Conventional surgical management of pelvic fractures entails incision and reduction with internal fixation, a procedure associated with significant bleeding, trauma, and a high surgical risk. The advent of advanced imaging techniques and sophisticated surgical instruments has led to a paradigm shift towards minimally invasive surgery as the prevailing treatment modality for such injuries. The efficacy of reduction is pivotal in determining the clinical prognosis of pelvic fractures, underscoring the importance of enhancing the quality of reduction in the minimally invasive surgery. The advent of 3D printing technology, intelligent orthopaedic surgical robots, mixed reality augmentation technology and high-precision optical localization tracking has catapulted minimally invasive pelvic fracture reduction to the forefront of research in the field of orthopaedics. Studies have demonstrated encouraging outcomes. This paper reviews relevant literature, mainly focusing on the evaluation and measurement, open reduction techniques, minimally invasive closed reduction techniques, and surgical robot assisted reduction techniques in treatment of pelvic fractures, to summarize the technical research progress in minimally invasive closed surgical reduction for pelvic fractures.

The development of polysaccharide conjugate vaccines, which convert polysaccharide antigens into T-cell-dependent immunogens through covalent conjugation with protein carriers, represents a critical strategy for enhancing immune protection in infants and young children. Globally licensed conjugate vaccines currently employ carrier proteins including Tetanus Toxoid, Diphtheria Toxoid, and Cross-Reacting Material 197. Recent advances have focused on three key areas: novel carrier protein discovery, optimized conjugation strategies, and evaluation of immune interference during co-administration of multivalent formulations. These efforts aim to achieve broader serotype coverage, prolonged protective efficacy, and simplified immunization schedules. This review synthesizes recent progress in carrier protein development, encompassing vaccine design principles, manufacturing processes, safety profiles, and epidemiological effectiveness. Furthermore, it critically examines current selection criteria for carrier proteins, their clinical applications, and persistent challenges, providing strategic insights to inform future conjugate vaccine development and immunization policy optimization in China.

Objective To establish an efficient,sensitive,and accurate ion chromatography method for the simultaneous determination of three impurity ions—bromide(Br-),nitrite(NO2-),and oxalate(C2 O42-)—in oral rehydration salts powder(Ⅲ).These impurity ions may pose potential toxic side effects on children's health;therefore,ensuring their content within safe limits is crucial for safeguarding pediatric medication safety.Methods A Metrosep A Supp 5 column(250 mm×4.0 mm,5 μm),packed with quaternary ammonium-bonded polyvinyl alcohol was used.The eluent consisted of carbonate buffer:Mobile phase A was a mixture of 3.2 mmol·L-1 sodium carbonate and 1.0 mmol·L-1 sodium bicarbonate(50∶50,V∶V),and mobile phase B was a mixture of 32 mmol·L-1 sodium carbonate and 10 mmol·L-1 sodium bicarbonate(50∶50,V∶V),with gradient elution.The column temperature was set at 35℃,and the flow rate was 0.7 mL·min-1.Limits for the three impurity ions were set according to the International Council for Harmonisation guidelines(ICH M7(R1)and ICH Q3B),and the method was validated by testing six actual samples.Results Within the concentration range of 0.02-0.50 μg·mL-1,the linear correlation coefficients(R2)for the three impurity ions were all greater than 0.999.The detection limits ranged from 1.2 to 3.4 ng·mL-1,and the spiked recovery rates were between 92.0%and 102.0%.Results from the six actual samples demonstrated that the method effectively controlled the content of impurity ions.Conclusion This study successfully established a gradient elution ion chromatography method for the simultaneous determination of three impurity ions in Oral rehydration salts powder(Ⅲ).The method is highly sensitive,specific,and accurate.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

The development of polysaccharide conjugate vaccines, which convert polysaccharide antigens into T-cell-dependent immunogens through covalent conjugation with protein carriers, represents a critical strategy for enhancing immune protection in infants and young children. Globally licensed conjugate vaccines currently employ carrier proteins including Tetanus Toxoid, Diphtheria Toxoid, and Cross-Reacting Material 197. Recent advances have focused on three key areas: novel carrier protein discovery, optimized conjugation strategies, and evaluation of immune interference during co-administration of multivalent formulations. These efforts aim to achieve broader serotype coverage, prolonged protective efficacy, and simplified immunization schedules. This review synthesizes recent progress in carrier protein development, encompassing vaccine design principles, manufacturing processes, safety profiles, and epidemiological effectiveness. Furthermore, it critically examines current selection criteria for carrier proteins, their clinical applications, and persistent challenges, providing strategic insights to inform future conjugate vaccine development and immunization policy optimization in China.

