OBJECTIVE T o investigate the pathogenic bacteria causing postoperative infection in patients with diabe-tes undergoing orthopedic surgery and analyze the risk factors for such postoperative infections.METHODS A total of 140 patients with diabetes who underwent orthopedic surgery at the Second Affiliated Hospital of Guangxi Med-ical University from Jan.2023 to Dec.2024 were selected.Based on postoperative infection status,they were di-vided into an infection group(n=24)and a non-infection group(n=116).The two groups were compared in terms of gender,age,body mass index,blood glucose levels,operation time,surgical approach,incision length and other indicators.Logistic regression analysis was performed to explore the risk factors for postoperative infec-tion in patients with diabetes undergoing orthopedic surgery.Additionally,the infected strains and levels of in-flammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)]were measured.RESULTS Among the 140 patients,24 cases developed postoperative infections,with an incidence rate of 17.14％(24/140).The majority of infections occurred at the incision site(45.83％).The levels of IL-6,TNF-α and CRP in the infection group were(2.71±0.43)ng/ml,(9.71±1.58)ng/ml and(11.62±1.35)mg/L,respectively,significantly higher than those in the non-infection group(P＜0.05).HbA1c level(OR=5.987)and incision type(OR=9.356)were identified as risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery(P＜0.05).A total of 31 pathogenic bacteria were isolated from specimens of infec-ted patients,including 21 gram-positive bacteria(67.74％)and 9 gram-negative bacteria(29.03％),with Staphy-lococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.CONCLUSIONS The postop-erative infection rate is high among patients with diabetes undergoing orthopedic surgery.Risk factors include HbA1c level and incision type,with Staphylococcus aureus and Staphylococcus epidermidis being the main path-ogenic bacteria.

Objective:To investigate the factors influencing the efficacy of etanercept in the treatment of toxic epidermal necrolysis (TEN) across different countries and regions.Methods:A total of 17 articles (case analyses or case reports) were selected through a comprehensive search in 4 Chinese databases (CNKI, Wanfang, VIP, and SinoMed) and 4 English databases (PubMed, Cochrane Library, Embase, and Elsevier SD). Clinical data from 52 patients originating from 7 countries were collected. Independent variables included age, sex, race, culprit drugs, disease severity, presence or absence of complications, initial dose, timing of administration, number of administrations of etanercept, and combination therapy; and the duration of hospitalization served as the dependent variable. Univariate and multiple linear regression analyses were conducted sequentially.Results:Among the 52 patients, 26 were male and 26 were female, with a median age M ( Q1, Q3) of 57.0 (36.0, 71.5) years. The median hospitalization duration was 12.0 (8.0, 17.5) d, and the median severity-of-illness score for TEN (SCORTEN) was 2 (2, 4). A total of 33 patients (63.5%) had at least one comorbidity. The initial etanercept dose was 50 mg in 37 patients (71.2%). The median timing of etanercept administration was 3 (3, 6) days after disease onset. Etanercept was used as monotherapy in 26 patients (50.0%) and as combination therapy in 26 patients (50.0%). Multiple linear regression analysis showed that age (partial regression coefficient β [95% CI]: -0.106 [-0.194, -0.018]), disease severity (2.216 [0.452, 3.980]), timing of administration (1.343 [0.827, 1.858]), and combination therapy (11.993 [4.149, 19.838]) significantly influenced the hospitalization duration of TEN patients (all P < 0.05). However, sex, race, presence of comorbidities, initial dose, and number of administrations did not affect hospitalization duration (all P > 0.05). Based on the standardized regression coefficients, the factors influencing hospitalization duration in TEN patients were ranked from strongest to weakest as follows: timing of administration (0.632), combination therapy (0.595), disease severity (0.337), and age (-0.233) . Conclusions:Early administration of etanercept is the key to achieving clinical benefit in the treatment of TEN. In cases where the response is inadequate or the condition is severe, combination therapy may be considered.

Occupational health technical service (OHTS) is one of the core contents in the technical support system of occupational disease prevention and control, and efficient management of OHTS institutions is necessary for improving the service ability. At present, OHTS institutions in China face several issues, such as uneven distribution in terms of quantity, function, unclear area coverage and roles and overlapping responsibilities among different types of institutions, and insufficient service capabilities with inconsistent service levels in some institutions. With the implementation of the national reform like the “separating permits from business license” and “delegate power, streamline administration and optimize government services"”policies, the management mode and operational approach of OHTS institutions have been profoundly changed. In light of this, five key recommendations are proposed to improve the management of OHTS institutions and enhance their management effectiveness, ensuring the sustainable development of national OHTS services. Firstly, it is necessary to clarify the relationship between national and provincial administrative levels in managing OHTS institutions to ensure their healthy and orderly development. Secondly, multiple measurements are taken to strengthen OHTS institutional capacity building to address regional disparities in technical capabilities and service quality. Thirdly, both technical capabilities and service quality should be focused on strengthening the supervision and management of OHTS institutions, preventing the decline of key conditions such as staffing, laboratories, equipment, and quality management after obtaining qualifications. Fourthly, “dual randomized- inspections and one open” and “internet+supervision” methods are used as basic tools for managing OHTS institutions operating across multiple provincial regions and enforcing cross-regional law. Fifthly, professional integrity of radiological health service institutions should be restored to effectively apply their technical advantages in their specialized fields.

