For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

At present, there are a series of problems in the clinical teaching of postgraduates, such as insufficient integration of professional teaching and ideological and political education, insufficient understanding of teachers and students, insufficient exploration of ideological and political elements, and immature construction of teaching system. This paper mainly starts from three aspects: improving the teaching system and mechanism, building a disease-based curriculum ideological and political chain and teaching implementation strategies, organically combines different professional curriculum contents with ideological and political education, and carries out preliminary exploration and practice in the construction of ideological and political teaching system of orthopedic clinical curriculum, so as to guide students to establish correct values, outlook on life and world outlook. It provides useful practical experience for improving the quality of clinical teaching and promoting the reform and innovation of graduate teaching.

Objective:To explore the current situation of work stress and job burnout of nursing staff in the Department of Infectious Diseases, and analyze its influencing factors.Methods:From January to June 2020, 63 nurses from the Department of Infectious Diseases of Zhejiang Hospital and the Affiliated Hospital of Chengde Medical University were selected as research subjects. Questionnaires were used to investigate general information, work stress, and job burnout.Results:63 questionnaires were issued and 60 were recovered. There was a statistically significant difference in work stress scores of nurses with different working hours, daily number of patients admitted, public recognition and respect, and training times ( P<0.05) . There were statistically significant differences in the scores of the personal accomplishment dimension of nurses with or without administrative positions and different professional titles, and in the scores of the depersonalization tendency dimension of nurses with different education levels, public recognition and respect, and training times, and in the scores of the emotional exhaustion dimension of nurses with different working hours, daily number of patients admitted, public recognition and respect, and training times ( P<0.05) . Conclusions:Nursing staff in the Department of Infectious Diseases are under high work stress, overall burnout is mild, and the personal sense of accomplishment of the nursing staff is low. The main reasons for this are closely related to the daily number of patients admitted, public recognition and respect, and the training times.

Objective:To explore the application of 3D printing technology combined with CPBL teaching mode in the teaching of master's degree in spine surgery.Methods:42 postgraduates in our department were randomly divided into two groups: experimental group (21) and control group (21). The experimental group used 3D printing technology combined with CPBL teaching mode as teaching techniques. Before class, the teacher would select some typical cases and design related problems. During class, 3D models were used to guide students to think and solve related problems; The control group used traditional teaching mode. Students in the two groups were compared for the theoretical knowledge and operational techniques they have mastered, and the students' satisfaction and recognition towards different teaching modes were obtained through questionnaire survey. Independent sample t-test was performed using SPSS 25.0.Results:The scores of the theoretical knowledge, operational techniques, teaching satisfaction and recognition of postgraduates were (84.7±3.4), (87.1±3.7), (9.7±0.3), (9.3±0.4) in the experimental group, and (79.7±3.3), (80.4 ± 4.0), (8.4±0.7) and (8.3±0.6) in the control group. The difference between the two groups was statistically significant ( P<0.05). Conclusion:The new teaching mode of combining 3D printing technology with CPBL teaching mode is better than the traditional teaching mode, which is worth further promotion and application.

Objective:To explore the feasibility and superiority of applying digital orthopedic technology of virtual human reconstruction and 3D printing to CBL teaching of kyphosis for clinical postgraduates.Methods:Thirty postgraduates of professional degree participated in the standardized training of resident doctors in our department were randomized into the experimental group (New CBL teaching mode group) and the control group (traditional teaching mode group) with 15 students in each group, and the two groups were taught differently (the teaching content was two typical cases of kyphosis). Among them, the experimental group adopted the new CBL teaching mode, and successively conducted small class theory teaching, model explanation, group discussion, preoperative design, surgery observation and specific questions and answers, etc. The control group only used the traditional method to teach theory in a large class. The teaching effect of the two groups was evaluated in t test by SPSS 25.0.Results:For the teaching of patients with ankylosing spondylitis and kyphosis, scores of the satisfaction with class interest, mastery of theoretical knowledge and understanding of operation plan in the experimental group were (9.4±0.2), (91.1±3.8), and (91.5±3.5) respectively, and those in the control group were (8.2±0.4), (82.1±3.5) and (83.1±4.7) respectively, with statistical significance ( P<0.05). Conclusion:In the teaching of kyphosis, the CBL teaching mode based on digital orthopedic technology is superior to the traditional teaching mode, which is conducive to improving clinical skills for students.

Objective To explore the effects of early functional exercise on the patients with shoulder-hand syndrome after acute stroke. Methods Totally 60 patients with shoulder-hand syndrome after acute stroke who were admitted in Zhejiang Hospital between January 2015 and January 2017 were prospectively selected and randomly divided into an observation group (n=30) and a control group (n=30). Patients in the observation group performed early functional exercise, while patients in the control group received only routine nursing. The clinical effect was compared between the patients in the two groups. Results There was no statistically significant difference in the scores for the swelling of the limb, the range of movement of metacarpophalangeal joints and the simple upper limb function before the intervention (P>0.05). After two weeks and four weeks of intervention, the swelling of the limb in the patients in the observation group was lower than that of the patients in the control group (P< 0.05). After four weeks of intervention, the scores for the range of movement of metacarpophalangeal joints in the patients in the observation group were higher than those of the patients in the control group (P<0.05). There was no statistically significant difference in the scores of anxiety and depression between the patients in the two groups (P> 0.05). After four weeks of intervention, the patients in the observation group showed lower scores of anxiety and depression than the patients in the control group (P<0.05). Conclusions Early functional exercise helps to improve the function of limbs, lower the level of anxiety and depression, and improve the quality of life in patients with shoulder-hand syndrome after acute stroke.