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 effect of Isoorientin(Iso)on development of oral squamous cell carcinoma(OSCC)and the regulation on immune response mediated by cGAS-STING signaling pathway.Methods:CAL 27 cells were divided into control group,low,medium and high concentration Iso groups and high concentration Iso+cGAS inhibitor group(high concentration Iso+RU.521 group).Proliferation activity of CAL 27 cells was detected by MTT;TUNEL method was applied to detect apoptosis of CAL 27 cells;Transwell chamber test was applied to detect migration and invasion of CAL 27 cells;Western blot was applied to detect expressions of cGAS-STING pathway related proteins in CAL 27 cells;the tumor transplantation model of mice was prepared,and the tumor inhibi-tion rate was calculated.At the same time,peripheral blood was taken to detect the differentiation of T lymphocyte subsets in peripheral blood of mice in each group by flow cytometry.Results:Compared with control group,proliferation activity,numbers of migration and invasive cells in Iso treated groups were decreased,apoptosis rate,expressions of cGAS,STING protein,and phosphorylation expres-sions of TBK1,IRF3,tumor inhibition rate of mice,and percentages of CD4+T,CD8+T cells in peripheral blood were increased(P<0.05);further use of cGAS inhibitors reversed the inhibitory effect of Iso on development of OSCC and the promotion on cGAS-STING signaling pathway(P<0.05).Conclusion:Iso can inhibit the development of OSCC by activating the immune response mediated by cGAS-STING signaling pathway.

Objectives:To investigate the clinical efficacy of the distal tension-offloading cosmetic suture technique in reducing hypertrophic scar formation following open thyroidectomy.Methods:Clinical data and postoperative incision appearance of 138 patients undergoing open thyroidectomy at the Department of Thyroid and Neck Oncology of Tianjin Medical University Cancer Institute and Hospital, as well as the Department of Head and Neck Oncology of Tianjin Cancer Hospital Airport Hospital, from Aug 2023 to Jan 2024 was enrolled. Patients were devided into two groups based on the incision closure method: the distal tension-offloading cosmetic suture group (tension reduction group, 37 cases) and ordinary intradermal suture group (control group A, 55 cases evaluated 3 months post-surgery; control group B, 46 cases evaluated 6 months post-surgery). The Vancouver Scar Scale (VSS) was employed to assess the appearance of the wounds at 3 and 6 months post-surgery .Results:On 3 and 6 months post-surgery, the total VSS scores for patients in the tension reduction group were 2.8 ± 2.3 and 2.5 ± 2.5, respectively,while that in control group A on 3 months was 5.2 ± 3.0, and in group B on 6 months was 5.3 ± 3.4. The differences were statistically significant (all P<0.001). On 3 and 6 months post-surgery, the proportions of hypertrophic scars in the tension reduction group were 14% (5/37) and 11% (4/37), respectively , while in control group A it was 35% (19/55) , and in control group B was 35% (16/46) at 6 months, with differences being statistically significant ( P=0.024, 0.011 ). On 6 months post-surgery, 51 % (19/37) of patients in the tension reduction group achieved 'socially invisible aesthetic incisions', while only 15% (7/46) of patients in control group B achieved the same outcome ( P<0.01). Conclusion:Distal tension-offloading cosmetic suture significantly reduces the incidence of incision hypertrophic scars in open thyroid surgery.

Through literature research,this study expounds the emergence of wholly foreign-owned hospitals(WFOHs)from both policy formulation and intrinsic demand perspectives.By accessing the current services landscape of WFOHs,the study systematically analyzes their developmental opportunities and challenges.Strategic recommendations are subsequently proposed across four key aspects:strengthening regulatory supervision,improving the medical insurance system,enhancing professional workforce development,and promoting Sino-foreign cooperation.These measures aim to facilitate WFOHs'high-quality develop-ment,thereby elevating institutional competitiveness,driving continuous healthcare service innovation,and ultimately delivering enhanced medical care that is efficient,accessible,and patient-centered.

