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.

Objective:To investigate the microstructural abnormalities of the white matter in first-episode medication-free patients with schizophrenia (FESZ) based on inter-voxel diffusivity metric local diffusion homogeneity (LDH) and traditional intra-voxel diffusivity metric.Methods:A total of 56 FESZ patients admitted to our hospital from January 2020 to December 2021 were selected as research subjects, and 64 healthy volunteers recruited during the same period were selected as healthy controls. All subjects accepted magnetic resonance diffusion tensor imaging, and the LDH, anisotropy fraction (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were obtained by FSL and PANDA software. Tract-based spatial statistics (TBSS) method was employed to analyze and compare the differences in the diffusivity metrics of white matter fibers between the two groups. For white matter fiber tracts with significant inter-group differences, receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of each diffusivity metric in FESZ, and Spearman partial correlation was used to analyze the relation between each diffusivity metric and positive and negative symptom scale (PANSS) scores.Results:As compared with that in the heathy control group, LDH in partial voxel clusters in bilateral anterior thalamic radiation of the FESZ group was statistically increased ( P<0.05, FWE correction). As compared with that in the heathy control group, the mean LDH in the tracts of interest (TOI) of the right inferior longitudinal fasciculus and the right uncinate fasciculus in the FESZ group was significantly increased ( P<0.05, FDR correction). In the above 4 fasciculi, ROC analysis showed that LDH had diagnostic efficacy ( P<0.05), and the diagnostic efficacy of LDH was the highest when the fasciculi structures were combined (AUC=0.733, P<0.001). LDH in white matter fiber tracts with significant inter-group differences had no statistical correlation with PANSS scores ( P>0.05). No voxel clusters or TOIs enjoyed statistical differences between groups were noted in the FA, MD, AD and RD parameter maps ( P>0.05). Conclusion:The inter-voxel diffusivity metric LDH can detect the compensatory changes of white matter microstructure in FESZ patients that could not be detected by traditional intra-voxel diffusivity metric.

Objective:To explore the current situation of attitudes toward seeking professional psychological help among parents of premature infants, and to analyze its influencing factors.Methods:From January to September 2019, this study selected 121 parents of premature infants at two ClassⅢ Grade A hospitals of Zhejiang Province as subjects by convenience sampling. Those parents were investigated with the General Information Questionnaire, the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF) , Simplified Coping Style Questionnaire (SCSQ) and the General Self-Efficacy Scale (GSES) . A total of 121 questionnaires were sent out and 112 valid questionnaires were collected with 92.6% for the valid recovery rate.Results:Among 112 parents of premature infants, the total score of ATSPPH-SF was (18.11±3.76) . There were statistical differences in the total score of ATSPPH-SF among parents with different body weight of premature infants, parents' genders, places of residence and family monthly income ( P<0.05) . Among parents of premature infants, the total score of ATSPPH-SF had a positive correlation with positive coping style ( r=0.337, P<0.05) , and had negative correlations with scores of negative coping style and self-efficacy ( r=-0.319, -0.296, P<0.05) . Multiple linear regression analysis showed that the influencing factors of attitudes toward seeking professional psychological help among parents of premature infants included the body weight of premature infants, family monthly income, positive coping style and self-efficacy with statistical differences ( P<0.05) . Conclusions:Nursing managers should pay attention to the attitudes toward seeking professional psychological help among parents of premature infants, especially in those with low levels of body weight of premature infants, family monthly income and self-efficacy. Nursing managers also should help them to establish the positive coping style so as to improve parents' acceptance of seeking professional psychological help.

Objective To investigate the difference of the motif patterns in brain directed functional network between first-episode schizophrenia patients and healthy controls, and to analysis the alterations of the underlying information flow patterns in patient networks. Methods The resting-state functional MRI data were collected from 44 first-episode schizophrenia patients and 39 healthy controls. The convergent cross mapping approach was employed to measure the causality connections between brain regions, and the directed functional networks were constructed. The calculations of the frequency and probability spectrum of all motif classes were performed at both whole brain and modular connected level. The between-group difference was then calculated. Results Compared with healthy controls, the frequency spectrum values of all motif classes in schizophrenia were significantly reduced (P＜0.05, FDR corrected), the Z scores of frequency spectrum of were decreased in chain-like motifs and increased in loop-like motifs. In the two groups, the probability values were higher at modular level than at whole brain level in two loop-like motifs (P＜0.05). Conclusion The present study revealed a loss in brain directed functional connections and abnormal alterations in the basic information flow patterns in first-episode schizophrenia brain.