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.

To investigate the characteristics and differences of immune cell infiltration between different SDHx gene expression and pheochromocytoma/paraganglioma(PPGL).

Doxorubicin (Dox) is an anthracycline drug widely applied in various malignancies. However, the fatal cardiotoxicity induced by Dox limits its clinical application. Post-transcriptional protein modification via ubiquitination/deubiquitination in cardiomyocytes mediates the pathophysiological process in Dox-induced cardiotoxicity (DIC). In this study, we aimed to clarify the regulatory role and mechanism of a deubiquitinating enzyme, ubiquitin-specific peptidase 13 (USP13), in DIC. RNA-seq analysis and experimental examinations identified that cardiomyocyte-derived USP13 positively correlated with DIC. Mice with cardiac-specific deletion of USP13 were subjected to Dox modeling. Adeno-associated virus serotype 9 (AAV9) carrying cTNT promoter was constructed to overexpress USP13 in mouse heart tissues. Cardiomyocyte-specific knockout of USP13 exacerbated DIC, while its overexpression mitigated DIC in mice. Mechanistically, USP13 deubiquitinates the stimulator of interferon genes (STING) and promotes the autolysosome-related degradation of STING, subsequently alleviating cardiomyocyte inflammation and death. Our study suggests that USP13 serves a cardioprotective role in DIC and indicates USP13 as a potential therapeutic target for DIC treatment.

Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

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:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

Objective:To explore the spousal correlations of total cholesterol(TC),total triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),and to investigate the reasons behind these spousal correlations.Methods:Participants and data were from the baseline survey of family-based cohort studies in Fangshan,Beijing and Tulou,Fujian.The ori-gin of spousal correlations were explored from perspectives of convergence,assortative mating,social ho-mogamy.Pearson's correlation and generalized linear models(GLM)were used to estimate the spousal correlation.Convergence was assessed by Pearson's correlation between the phenotypic differences be-tween couples and the duration of marriage,with GLM used for further validation.Pearson's correlation of genetic risk scores(GRS)and couple-specific Mendelian randomization(MR)were calculated to assess the genetic correlation and possible causal relationships between spouses.Two-independent-sample t-tests were used to compare GRS consistency across subgroups divided by education attainment,couple-specific MR and Q statistics used to test assortative mating in subgroups and intergroup differences.Results:In the study,342 couples(287 couples from Fangshan and 55 couples from Fujian)were included,with the average age of(64.91±8.76)years.Spousal correlations of TC,TG,HDL-C,and LDL-C showed statistically significant associations both before and after adjusting for covariates,with effect sizes of 0.229(95％CI:0.125-0.327),0.257(95％CI:0.155-0.354),0.179(95％CI:0.074-0.280),and 0.181(95％CI:0.076-0.282).For convergence,for each additional year of marriage,ΔTC increased by 0.016 mmol/L(95％CI:0.001-0.033 mmol/L),and ΔLDL-C increased by 0.017 mmol/L(95％CI:0.002-0.031 mmol/L).For assortative mating,GRS correlations and results of couple specific MR didn't show any statistical significance.For social homogamy,no differences in GRS or assortative mating were found between subgroups stratified by education attainment.Conclusion:The blood lipid in participants exhibit spousal phenotypic correlations,however,no effects of convergence,assortative mating or social homogamy were observed.More independent studies with larger sample sizes are warranted to further validate these findings in the future.