OBJECTIVE To investigate the effect and underlying mechanism of hydroxytyrosol(HT)on mouse chondrocyte injury induced by oxidative stress.METHODS Mouse chondrocytes were incubated with varying concentrations of HT 0-400 μmol L-1 for 24 h,and the viability of the mouse chondrocytes was assessed using CCK-8 kit.An oxidative stress model of chondrocytes was estab-lished by the addition of H2O2 200 μmol L-1.The experimental groups included the cell control group,H2O2 group,and H2O2+HT 10,50 and 250 μmol·L-1 groups.After 24 h,the mRNA expression levels of interleukin-6(IL-6),cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),inducible nitric oxide synthase(iNOS),matrix metalloproteinase-3(MMP-3),MMP-13,a disintegrin and metalloproteinase with throm-bospondin motifs-4(ADAMTS-4),ADAMTS-5,SRY-box transcription factor-9(SOX-9)and aggrecan(ACAN)in mouse chondrocytes were detected by real-time quantitative PCR,the intracellular reactive oxygen species(ROS)level in chondrocytes was measured with 2,7-dichlorodihydrofluorescein diace-tate(DCFH-DA)staining,while the mitochondrial membrane potential was evaluated using JC-1 staining.After 48 h,the protein expression levels of iNOS,COX-2,MMP-13,and type Ⅱ collagen(Col-2)in mouse chondrocytes were detected using Western blotting.RESULTS HT at concentrations≤350 μmol·L-1 had no significant effect on the survival of mouse chondrocytes.Compared with the cell control group,after 24 h,the mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MMP-3,MMP-13,ADAMTS-4 and ADAMTS-5 in the chondrocytes of mice in the H2O2 group were increased,while the mRNA expression levels of SOX-9 and ACAN were decreased.Additionally,there was an elevation in the ROS level and a significant loss of mitochondrial membrane potential in the chondrocytes of mice.Compared with the H2O2 group,after treatment with HT 10,50 and 250 μmol·L-1,there were significant decreases in mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MM P-3,MMP-13,ADAMTS-4 and ADAMTS-5,the mRNA expressions of SOX-9 and ACAN were increased,the ROS level was lowered.After treatment with HT 50 and 250 μmol L-1,the loss of mitochondrial membrane potential was ameliorated.Compared to the cell control group,the protein expressions of iNOS,COX-2 and MMP-13 were upregulated in the H2O2 group,while the protein expression of Col-2 was downregulated after 48 h.Compared to the H2O2 group,treatment with HT at concentrations of 10,50 and 250 μmol·L-1 resulted in decreased protein expressions of iNOS,COX-2 and MMP-13 in mouse chondrocytes,but the protein expression of Col-2 increased following treatment with HT 50 and 250 μmol L-1.CONCLUSION HT can ameliorate H2O2-induced chondrocyte injury by reducing intracellular ROS levels and alleviating the loss of mitochondrial membrane potential,suppressing the release of inflammatory cytokines,inhibiting catabolic processes,and promoting anabolic activities.

Objective·To investigate the inhibitory effects of spermidine(SPD)on inflammatory osteolysis both in vivo and in vitro.Methods·The CCK-8 assay was used to assess the viability of RAW264.7 macrophages treated with various concentrations of SPD.The levels of intracellular reactive oxygen species(ROS)in lipopolysaccharide(LPS)-activated RAW264.7 cells were evaluated by staining with dichlorodihydrofluorescein diacetate(DCFH-DA)and dihydroethidium(DHE),respectively.Reverse transcription real-time fluorescence quantitative PCR(RT-qPCR)was utilized to determine the effects of SPD on the expression of pro-inflammatory genes in LPS-activated RAW264.7 cells.Tartrate-resistant acid phosphatase(TRAP)staining was used to evaluate the effect of SPD on the differentiation of mouse primary bone marrow-derived macrophages(BMMs)into osteoclasts.RT-qPCR was employed to further analyze the effect of SPD on the expression of genes related to osteoclast differentiation and functions after BMM-induced differentiation.An LPS-induced mouse calvarial osteolysis model was constructed,and the therapeutic efficacy of SPD on inflammatory osteolysis was assessed using Micro-CT analysis,hematoxylin-eosin(H-E)staining and TRAP staining of histological sections.Results·The CCK-8 assay showed that SPD,even at a concentration of 1 000 μmol/L,exhibited no significant cytotoxicity to RAW264.7 cells.ROS analysis revealed that SPD markedly inhibited LPS-induced elevation of intracellular ROS levels in macrophages.RT-qPCR results indicated that SPD suppressed the expression of pro-inflammatory genes induced by LPS.Both TRAP staining and RT-qPCR demonstrated that SPD effectively inhibited the differentiation of BMMs into osteoclasts induced by receptor activator of nuclear factor-κB ligand(RANKL)and reduced the expression of genes associated with osteoclast differentiation and function.In the mouse calvarial osteolysis model,Micro-CT analysis showed that the bone volume fraction and bone mineral density in the SPD-treated groups were significantly higher than those in the LPS group.Histological staining revealed that SPD treatment reduced inflammatory cell infiltration,decreased osteoclast numbers,and alleviated tissue damage.Conclusion·SPD inhibits macrophage inflammatory responses and RANKL-induced osteoclast differentiation in vitro;in vivo,it alleviates LPS-induced inflammatory calvarial osteolysis in mice.

