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.

BACKGROUND:Periprosthetic fracture of the femoral of the knee after total knee arthroplasty is one of the common complications,and there is a lack of biomechanical research on the periprosthetic fractures of the femoral of the knee under different bone strength conditions.The three-dimensional finite element analysis can provide a biomechanical basis for clinical practice. OBJECTIVE:To investigate the biomechanical changes of anterior femoral notching after total knee arthroplasty under different bone strengths,and to provide a mechanical basis for the clinical prevention of supracondylar femoral periprosthetic fractures after knee arthroplasty. METHODS:The femoral CT data of healthy adults were obtained,and the three-dimensional model of femoral lateral replacement of the knee joint was established by Mimics,Geomagic studio,and Solidworks software.Anterior femoral notching models of different depths were constructed,and the models were imported into ANSYS software to analyze the changes of biological stress on the femoral condyle with different bone strengths and different anterior femoral notching depths.The stress changes of the femoral anterior condyle section after and before the filling of anterior femoral notching with bone cement were analyzed. RESULTS AND CONCLUSION:(1)Under any bone strength,the supracondylar stress increased with the depth of anterior femoral notching.In normal bone conditions,there was a stress abrupt change point when the anterior femoral notching depth was between 3 mm and 4 mm.In the case of osteoporosis,there was a stress abrupt point when the anterior femoral notching depth was between 2 mm and 3 mm.(2)When anterior femoral notching occurred during knee arthroplasty and the depth exceeded the thickness of the bone cortex,the supracondylar stress of the femoral gradually increased as the bone strength decreased.(3)The stress of the anterior femoral condyle section decreased when the model with an anterior femoral notching depth of 3 mm was filled with bone cement.(4)The results show that anterior femoral notching should be avoided during knee arthroplasty,especially in patients with osteoporosis.If anterior femoral notching occurs during surgery,bone cement can be used to evenly fill the anterior femoral notching to reduce the supracondylar stress of the femur and reduce the incidence of periprosthetic fractures of the femoral joint

Infection Prevention and Control(IPC)programs are crucial for prevention of hospital-associated infec-tions(HAIs),health and safety of patients and health care workers.The major task confronting the health care is to effectively carry out the IPC programs so as to raise the efficiency and quality of management of HAIs.In recent years,the rapid development of artificial intelligence(AI)technology has provided new ideas for the management of HAIs.The application and progress of research on application of AI technologies such as machine learning,nat-ural language processing and computer vision in surveillance,early warning,diagnosis,prevention and control,smart medical equipment and management of antibiotics were reviewed in the article.Meanwhile,the problems and challenges confronting the AI application,such as technical breakthroughs,data privacy and health care work-ers' acceptance,were also expounded.In the future,it is necessary to push forward the technology research and development,establish the safe and reliable data management system,increase the experience of health care work-ers and energize the interdisciplinary cooperation on IPC.

Metastatic uveal melanoma (MUM) is a rare but highly invasive ocular malignant tumor with poor prognosis.At present, there is a lack of standardized methods for the treatment of MUM, resulting in poor prognosis.However, in recent years, the emergence of immune checkpoint inhibitors, new immune drug Tebenfos, comprehensive targeted therapy, combined sequential therapy and other treatment methods has brought new hope to MUM patients.This review aims to summarize the latest progress in the diagnosis, treatment, and prognosis of MUM.

Objective:To analyze the characteristics of anonymous online dating and related factors of not being tested for HIV among men who have sex with men and to provide the basis for developing targeted HIV prevention strategies and intervention measures.Methods:Using a cross-sectional study design, respondents were recruited with the assistance of MSM social organizations from April to July 2023 in eight cities in Shandong Province. Snowball sampling, activity venues, and networks were employed, targeting a sample size of 400 people per city. A face-to-face questionnaire survey collected data on sociodemographic characteristics, drug use, sexual intercourse, and online informed dating. Blood samples were also collected for HIV and syphilis antibody testing.Results:In the past six months, 2 787 MSM sought homosexual partners through the Internet, and 78.26% (2 181/2 787) chose to make anonymous online dating. Before having homosexual sex with online sexual partners, 10.41% (290/2 787) of them did not ask each other about HIV infection status and 33.37% (930/2 787) of them not being tested for HIV. There were statistically significant differences in the distribution of age, marital status, household registration, education level, sexual orientation, ways to find male sexual partners, not asking online sexual partners about their HIV status before sexual intercourse, no mutual HIV testing with online sexual partners before sexual intercourse, and syphilis antibody between anonymous and non-anonymous online dating persons (all P<0.05). The results of multivariate logistic regression analysis showed that <25 years old (a OR=1.43, 95% CI: 1.15-1.77) and ≥35 years old age group (a OR=1.61, 95% CI: 1.29-2.01), people with no AIDS knowledge (a OR=2.37, 95% CI: 1.25-4.49), drug users (a OR=1.38, 95% CI: 1.17-1.63), online dating anonymous (a OR=2.19, 95% CI: 1.76-2.73), HIV antibody positive (a OR=3.61, 95% CI: 2.22-5.88) and no intervention services in the last 1 year (a OR=1.58, 95% CI: 1.05-2.38) were the related factors of MSM not being tested for HIV before having sexual intercourse through online dating. Conclusions:The phenomenon of anonymous online dating was common among MSM in Shandong Province, and the proportion of MSM not being tested for HIV before having sexual intercourse through anonymous online dating was relatively high. It is necessary to strengthen health publicity and promote informed dating in MSM.

