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.

COVID-19 ; Female ; Humans ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy* ; Pregnancy Outcome ; Premature Birth ; Retrospective Studies ; SARS-CoV-2

Objective:To evaluate the effects of dexamethasone on systemic lupus erythematosus complicated with cognitive dysfunction.Methods:Ten wild type mice and 20 MRL/lpr mice were applied for the research.MRL/lpr mice were randomly assigned to a MRL/lpr group and a MRL/lpr + dexamethasone (1.5 mg/kg) group.Interleukin-6 (IL-6),IL-1β,and tumor necrosis factor alpha (TNF-α) in serum and hippocampus were detected.The protein phosphorylation levels of phosphoinositide 3-kinase (P-PI3K),protein kinase B (P-Akt),NF-kappa-B inhibitor alpha (P-IκBa) and nuclear transcription factor kappa-B p65 (P-NF-κB p65) were detected by Western blot,the level of P-NF-κB p65 also was detected by immunohistochemistry.Results:Treatment with dexamethasone (1.5 mg/kg) alleviated the cognitive dysfunction and decreased the levels of IL-6,IL-1 β and TNF-α in serum and hippocampus,and reduced the levels of P-PI3K,P-Akt,P-IκBa and P-NF-κB p65 in hippocampus in MRL/lpr mice.Conclusion:Dexamethasone may play a protective role in the cognitive function by decreasing the levels of TNF-α and IL-1 β in the hippocampus of MRL/lpr lupus mice.

Heuristic teaching is propitious to cultivating students' ideation. We have used different heuristic modes for example problems, stories, contrast, associationin and so on to cultivate medical students' ideation in pathobiology and immunology teaching and acquired good effect.

Objective To evaluate the efficacy and safety of combined intravenous(Ⅳ)and intra-arterial(IA)thrombolysis in patients with acute ischemic stroke.Methods A prospective and open-label trial was performed on 40 patients with acute ischemic stroke in the carotid artery system within 3 hours of symptom onset,admitted to our hospital from May 2005 to February 2009; these patients were treated with recombinant tissue plasminogen activator(rt-PA)by a combined Ⅳ and IA thrombolysis approach.The percentage of favorable prognosis,incidence of symptomatic intraeranial haemorrhage(SICH)and fatality rate in these patients were compared with those research results from foreigners having large samples.Results According to the results of DSA,recanalization rate (grade-2 or-3 in the Thrombolysis in Cerebral Infarction[TICI]scale)after Ⅳ thrombolysis was 25％(10/40),rate of serious cerebrovascular stenosis was 7.5％(3/40),including 2 patients with stenosis of the internal carotid artery(ICA)and 1 with stenosis of the middle cerebral artery(MCA),and rate of vascular occlusion was 67.5％(27/40),including 9 patients with ICA occlusion and 18 with MCA occlusion.Twenty-four patients adopted combined Ⅳ and IA thrombolysis approach after 180-390 min(mean[304±61]min)of stroke onset,and their recanalization rate was 79.2％(19/24).Re-infarction rate was 7.5％(3/40).Three months after the thrombolysis,percentage of good functional outcomes(modified Rankin Scale[mRS])scores:0-2)was 60％(24/40),which had significant differences as compared with that with NINDS placebo treatment(27.2％[85/312],P＜0.05); percentage of good functional outcomes(NIHSS score ≤ 1)was 52.5％(21/40),which had significant differences as compared with that of groups with NINDS rt-PA treatment(31％[97/312]),NINDS placebo treatment(20％[62/312])and interventionalmanagement of stroke(IMS,27.5％[22/80]),P＜0.05); SICH was noted in 2.5％(1/40)and fatality in 10％(4/40)accepted thrombolysis,and no significant differences were noted as compared with those in groups with NINDS rt-PA treatment,NINDS placebo treatment,emergency management of stroke EMS and IMS (P＞0.05).Conclusion Combined Ⅳ and IA thrombolysis is an effective and safe new method in treating patients with acute ischemic stroke by providing good vascular recanalization rate and good clinical outcomes.

Adult ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVESTo discuss the methods and outcome of shorting proximal femoral and total hip arthroplasty for Crowe IV dysplastic hip of adults.

METHODSFrom July 2000 to February 2006, 13 cases of osteoarthritis secondary to severe development dysplastic hip were treated by total hip replacement and the shorting proximal femoral.

RESULTSThe duration of follow-up ranged from 4 months to 55 months. The average score increased from 36.9 to 84.1 points after the surgery according to Harris. All the patients could walk independently. Their paces were improved obviously and the function of their hips was satisfactory.

CONCLUSIONSThe treatment by total hip arthroplasty and the shorting of posterior femoral is effective and efficient for osteoarthritis secondary to Crowe IV development dysplastic hip in adults. The long-term followup is necessary for further study.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur ; surgery ; Follow-Up Studies ; Hip Dislocation ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Osteotomy ; methods ; Retrospective Studies ; Treatment Outcome