Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective To compare the clinical efficacy and safety between percutaneous vertebroplasty (PVP) and conservative treatment for osteoporosis vertebral compression fracture (OVCF).Methods A total of 55 patients undergoing PVP and 65 patients with conservative treatment for OVCF in our hospital from 2006 to 2011 were retrospectively analysed.The degree of pain and personal life before treatment and after treatment at different time points were investigated by visual analogue scale (VAS) pain scale and Oswestry Disability Index (ODD.Results The degree of pain in lower back was reduced after the treatment.The VAS pain scales in PVP group versus control group were (8.3±0.5) vs.(8.50.6),(6.9±0.7) vs.(4.5±0.7),(5.40.6) vs.(3.4±0.5),(4.8±0.3) vs.(2.8±0.5),(4.0±0.4) vs.(2.3±0.4),(3.1±0.5) vs.(2.0±0.2)before treatment and 1 week,1,3,6 and 12 months after treatment,respectively.The VAS pain scales were reduced more rapidly in PVP group than in control group,showing a better relief of pain.There were differences in VAS pain scales between the two groups at different time points (t=17.89,19.74,28.38,24.49,14.01,respectively,all P＜0.01).The ODI scores in PVP group and control group were [(88.8±5.0) vs.(87.2±5.1)],[(72.6±7.8) vs.(53.1±6.3)],[(62.0±8.5) vs.(37.2±6.0)],[(47.1±12.6) vs.(26.5±3.6)],[(36.7±9.3) vs.(17.9±5.5)],[(24.3±10.0) vs.(9.4±2.5)] before treatment and 1 week,1,3,6 and 12 months after treatment,respectively.The ODI scores were reduced more rapidly in PVP group than in control group,showing a better recovery of daily life.There were differences in ODI scores between the two groups at different time points (t=15.00,18.17,11.74,13.20,10.72,respectively,all P＜0.01).Conclusions PVP can alleviate pain and restore daily life rapidly.It shows advantages in rccovery of the fractured vertebrae height.

OBJECTIVETo establish a quick method for evaluation of the antioxidant activities based on the correlation analysis of lignans content and antioxidant activities of Schisandra chinensis fruits.

METHODThe content of five lignans components in 37 batches of S. chinensis fruits from different regions of Jilin province were measured by HPLC. Simultaneously, the antioxidant activities of the above samples were detected, such as lipid peroxidation inhibition activity in liver (LPIL), kidney (LPIK) and brain (LPIB) and the clearance rate of DPPH (CRD). Bivariate correlation analysis and stepwise regression analysis were carried out by the software of SPSS for windows 11.5.

RESULTThe results of bivariate correlation analysis showed that deoxyschizandrin was negative correlation (P<0.01) to the activity of LPIL, LPIB, CRD. Schisandrin was positive correlation (P<0.01) to the activity of LPIL, LPIB, CRD. Schisandrol B was also positive correlation (P<0.05 or P<0.01) to the above four kinds of antioxidant activity. The results of stepwise regression analysis were mostly consistent with the bivariate correlation analysis results. For the other 10 batches of samples, the simulated antioxidant activities according to the regression equation calculated was consistent with the measured activities.

CONCLUSIONBy using the bivariate correlation analysis and linear stepwise regression analysis, the bioactive components related to the antioxidant activity of S. chinensis fruits were found. Meanwhile, the antioxidant activity of samples will be inferred according to the content of Schisandra lignans.

Antioxidants ; chemistry ; Fruit ; chemistry ; Lignans ; chemistry ; Schisandra ; chemistry