Objective:To study the effects of chlorhexidine (CHX) and ethylene diamine tetraacetic acid (EDTA) on adhesive properties of moderate fluorosis dentin.Methods:From August to September 2024, a total of 30 freshly extracted, non-carious and non-defective mandibular molars with moderate dental fluorosis, extracted for impaction or orthodontic reasons, were collected from the patients at the Department of Oral and Maxillofacial Surgery at Guiyang Stomatological Hospital and randomly divided into three groups (Groups A, B, and C, n = 10) using a simple randomization method, and pretreated for 60 s with normal saline (Group A), 17%EDTA gel (Group B), and 2%CHX solution (Group C), respectively. Subsequently, microtensile bonding strength testing and microleakage evaluation were performed. Results:The immediate bonding strengths of Groups A, B, and C were (14.23 ± 4.75), (20.94 ± 7.46), and (28.76 ± 14.61) MPa, respectively, and the bonding strengths after aging were (9.89 ± 3.81), (19.05 ± 7.85), and (22.15 ± 8.67) MPa, respectively. There were statistically significant differences in both immediate and aged bonding strengths among the three groups ( F = 6.08, 8.07, P = 0.010, 0.002). The immediate bonding strength of Group C was significantly higher than that of Group A ( P < 0.05), and the post aging bonding strength of both Group B and Group C was significantly higher than that of Group A ( P < 0.05). The proportion of silver staining area with microleakage in Groups A, B, and C were 21.87% (14.65%, 40.15%), 2.34% (1.87%, 5.29%), and 17.54% (4.59%, 20.47%), respectively, with statistically significant differences among the three groups ( H = 27.36, P = 0.001). The proportion of silver stained area with microleakage in Group B was significantly lower than that in Group A and Group C, and the difference was statistically significant ( P < 0.05). Conclusions:Pretreatment of moderate fluorosis dentin with 2%CHX or 17%EDTA can improve resin bongding performance, with EDTA being superior in reducing microleakage and CHX being better in enhancing adhesion strength.

Objective:To investigate the learning curves of gastroscopy and colonoscopy for surgeons.Methods:Clinical data of ordinary digestive endoscopy performed by gastrointestinal surgeons in Peking University People's Hospital from March, 2022 to March, 2024 were collected retrospectively. Learning curves were plotted according to the number of examinations and learning time, and the cumulative sum control chart method was used to determine the number of cases required to achieve proficiency in endoscopic examination.Results:Six gastrointestinal surgeons (sequentially) received training in gastroscopy and colonoscopy. All surgeons were male physicians with a doctoral degree and the professional title of attending physician. The average age was (33.0 ±1.9) years, and the average job tenure was (4.0±1.8) years. The median time required for proficiency in gastroscopy was 31 weeks, with a median number of cases of 624. Similarly, the median time required for proficiency in colonoscopy was also 31 weeks but with a median number of cases of 470.Conclusions:Surgeons need at least 31 weeks of independent operation to become proficient in endoscopic examination and more than 600 cases to be proficient in gastroscopy. Surgeons with gastroscopy experience also need 31 weeks of independent operation but at least 450 cases to become proficient in colonoscopy.

Objective:To study the effects of chlorhexidine (CHX) and ethylene diamine tetraacetic acid (EDTA) on adhesive properties of moderate fluorosis dentin.Methods:From August to September 2024, a total of 30 freshly extracted, non-carious and non-defective mandibular molars with moderate dental fluorosis, extracted for impaction or orthodontic reasons, were collected from the patients at the Department of Oral and Maxillofacial Surgery at Guiyang Stomatological Hospital and randomly divided into three groups (Groups A, B, and C, n = 10) using a simple randomization method, and pretreated for 60 s with normal saline (Group A), 17%EDTA gel (Group B), and 2%CHX solution (Group C), respectively. Subsequently, microtensile bonding strength testing and microleakage evaluation were performed. Results:The immediate bonding strengths of Groups A, B, and C were (14.23 ± 4.75), (20.94 ± 7.46), and (28.76 ± 14.61) MPa, respectively, and the bonding strengths after aging were (9.89 ± 3.81), (19.05 ± 7.85), and (22.15 ± 8.67) MPa, respectively. There were statistically significant differences in both immediate and aged bonding strengths among the three groups ( F = 6.08, 8.07, P = 0.010, 0.002). The immediate bonding strength of Group C was significantly higher than that of Group A ( P < 0.05), and the post aging bonding strength of both Group B and Group C was significantly higher than that of Group A ( P < 0.05). The proportion of silver staining area with microleakage in Groups A, B, and C were 21.87% (14.65%, 40.15%), 2.34% (1.87%, 5.29%), and 17.54% (4.59%, 20.47%), respectively, with statistically significant differences among the three groups ( H = 27.36, P = 0.001). The proportion of silver stained area with microleakage in Group B was significantly lower than that in Group A and Group C, and the difference was statistically significant ( P < 0.05). Conclusions:Pretreatment of moderate fluorosis dentin with 2%CHX or 17%EDTA can improve resin bongding performance, with EDTA being superior in reducing microleakage and CHX being better in enhancing adhesion strength.