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.

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.

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.

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.

This experiment aims to screen and isolate bacteria for the domestication of macrophages and to identify their domestication effector molecules.Bacteria were isolated and purified from cow and sheep feces.The procedures included preparing fermentation supernatant and conducting ex-periments with a mouse peritoneal macrophage model.Nitric oxide(NO)levels were measured,tumor necrosis factor-alpha(TNF-α)was analyzed using ELISA,the domestication activity was e-valuated by mouse peritoneal macrophage model.The activated bacteria were subjected to 16S rRNA gene sequences identification,growth curves determination,and saturated ammonium sul-fate precipitation for NO assay and ELISA analysis of TNF-α to assess the phagocytic capability of domesticated macrophages against Staphylococcus aureus.One strain,ED-8,with immunomodula-tory polarizing properties was successfully isolated.Alignment of its 16S rRNA gene sequence showed 99.86％similarity with Streptococcus zooepidemicus,classifying it as such species.The fermentation supernatant significantly stimulated NO and TNF-a secretion in macrophages.The phagocytic capability against Staphylococcus aureus of macrophages polarized by ED-8 also en-hanced.This effect was retained after crude extraction,indicating the presence of immunomodula-tory activity.In this study,multiple animal chain streptococcus ED-8 was successfully isolated.Its secreted products were shown to induce the trained immunity of macrophages,enhancing their phagocytic activity.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.