Infection Prevention and Control(IPC)programs are crucial for prevention of hospital-associated infec-tions(HAIs),health and safety of patients and health care workers.The major task confronting the health care is to effectively carry out the IPC programs so as to raise the efficiency and quality of management of HAIs.In recent years,the rapid development of artificial intelligence(AI)technology has provided new ideas for the management of HAIs.The application and progress of research on application of AI technologies such as machine learning,nat-ural language processing and computer vision in surveillance,early warning,diagnosis,prevention and control,smart medical equipment and management of antibiotics were reviewed in the article.Meanwhile,the problems and challenges confronting the AI application,such as technical breakthroughs,data privacy and health care work-ers' acceptance,were also expounded.In the future,it is necessary to push forward the technology research and development,establish the safe and reliable data management system,increase the experience of health care work-ers and energize the interdisciplinary cooperation on IPC.

Objective:To analyze the characteristics of anonymous online dating and related factors of not being tested for HIV among men who have sex with men and to provide the basis for developing targeted HIV prevention strategies and intervention measures.Methods:Using a cross-sectional study design, respondents were recruited with the assistance of MSM social organizations from April to July 2023 in eight cities in Shandong Province. Snowball sampling, activity venues, and networks were employed, targeting a sample size of 400 people per city. A face-to-face questionnaire survey collected data on sociodemographic characteristics, drug use, sexual intercourse, and online informed dating. Blood samples were also collected for HIV and syphilis antibody testing.Results:In the past six months, 2 787 MSM sought homosexual partners through the Internet, and 78.26% (2 181/2 787) chose to make anonymous online dating. Before having homosexual sex with online sexual partners, 10.41% (290/2 787) of them did not ask each other about HIV infection status and 33.37% (930/2 787) of them not being tested for HIV. There were statistically significant differences in the distribution of age, marital status, household registration, education level, sexual orientation, ways to find male sexual partners, not asking online sexual partners about their HIV status before sexual intercourse, no mutual HIV testing with online sexual partners before sexual intercourse, and syphilis antibody between anonymous and non-anonymous online dating persons (all P<0.05). The results of multivariate logistic regression analysis showed that <25 years old (a OR=1.43, 95% CI: 1.15-1.77) and ≥35 years old age group (a OR=1.61, 95% CI: 1.29-2.01), people with no AIDS knowledge (a OR=2.37, 95% CI: 1.25-4.49), drug users (a OR=1.38, 95% CI: 1.17-1.63), online dating anonymous (a OR=2.19, 95% CI: 1.76-2.73), HIV antibody positive (a OR=3.61, 95% CI: 2.22-5.88) and no intervention services in the last 1 year (a OR=1.58, 95% CI: 1.05-2.38) were the related factors of MSM not being tested for HIV before having sexual intercourse through online dating. Conclusions:The phenomenon of anonymous online dating was common among MSM in Shandong Province, and the proportion of MSM not being tested for HIV before having sexual intercourse through anonymous online dating was relatively high. It is necessary to strengthen health publicity and promote informed dating in MSM.

Metastatic uveal melanoma (MUM) is a rare but highly invasive ocular malignant tumor with poor prognosis.At present, there is a lack of standardized methods for the treatment of MUM, resulting in poor prognosis.However, in recent years, the emergence of immune checkpoint inhibitors, new immune drug Tebenfos, comprehensive targeted therapy, combined sequential therapy and other treatment methods has brought new hope to MUM patients.This review aims to summarize the latest progress in the diagnosis, treatment, and prognosis of MUM.

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.

Acromioclavicular joint dislocation is a common clinical condition in shoulder injuries, causing shoulder pain, swelling, and tenderness, and leading to limitations in abduction, elevation, forward flexion, and extension of the upper limb, which severely affects the patient′s daily life. Rockwood type ⅢB to type Ⅵ acromioclavicular joint dislocations, involving coracoclavicular ligament rupture, often require surgical treatment. Coracoclavicular fixation or ligament reconstruction, by reconstructing the coracoclavicular ligament, restores the vertical stability of the acromioclavicular joint and is more in line with the anatomical structure of the joint, which has been widely accepted by clinical physicians and patients. However, in recent years, there have been reports questioning its adequacy in horizontal stability. This article aims to review the treatment of acromioclavicular joint dislocations with coracoclavicular fixation and coracoclavicular ligament reconstruction and to discuss the future prospects of this approach.