Objective To establish an efficient,sensitive,and accurate ion chromatography method for the simultaneous determination of three impurity ions—bromide(Br-),nitrite(NO2-),and oxalate(C2 O42-)—in oral rehydration salts powder(Ⅲ).These impurity ions may pose potential toxic side effects on children's health;therefore,ensuring their content within safe limits is crucial for safeguarding pediatric medication safety.Methods A Metrosep A Supp 5 column(250 mm×4.0 mm,5 μm),packed with quaternary ammonium-bonded polyvinyl alcohol was used.The eluent consisted of carbonate buffer:Mobile phase A was a mixture of 3.2 mmol·L-1 sodium carbonate and 1.0 mmol·L-1 sodium bicarbonate(50∶50,V∶V),and mobile phase B was a mixture of 32 mmol·L-1 sodium carbonate and 10 mmol·L-1 sodium bicarbonate(50∶50,V∶V),with gradient elution.The column temperature was set at 35℃,and the flow rate was 0.7 mL·min-1.Limits for the three impurity ions were set according to the International Council for Harmonisation guidelines(ICH M7(R1)and ICH Q3B),and the method was validated by testing six actual samples.Results Within the concentration range of 0.02-0.50 μg·mL-1,the linear correlation coefficients(R2)for the three impurity ions were all greater than 0.999.The detection limits ranged from 1.2 to 3.4 ng·mL-1,and the spiked recovery rates were between 92.0%and 102.0%.Results from the six actual samples demonstrated that the method effectively controlled the content of impurity ions.Conclusion This study successfully established a gradient elution ion chromatography method for the simultaneous determination of three impurity ions in Oral rehydration salts powder(Ⅲ).The method is highly sensitive,specific,and accurate.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

Conventional surgical management of pelvic fractures entails incision and reduction with internal fixation, a procedure associated with significant bleeding, trauma, and a high surgical risk. The advent of advanced imaging techniques and sophisticated surgical instruments has led to a paradigm shift towards minimally invasive surgery as the prevailing treatment modality for such injuries. The efficacy of reduction is pivotal in determining the clinical prognosis of pelvic fractures, underscoring the importance of enhancing the quality of reduction in the minimally invasive surgery. The advent of 3D printing technology, intelligent orthopaedic surgical robots, mixed reality augmentation technology and high-precision optical localization tracking has catapulted minimally invasive pelvic fracture reduction to the forefront of research in the field of orthopaedics. Studies have demonstrated encouraging outcomes. This paper reviews relevant literature, mainly focusing on the evaluation and measurement, open reduction techniques, minimally invasive closed reduction techniques, and surgical robot assisted reduction techniques in treatment of pelvic fractures, to summarize the technical research progress in minimally invasive closed surgical reduction for pelvic fractures.

Objective:To construct and validate a nomogram for prediction of in-hospital postoperative heart failure(PHF)in elderly patients with hip fracture.Methods:This was a retrospective cohort study.The patients aged ≥65 years undergoing hip fracture surgery in Peking University Third Hospital from July 2015 to December 2023 were enrolled.The patients admitted from July 2015 to December 2021 were divided into a development cohort,and the others admitted from January 2022 to December 2023 in to a validation cohort.The patients'clinical data were collected from the electronic medical record sys-tem.Univariate and multivariate Logistic regression were employed to screen the predictors for PHF in the patients.The R software was used to construct a nomogram.Internal and external validation were per-formed by the Bootstrap method.The discriminatory ability of the model was determined by the area un-der the receiver operating characteristic curve(AUC).The calibration was evaluated by the calibration plot and Hosmer-Lemeshow goodness-of-fit test.Decision curve analysis(DCA)was performed to assess the clinical utility.Results:In the study,944 patients were eventually enrolled in the development co-hort,and 469 were in the validation cohort.A total of 54(5.7％)patients developed PHF in the deve-lopment cohort,and 18(3.8％)patients had PHF in the validation cohort.Compared with those from non-PHF group,the patients from PHF group were older,had higher prevalence of heart disease,hyper-tension and pulmonary disease,had poorer American Society of Anesthesiologists(ASA)classification(Ⅲ-Ⅳ),presented with lower preoperative hemoglobin level,lower left ventricular ejection fraction,higher preoperative serum creatinine,received hip arthroplasty and general anesthesia more frequently.Multivariate Logistic regression analysis showed that age(OR=1.071,95％CI:1.019-1.127,P=0.008),history of heart disease(OR=5.360,95％CI:2.808-10.234,P＜0.001),preoperative he-moglobin level(OR=0.979,95％CI:0.960-0.999,P=0.041),preoperative serum creatinine(OR=1.007,95％CI:1.001-1.013,P=0.015),hip arthroplasty(OR=2.513,95％CI:1.259-5.019,P=0.009),and general anesthesia(OR=2.024,95％CI:1.053-3.890,P=0.034)were the independent predictors for PHF in elderly patients with hip fracture.Four preoperative predictors were incorporated to construct a preoperative nomogram for PHF in the patients.The AUC values of the nomo-gram in internal and external validation were 0.818(95％CI:0.768-0.868)and 0.873(95％CI:0.805-0.929),indicating its good accuracy.The calibration plots and Hosmer-Lemeshow goodness-of-fit test(internal validation:x2=9.958,P=0.354;external validation:x2=5.477,P=0.791)showed its satisfactory calibration.Clinical usefulness of the nomogram was confirmed by decision curve analysis.Conclusion:An easy-to-use nomogram for prediction of in-hospital PHF in elderly patients with hip fracture is well developed.This preoperative risk assessment tool can effectively identify patients at high risk of PHF and may be useful for perioperative management optimization.

