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.

Essential oils (EOs) are natural, volatile substances derived from aromatic plants. They exhibit multiple pharmacological effects, including antibacterial, anticancer, anti-inflammatory, and antioxidant properties, with broad application prospects in health care, food, and agriculture. However, the instability of volatile components, which are susceptible to deterioration under light, heat, and oxygen exposure, as well as limited water solubility, have significantly impeded the development and application of EOs. Porous nanoclays are natural clay minerals with a layered structure. They possess unique structural characteristics such as large pore size, regular distribution, and tunable particle size, which are extensively utilized in drug delivery, adsorption separation, reaction catalysis, and other fields. Natural-derived porous nanoclays have garnered considerable attention for the encapsulation and delivery of EOs. This review comprehensively summarizes the structure, types, and properties of natural-derived porous nanoclays, focusing on the structural characteristics of porous nanoclays such as montmorillonite, palygorskite, halloysite, kaolinite, vermiculite, and natural zeolite. It also examines research advances in their delivery of EOs and explores engineering strategies to enhance the delivery of EOs by natural-derived porous nanoclays. Finally, various applications of natural-derived porous nanoclays for EOs in antibacterial, food preservation, repellent, and insecticide aspects are presented, providing a reference for the development and application of EOs.
Humans ; Nanoparticles/chemistry* ; Oils, Volatile/administration & dosage* ; Porosity ; Nanoparticle Drug Delivery System/chemistry*

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: This study is designed to compare the changes of intestinal microflora and cytokine levels in patients with schizophrenia in different periods, analyze the correlation between intestinal microflora and disease symptoms, and explore the influence of intestinal microflora changes on the symptoms of patients with schizophrenia. Methods: 40 schizophrenic patients in different periods were included in the study, with their demographic data of age, body mass index(BMI), sex and course of disease collected. For each subject, serum was first collected for the levels of cytokines to be determined by an Meso Scale Discovery. The severity of schizophrenia was then assessed using negative and positive symptom scales. Finally macrofactor sequencing of intestinal flora was performed using MetaGeneMark. Results: Serum levels of interleukin-6(IL-6), interleukin-10(IL-10), interleukin-17(IL-17), interleukin-23(IL-23), and tumor necrosis factor-α(TNF-α) in the acute stage were higher than those in remission stage, and the results were statistically significant(P<0.05). Negative and positive symptom Scale(PANSS) positive factor scores were negatively correlated with TNF-α and IL-17(R=-0.312,P<0.05;R=-0.399,P<0.05); IL-23 was positively correlated with the negative factor score of the scale(R=-0.344,P<0.05). IL-6 was positively correlated with scale cognitive factor score(R=-0.339,P<0.05). IL-23 was positively correlated with the total score of the scale(R=-0.370,P<0.05). The microbial diversity detected in stool samples of patients with acute schizophrenia was lower than that of patients with remission, and certain difference was detected in the intestinal flora species composition between patients in the acute stage and in the remission stage. Conclusion The level of serum cytokines in the acute stage of schizophrenia is higher than that in the remission stage, and some cytokines levels are correlated with clinical symptoms.

Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

Objective To investigate the safety and short-term outcomes of laparoscopic abdominoperineal resection with pelvic peritoneum closure (LARP-PPC) for low rectal cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 132 patients with low rectal cancer who were admitted to Ruijin Hospital of Shanghai JiaoTong University School of Medicine from January 2014 to December 2017 were collected.There were 81 males and 51 females,aged from 45 to 83 years,with an average age of 62 years.Among the 132 patients,60 undergoing LARP-PPC were allocated into LARP-PPC group,and 72 patients undergoing conventional LARP were allocated into LARP group.All the patients received standardized preoperative and postoperative treatments.Observation indicators:(1) surgical and postoperative conditions;(2) postoperative pathological examination;(3) postoperative complications.The measurement data with normal distribution were expressed as Mean±SD,and the t test was used for comparison between groups.The measurement data with skewed distribution were expressed as M (range),and the Mann-Whitney U test was used for comparison between groups.The count data were expressed as absolute numbers,and the chi-square test or the Fisher exact probability was used for comparison between groups.Mann-Whitney U test was used for comparison of ordinal data between groups.Results (1) Surgery and postoperative conditions:all the patients in the two groups underwent successful surgery without conversion to open surgery.The operation time,volume of intraoperative blood loss,time to first flatus,and time to first liquid intake of the LARP-PPC group were (163±45) minutes,168 mL(range,85-280 mL),2 days(range,1-5 days),3 days(range,2-6 days),versus (155±39) minutes,160 mL(range,100-305 mL),3 days(range,1-7 days),4 days(range,2-7 days) of the LARP group;there was no differencebetween the two group (t =1.113,Z =-1.623,-1.468,-0.321,P＞0.05).The duration of postoperative hospital stay in the LARP-PPC group and the LARP group were 16 days (range,11-21 days) and 19 days (14-24 days),respectively,with a significant difference between the two groups (Z =-5.888,P＜0.05)].In the LARP-PPC group,time of PPC was (13± 3) minutes.(2) Postoperative pathological examination:the length of specimen,the number of lymph node dissection,tumor diameter,cases with high-,middle-,and low-differentiated tumor in the LARP-PPC group was (18±4)cm,16±t5,(3.7±1.4)cm,10,34,16 in the LARP-PPC group,and (18±4)cm,16±5,(3.9±1.5) cm,13,41,18 in the LARP group,showing no significant difference between the two groups (t =0.779,0.390,0.703,Z=-0.267,P＞0.05).(3) Postoperative complications:cases with perineal wound infection,delayed perineal wound healing,intestinal obstruction,and perineal hernia were 2,1,1,0 in the LARP-PPC group,and 12,10,8,6 in the LARP group,showing significant differences between the two groups (x2 =6.137,6.400,P＜0.05).There were 2 and 4 patients with urinary tract infection in the LARP-PPC group and the LARP group,respectively,showing no significant difference between the two groups (P ＞ 0.05).Conclusion LARP-PPC is safe and feasible for the treatment of low rectal cancer,which can significantly reduce postoperative perineal-related complications and consequently shorten postoperative hospital stay.

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Objective:To evaluate the performance of reticulocyte (Ret) detected by Sysmex XN-3000 automatic blood analyzer.Methods: 96 blood samples were collected randomly in clinical detection of reticulocytes, and respectively were detected by XN-3000 automatic blood analyzer and microscopy. The precision, stability, linearity and carryover of Ret in blood samples detected by XN-3000 automatic blood analyzer were evaluated by the correlation analysis of the results from the two methods and the correlation analysis would be completed by microscopy.Results: precision, linear range and sensitivity of Ret measured by XN-3000 were within the allowable range. The stability did not change significantly below 4℃ within 48h (CV<1%). The carryover rate was 0.14%. The results measured by XN-3000 were well compared with microscopy (r=0.979).Conclusion: Sysmex XN-3000 automatic blood analyzer is applied to the clinical detection of large quantities of specimens and it is ideal for measuring Ret.