This study aims to establish BHK-21 stable cell lines expressing APN from four species(human,pig,dog,and cat),the APN fragments were amplified from pEGFP-C1-APN plasmids of the four species stored in the laboratory to generate the recombinant plasmids pcDNA4.0-APN.Af-ter the recombinant plasmids were transfected into BHK-21 cells,the stable BHK-21 cell lines ex-pressing the APNs were selected by two rounds of limited dilution.The constructed BHK-21 cell lines were identified by indirect immunofluorescence assay(IFA),and their susceptibility to PD-CoV and TGEV was tested for these four cell lines.Virus infection experiments revealed that PD-CoV infected cells expressing human,pig,and dog APNs,while it did not infect cells expressing cat APN.Simultaneously,TGEV infected cells expressing pig,dog,and cat APNs,but did not infect cells expressing human APN.The results suggest that the risk of cross-species infection for different coronaviruses and the established cell line can be used effectively to evaluate the virus in-fection.The findings also revealed that PDCoV has the potential risk of cross-species infection of human and dog,and TGEV has the potential risk of cross-species infection of dog and cat.These results provide a basis for the prevention and control strategy of coronaviruses.

Objective Predictive value of mismatch repair(MMR)protein expression in endometrial cancer(EC)tissues and blood immune-inflammatory marker levels on postoperative survival.Methods A total of 118 patients with EC who were treated at Jiamusi Central Hospital from January 2017 to January 2020 were selected as study subjects.The status of MMR proteins in endometrial cancer tissues was analyzed by immunohistochemistry,and based on the staining results,patients were divided into a MMR-deficient group(dMMR group,n=40)and a MMR-proficient group(pMMR group,n=78).The preoperative systemic immune-inflammation index(SII)was calculated.The pelvic lymph node status of the patients was observed.Enzyme-linked im-munosorbent assay(ELISA)was used to detect serum levels of tumor necrosis factor-alpha(TNF-α),interleukin(IL)-1β,IL-6 and C-reactive protein(CRP)in the patients.Disease-free survival(DFS)and overall survival(OS)as well as their influencing factors were analyzed between the two groups.Results Comparison of age,FIGO stage,tumor histopathology,pelvic lymph node status and SII between the pMMR group and dMMR groups in patients,and the differences were statistically significant(Z/t/χ2=3.202～11.151,all P＜0.05).The average DFS of patients in pMMR group and dMMR group was 1 477 days and 756 days,the average OS was 1 588 and 826 days respectively,and the differences between the two groups were statistically significant(Log Rank χ2=24.804,30.411,all P<0.001).COX regression analysis showed that SII was an independent influencing factor of DFS in EC patients(Wald χ2=8.152,P<0.05).SII,pelvic lymph node status and MMR status were independent influencing factors of OS in EC patients(Wald χ2=7.066,5.936,6.971,all P<0.05).The ability of combining MMR status with SII to predict DFS and OS in EC patients was further improved,with AUC of 0.793 and 0.859,sensitivity of 72.4%and 75.0%,specificity of 78.3%and 80.0%,respectively.Conclusion MMR status and increased SII are independent influencing factors of poor postoperative prog-nosis of EC patients,and their combination is helpful to predict disease-free survival and overall survival of EC patients.