Objective:To explore the value of serum procalcitonin (PCT) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on predicting prognosis of elderly patients with sepsis.Methods:A retrospective cohort study, patients with sepsis who admitted to the department of emergency and the department of geriatric medicine of Peking University Third Hospital from March 2020 to June 2021 were enrolled. Patients' demographics, routine laboratory examinations, APACHE Ⅱ score that within 24 hours of admission were obtained from their electronic medical records. The prognosis during the hospitalization and one year after discharge were collected, retrospectively. Univariate and multivariate analysis of prognostic factors were performed. And Kaplan-Meier survival curves were used to examine overall survival.Results:A total of 116 elderly patients met inclusion criteria, 55 were alive and 61 were died. On univariate analysis, clinical variables such as lactic acid [Lac, hazard ratio ( HR) = 1.16, 95% confidence interval (95% CI) was 1.07-1.26, P < 0.001], PCT ( HR = 1.02, 95% CI was 1.01-1.04, P < 0.001), alanine aminotransferase (ALT, HR = 1.00, 95% CI was 1.00-1.00, P = 0.143), aspartate aminotransferase (AST, HR = 1.00, 95% CI was 1.00-1.01, P = 0.014), lactate dehydrogenase (LDH, HR = 1.00, 95% CI was 1.00-1.00, P < 0.001), hydroxybutyrate dehydrogenase (HBDH, HR = 1.00, 95% CI was 1.00-1.00, P = 0.001), creatine kinase (CK, HR = 1.00, 95% CI was 1.00-1.00, P = 0.002), MB isoenzyme of creatine kinase (CK-MB, HR = 1.01, 95% CI was 1.01-1.02, P < 0.001), Na ( HR = 1.02, 95% CI was 0.99-1.05, P = 0.183), blood urea nitrogen (BUN, HR = 1.02, 95% CI was 0.99-1.05, P = 0.139), fibrinogen (FIB, HR = 0.85, 95% CI was 0.71-1.02, P = 0.078), neutrophil ratio (NEU%, HR = 0.99, 95% CI was 0.97-1.00, P = 0.114), platelet count (PLT, HR = 1.00, 95% CI was 0.99-1.00, P = 0.108) and total bile acid (TBA, HR = 1.01, 95% CI was 1.00-1.02, P = 0.096) shown to be associated with poor prognosis. On multivariable analysis, level of PCT was an important factor influencing the outcome of sepsis ( HR = 1.03, 95% CI was 1.01-1.05, P = 0.002). Kaplan-Meier survival curve showed that there was no significant difference with respect to the overall survival between the two groups, with patients of PCT ≤ 0.25 μg/L and PCT > 0.25 μg/L ( P = 0.220). It also showed that the overall survival rate in patients with high APACHE Ⅱ score (> 27 points) was significantly lower than that in patients with low APACHE Ⅱ score (≤ 27 points, P = 0.015). Conclusion:Serum PCT level is valuable prognostic factors of elderly patients with sepsis, and higher APACHE Ⅱ score (> 27 points) indicates a poor prognosis.