Objective:To investigate the factors influencing the efficacy of etanercept in the treatment of toxic epidermal necrolysis (TEN) across different countries and regions.Methods:A total of 17 articles (case analyses or case reports) were selected through a comprehensive search in 4 Chinese databases (CNKI, Wanfang, VIP, and SinoMed) and 4 English databases (PubMed, Cochrane Library, Embase, and Elsevier SD). Clinical data from 52 patients originating from 7 countries were collected. Independent variables included age, sex, race, culprit drugs, disease severity, presence or absence of complications, initial dose, timing of administration, number of administrations of etanercept, and combination therapy; and the duration of hospitalization served as the dependent variable. Univariate and multiple linear regression analyses were conducted sequentially.Results:Among the 52 patients, 26 were male and 26 were female, with a median age M ( Q1, Q3) of 57.0 (36.0, 71.5) years. The median hospitalization duration was 12.0 (8.0, 17.5) d, and the median severity-of-illness score for TEN (SCORTEN) was 2 (2, 4). A total of 33 patients (63.5%) had at least one comorbidity. The initial etanercept dose was 50 mg in 37 patients (71.2%). The median timing of etanercept administration was 3 (3, 6) days after disease onset. Etanercept was used as monotherapy in 26 patients (50.0%) and as combination therapy in 26 patients (50.0%). Multiple linear regression analysis showed that age (partial regression coefficient β [95% CI]: -0.106 [-0.194, -0.018]), disease severity (2.216 [0.452, 3.980]), timing of administration (1.343 [0.827, 1.858]), and combination therapy (11.993 [4.149, 19.838]) significantly influenced the hospitalization duration of TEN patients (all P < 0.05). However, sex, race, presence of comorbidities, initial dose, and number of administrations did not affect hospitalization duration (all P > 0.05). Based on the standardized regression coefficients, the factors influencing hospitalization duration in TEN patients were ranked from strongest to weakest as follows: timing of administration (0.632), combination therapy (0.595), disease severity (0.337), and age (-0.233) . Conclusions:Early administration of etanercept is the key to achieving clinical benefit in the treatment of TEN. In cases where the response is inadequate or the condition is severe, combination therapy may be considered.

OBJECTIVE T o investigate the pathogenic bacteria causing postoperative infection in patients with diabe-tes undergoing orthopedic surgery and analyze the risk factors for such postoperative infections.METHODS A total of 140 patients with diabetes who underwent orthopedic surgery at the Second Affiliated Hospital of Guangxi Med-ical University from Jan.2023 to Dec.2024 were selected.Based on postoperative infection status,they were di-vided into an infection group(n=24)and a non-infection group(n=116).The two groups were compared in terms of gender,age,body mass index,blood glucose levels,operation time,surgical approach,incision length and other indicators.Logistic regression analysis was performed to explore the risk factors for postoperative infec-tion in patients with diabetes undergoing orthopedic surgery.Additionally,the infected strains and levels of in-flammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)]were measured.RESULTS Among the 140 patients,24 cases developed postoperative infections,with an incidence rate of 17.14％(24/140).The majority of infections occurred at the incision site(45.83％).The levels of IL-6,TNF-α and CRP in the infection group were(2.71±0.43)ng/ml,(9.71±1.58)ng/ml and(11.62±1.35)mg/L,respectively,significantly higher than those in the non-infection group(P＜0.05).HbA1c level(OR=5.987)and incision type(OR=9.356)were identified as risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery(P＜0.05).A total of 31 pathogenic bacteria were isolated from specimens of infec-ted patients,including 21 gram-positive bacteria(67.74％)and 9 gram-negative bacteria(29.03％),with Staphy-lococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.CONCLUSIONS The postop-erative infection rate is high among patients with diabetes undergoing orthopedic surgery.Risk factors include HbA1c level and incision type,with Staphylococcus aureus and Staphylococcus epidermidis being the main path-ogenic bacteria.

