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 evaluate the clinical efficacy of Long's spinal manipulation therapy combined with four postures of rotational tendon-releasing maneuver in treating lumbar disc herniation(LDH).Methods Sixty-eight patients diagnosed with LDH were enrolled from the Department of Acupuncture and Rehabilitation at Guangdong Second Traditional Chinese Medicine Hospital between July 2024 and December 2024.Patients were randomly divided into an observation group and a control group using a random number table,with 34 cases in each group.The control group received Long's spinal manipulation therapy,while the observation group received additional training in four postures of rotational tendon-releasing maneuver.Both groups were treated for 2 weeks,with a 1-month follow-up.Clinical efficacy was evaluated after treatment by comparing Visual Analogue Scale(VAS)scores,Oswestry Disability Index(ODI)scores,and Japanese Orthopaedic Association(JOA)scores before and after intervention.Spinal parameters including maximum lumbar curvature angle,pelvic tilt angle,and maximum vertebral rotation angle were assessed using the DIERS formetric 3D evaluation system.Results(1)The total effective rate was 94.12%(32/34)in the observation group and 91.18%(31/34)in the control group,and both groups achieved ideal therapeutic efficacy,but the difference was not statistically significant(P＞0.05).(2)After treatment,the VAS scores of patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving VAS scores,with statistically significant differences(P＜0.05).At the 1-month follow-up after treatment,the VAS score of the observation group significantly improved(P＜0.05),and the observation group was significantly superior to the control group,and the difference was statistically significant(P＜0.05).(3)After treatment,the JOA and ODI scores of the patients in the two groups significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the JOA and ODI scores,and the difference was statistically significant(P＜0.05).At 1-month follow-up after treatment,JOA and ODI scores of the observation group significantly improved(P＜0.05),and the observation group was significantly superior to the control group,with statistically significant differences(P＜0.05).(4)After treatment,the maximum angle of lumbar flexion,pelvic torsion angle,and maximum rotation angle of the vertebral body of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly better than the control group,and the difference was statistically significant(P＜0.05).At the 1-month follow-up after treatment,the maximum angle of lumbar flexion,pelvic torsion angle,and maximum vertebral rotation angle of the observation group were significantly improved(P＜0.05),and the observation group was significantly superior to the control group,and the difference was statistically significant(P＜0.05).Conclusion The combination of Long's spinal manipulation therapy and four postures of rotational tendon-releasing maneuve significantly improves spinal alignment,reduces pain and disability,and enhances quality of life in patients with LDH,demonstrating notable clinical efficacy.

OBJECTIVE To investigate the effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease （NAFLD）. METHODS Thirty-two SD rats were randomly divided into normal group and modeling group. The modeling group was fed a high-fat diet to establish a NAFLD model. The successfully modeled rats were then randomly divided into model group， atorvastatin group[positive control， 2 mg/（kg·d）]， and Jingangteng capsules low- and high-dose groups [0.63 and 2.52 mg/（kg·d）]， with 6 rats in each group. The pathological changes of the liver were observed by hematoxylin-eosin staining and oil red O staining. Enzyme-linked immunosorbent assay was performed to determine the serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine transaminase （ALT）， aspartate transaminase （AST）， tumour necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-18. 16S rDNA amplicon sequencing and metabolomics techniques were applied to explore the effects of Jingangteng capsules on gut microbiota and metabolisms in NAFLD rats. Based on the E-mail：591146765@qq.com metabolomics results， Western blot analysis was performed to detect proteins related to the nuclear factor kappa-B （NF-κB）/NOD-like receptor family protein 3 （NLRP3） signaling pathway in the livers of NAFLD rats. RESULTS The experimental results showed that Jingangteng capsules could significantly reduce the serum levels of TG， TC， LDL-C， AST， ALT， TNF-α， IL-1β， IL-6， IL-18， while increased the level of HDL-C， and alleviated the hepatic cellular steatosis and inflammatory infiltration in NAFLD rats. They could regulate the gut microbiota disorders in NAFLD rats， significantly increased the relative abundance of Romboutsia and Oscillospira， and significantly decreased the relative abundance of Blautia （P＜0.05）. They also regulated metabolic disorders primarily by affecting secondary bile acid biosynthesis， fatty acid degradation， O-antigen nucleotide sugar biosynthesis， etc. Results of Western blot assay showed that they significantly reduced the phosphorylation levels of NF-κB p65 and NF-κB inhibitor α， and the protein expression levels of NLRP3， caspase-1 and ASC （P＜0.05 or P＜0.01）. CONCLUSIONS Jingangteng capsules could improve inflammation， lipid accumulation and liver injury in NAFLD rats， regulate the disorders of gut microbiota and metabolisms， and inhibit NF-κB/NLRP3 signaling pathway. Their therapeutic effects against NAFLD are mediated through the inhibition of the NF-κB/NLRP3 signaling pathway.

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.

Probiotics can improve the microecological balance of the body and have special effects in promoting nutrient absorption, controlling intestinal infections, and regulating immune function. However, there are problems such as difficult colonization in the gastrointestinal environment and low oral bioavailability. Bacterial biofilms are organized bacterial cells that adhere to an abiotic or biotic surface and are enclosed in extracellular polymeric substances of exopolysaccharides (EPS), extracellular DNA (eDNA), proteins and lipids, with a three-dimensional spatial structure. Probiotics with the help of bacterial biofilms have obvious advantages over planktonic bacteria in stress resistance, combating pathogens and modulating the host's immune function, which provides a new research idea for the development of probiotics. This paper expounded on the advantages of probiotics with the help of bacterial biofilms, and focused on introducing substances that could promote the formation of probiotic biofilms and the mechanisms, and the safety of probiotic biofilms. Currently, research on probiotic biofilms is still in its infancy, and this paper is expected to provide references for future research in this field.
Bacteria ; Biofilms ; Extracellular Polymeric Substance Matrix ; Probiotics

Numerous studies have reported that the resistance of biofilm bacteria to antibiotics can be up to 10-1 000 fold higher than that of planktonic bacteria. Bacterial biofilms are reported to be responsible for more than 80% of human microbial infection, posing great challenges to the healthcare sector. Many studies have reported that plant extracts and their active ingredients can inhibit the formation and development of bacterial biofilms, including reducing biofilm biomass and the number of viable bacteria in biofilms, as well as eradicating mature biofilms. This review summarized the plant extracts and their active ingredients that are inhibitory to bacterial biofilms, and analyzed the underpinning mechanisms. This review may serve as a reference for the development of plant drugs to prevent and treat biofilm infections.
Anti-Bacterial Agents/pharmacology* ; Bacteria ; Biofilms ; Humans ; Plant Extracts/pharmacology* ; Quorum Sensing