrospective case series study was conducted to analyze the clinical data of 14 patients with type B3 distal radius fractures admitted to Wuxi Ninth People′s Hospital from February 2021 to January 2024, including 6 males and 8 females, aged 21-78 years [(50.9±15.5)years]. The steel plate was inserted first through single minimally invasive volar approach of 15 mm, followed by reduction and temporary fixation of the fractures. Further adjustment of the reduction and final fixation were performed under fluoroscopy. The length of the incision was observed at the end of the surgery and at the last follow-up. The reduction quality of the articular surface was evaluated by CT at postoperative 3 days. The bone healing was observed and the healing time was recorded. The visual analogue scale (VAS) scores before surgery and at 7, 14 days after surgery and at the last follow-up were compared. The grip strengths, range of motions of the wrist joint (flexion-extension, pronation-supination and ulnar-radial deviation), and Gartland-Werley wrist scores at 3, 6 months after surgery and at the last follow-up were detected. The occurence of postoperative complications was observed.Results:All the patients were followed up for 6-34 months [(17.1±5.2)months]. The incision length was (20.3±6.9)mm at the end of the surgery and was (19.1±6.3)mm at the last follow-up. As shown in CT scan at postoperative 3 days, excellent reduction of the articular surface was observed in 9 patients, good in 4 and fair in 1, with an excellent and good rate of 92.9%. The fractures were all healed, with the healing time of 5-8 weeks [(5.9±0.6)weeks]. At 7, 14 days after surgery and at the last follow-up, the VAS scores were 3.0(3.0, 4.0)points, 3.0(2.0, 3.0)points and 0.0(0.0, 1.0)points respectively, significantly lower than 5.0(3.8, 6.0)points before surgery ( P<0.01), and the VAS scores significantly decreased over time after surgery ( P<0.05). At 3, 6 months after surgery and at the last follow-up, the grip strengths [(72.1±5.3)%, (78.9±4.0)% and (82.9±4.8)% respectively], ranges of wrist flexion-extension [(76.6±3.3)°, (80.9±3.6)° and (82.3±3.6)°respectively], ranges of pronation-supination [(159.4±5.7)°, (172.1±6.2)° and (173.9±3.7)° respectively], ranges of ulnar-radial deviation [(35.8±3.9)°, (37.6±4.0)° and (38.3±3.5)° respectively], and Gartland-Werley wrist scores [7.0(2.8, 8.0)points, 2.0(2.0, 4.5)points, 2.0(2.0, 2.0)points] were all significantly improved compared with the values preoperatively [(63.4±8.0)%, (74.9±5.4)°, (150.6±10.3)°, (32.7±4.9)° and 18.0(16.8, 20.0)points respectively] ( P<0.05). Moreover, the ranges of wrist motion were significantly improved over time after surgery ( P<0.05), while the grip strengths and Gartland-Werley wrist scores were significantly improved at postoperative 3 and 6 months ( P<0.05). According to their Gartland-Werley wrist scores at the last follow-up, 8 patients were rated excellent, 5 good, and 1 fair, with an excellent and good rate of 92.9%. There were 2 patients with delayed incision healing, one injury to the palmar cutaneous branch of the median nerve, and one with extensor tendon irritation because of the overlength of the screw. Conclusion:Modified locking plate implantation through single minimally invasive volar approach of 15 mm for type B3 distal radius fractures has advantages of small incision, fast bone healing, reduced pain, increased grip strengths and range of motions of the wrist joint, good wrist function recovery, and few complications.