Scars are classified into 5 types:Superficial scars,hypertrophic scars,atrophic scars,depressed scars,and keloid.These types are primarily characterized by abnormal production of fibroblasts and collagen,as well as the disorderly arrangement of connective tissue.Laser treatment for scars involves the coordinated activation of various signaling pathways and cytokines.However,the exact pathological mechanism for scar formation remains unclear,leading to a lack of radical treatment.Recently,laser treatment has gained popularity as a new minimally invasive approach for scar treatment.The emergence of new theories such as fractional,picosecond laser,and laser-assisted drug delivery has led to continuous advance in laser treatment.Up to now,it has been developed numerous novel treatments,including combined with drug,physical,and other treatments,which have shown superior therapeutic effects.In order to optimize laser treatment in the future,it is crucial to combine new materials with postoperative care.This will help clinicians develop more comprehensive treatment strategies.Therefore,it is important to explore treatment options that have broader applicability.

The correspondence between prescription and syndrome is the advantage and characteristic of traditional Chinese medicine(TCM)treatment.However,the pathogenesis of clinical diseases is complex and the condition is changeable,and the clinical application is difficult to achieve the maximum effect under the existing cognition of the correspondence between prescription and syndrome.In this paper,the five categories of physiological characteristics,pathological characteristics,constitution,syndrome,and disease of the longitudinal classification of"TCM state"are introduced into the correspondence of prescription and syndrome.Under the vertical perspective of"TCM state",the theoretical connotation of the correspondence between prescription and syndrome is interpreted as"correspondence between prescription and state",namely correspondence of"prescription-physiological characteristics",correspondence of"prescription-pathological characteristics",correspondence of"prescription-constitution",correspondence of"prescription-syndrome",and correspondence of"prescription-disease".It is hoped to accurately grasp the corresponding connotation of the correspondence between prescription and syndrome,in order to deepen the clinical thinking mode of TCM.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Diabetic osteoporosis(DOP)is a serious complication of diabetes mellitus(DM),with bone loss and microstructure destruction.The onset of DOP is insidious,and early symptoms are not obvious.As the condition progresses,the disability and mortality rates increase in DM patients.The advanced glycation end products receptor(AGEs-RAGE)axis can mediate different signaling pathways involved in regulating osteoblasts.This article reviews the mechanism of AGEs-RAGE axis mediated p38 mitogen activated protein kinase signaling pathway in regulation of osteoblasts in DOP.

BACKGROUND:At present,a large number of studies have found that Liuwei Dihuang Pill can be used to treat osteoporosis,but there are few related studies on the differentiation and mineralization of osteoblasts induced by wear particles using Liuwei Dihuang Pill. OBJECTIVE:To investigate the positive effect of different concentrations of Liuwei Dihuang Pill-containing serum on titanium particle-induced mouse MC3T3-E1 osteoblast in vitro osteolysis model. METHODS:Drug-containing serum was extracted after oral administration of Liuwei Dihuang Pill.The best concentration of Liuwei Dihuang Pill-containing serum and titanium particles on the viability of MC3T3-E1 cells was screened.MC3T3-E1 cells were divided into three groups.The blank group was given osteoblastic differentiation culture.The model group was given titanium particles(5 μg/mL)ossification culture.The drug-containing serum group was given titanium particles(5 μg/mL)+ Liuwei Dihuang Pill-containing serum(10%,15%and 20%doses).Osteoblast viability was detected by CCK-8 assay.Cell alkaline phosphatase activity was detected by alkaline phosphatase staining.Cell mineralization was detected by silver nitrate(Von Kossa)and alizarin red staining.Expression levels of bone differentiation-related genes Runx-2,Osterix,Ocn,Axin,Alp,and Opn were detected by qRT-PCR.Wnt/β-catenin signaling pathways β-catenin,p-GSK-3β,GSK-3β,Runx2 and Osterix protein expression levels were detected by western blot assay. RESULTS AND CONCLUSION:(1)Liuwei Dihuang Pill-containing serum culture reversed the decrease in alkaline phosphatase activity of MC3T3E-1 cells induced by titanium particles,increased the alizarin red staining and calcification of MC3T3E-1 cells,increased the expression of osteogenesis-related genes in MC3T3E-1 cells,and increased the expression of proteins related to the Wnt/β-catenin signaling pathway.(2)These findings indicate that Liuwei Dihuang Pill-containing serum can reverse the inhibitory effect of titanium particles on the differentiation and mineralization of osteoblasts,upregulate the expression of osteogenesis-related genes,and its mechanism is related to the regulation of Wnt/β-catenin signaling pathway,suggesting that Liuwei Dihuang Pill is expected to become an effective drug for preventing aseptic loosening of artificial joints.