Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Osteoarthritis(OA),a common age-related chronic disease,is characterized by degenerative changes in the joints and surrounding tissues.Traditionally,research on OA has primarily focused on the pathological changes in articular cartilage and its repair.However,with the advancements in animal disease modeling in recent years,especially the widespread use of spatiotemporally specific transgenic mouse models,scholars have gradually come to realize that the subchondral bone also plays an important role in the occurrence and development of OA.That is,the pathological changes in articular cartilage and bone mutually affect and promote each other,jointly driving the progression of OA,involving such pathological processes as vascular invasion,ectopic calcification,nerve growth,and the occurrence of pain.Given the complexity of cartilage-bone pathological relationship,it is difficult to conduct in-depth research on subchondral bone pathology using clinical human samples,or to simulate the pathological processes of OA through in vitro cell experiments.Therefore,animal models play an irreplaceable role in investigating the pathological mechanisms of OA and developing clinical drugs.This review,in addition to providing an overview of OA animal models,synthesizes the latest progress in animal experimental research on OA,highlighting the active role of the cartilage-bone pathological relationship in OA progression.These new findings provide references for future in-depth investigations and also provide a theoretical basis for developing fundamental strategies for OA prevention and treatment.

Osteoporosis and cardiovascular calcification,two major age-related chronic diseases that China is confronting today,pose serious threats to public health.Previous studies have reported overlapping connections in the pathological processes and molecular mechanisms of these two diseases,particularly concerning inflammation,oxidative stress,and dysregulation of mineral metabolism,and that these two diseases tend to share common pathogenic factors.However,research exploring the comorbidity mechanisms of the two diseases remains limited in both depth and scope,largely due to the lack of widely accepted comorbidity animal models.Herein,we analyzed the latest research findings on the comorbidity mechanisms of vascular calcification and osteoporosis,focusing on summarizing the animal disease models currently in extensive use and the relevant evaluation criteria.We aim to provide new references for comorbidity research models and offer scientific evidence for future studies on pathological mechanisms and the development of new therapeutic strategies.

Objective To investigate the effect of microRNA(miR)-34a-5p on neurological function of rats with intracerebral hemorrhage(ICH)by adjusting PTEN-induced kinase 1(PINK1)/Parkin pathway.Methods SD rats were assigned into sham surgery group(Sham),ICH group,inhibitor NC group,miR-34a-5p inhibitor group,miR-34a-5p inhibitor+DMSO group,and miR-34a-5p inhibitor+Mdivi-1 group,with 8 rats in each group.Modified neurological severity score(mNSS)was used to assess changes in neurological function of rats;HE staining was used to observe the pathological changes in the brain tissue of rats;transmission electron microscopy was used to observe autophagy in brain tissue;TUNEL staining was used to observe cell apoptosis;qRT-PCR experiment was used to detect the mRNA levels of miR-34a-5p,PINK1 and Parkin in the brain tissues;Western blot experiments were used to measure PINK1,Parkin,Beclin1 and P62 proteins in the brain tissues of rats;dual luciferase reporter gene assay was used to determine the targeting relationship between miR-34a-5p and PINK1.Results Compared with the inhibitor NC group,the miR-34a-5p inhibitor group demonstrated lower levels of neuronal necrosis,red blood cell amount,inflammatory cell amount,autophagic vacuole amount,mNSS score,TUNEL positivity rate,miR-34a-5p expression and p62 protein,but higher levels of PINK1,Parkin mRNA and protein expression,and Beclin1 protein expression(P＜0.05).Compared with the miR-34a-5p inhibitor+DMSO group,the changes mentioned above in rat of the miR-34a-5p inhibitor+Mdivi-1 group are all reversed(P＜0.05).In the dual luciferase reporter gene experiment,the relative luciferase activity of cells in the miR-34a-5p mimic and PINK1-WT cotransfected group was greatly reduced(P＜0.05).Conclusion The downregulation of miR-34a-5p may alleviate neurological dysfunction in ICH rats by adjusting PINK1/Parkin pathway.

Objective To investigate the effect of microRNA(miR)-34a-5p on neurological function of rats with intracerebral hemorrhage(ICH)by adjusting PTEN-induced kinase 1(PINK1)/Parkin pathway.Methods SD rats were assigned into sham surgery group(Sham),ICH group,inhibitor NC group,miR-34a-5p inhibitor group,miR-34a-5p inhibitor+DMSO group,and miR-34a-5p inhibitor+Mdivi-1 group,with 8 rats in each group.Modified neurological severity score(mNSS)was used to assess changes in neurological function of rats;HE staining was used to observe the pathological changes in the brain tissue of rats;transmission electron microscopy was used to observe autophagy in brain tissue;TUNEL staining was used to observe cell apoptosis;qRT-PCR experiment was used to detect the mRNA levels of miR-34a-5p,PINK1 and Parkin in the brain tissues;Western blot experiments were used to measure PINK1,Parkin,Beclin1 and P62 proteins in the brain tissues of rats;dual luciferase reporter gene assay was used to determine the targeting relationship between miR-34a-5p and PINK1.Results Compared with the inhibitor NC group,the miR-34a-5p inhibitor group demonstrated lower levels of neuronal necrosis,red blood cell amount,inflammatory cell amount,autophagic vacuole amount,mNSS score,TUNEL positivity rate,miR-34a-5p expression and p62 protein,but higher levels of PINK1,Parkin mRNA and protein expression,and Beclin1 protein expression(P＜0.05).Compared with the miR-34a-5p inhibitor+DMSO group,the changes mentioned above in rat of the miR-34a-5p inhibitor+Mdivi-1 group are all reversed(P＜0.05).In the dual luciferase reporter gene experiment,the relative luciferase activity of cells in the miR-34a-5p mimic and PINK1-WT cotransfected group was greatly reduced(P＜0.05).Conclusion The downregulation of miR-34a-5p may alleviate neurological dysfunction in ICH rats by adjusting PINK1/Parkin pathway.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Objective: To understand the changes of children s height, weight, blood pressure and gender differences, to explore the relationship between overweight, obesity and childhood hypertension, and to provide a scientific basis for childhood hypertension prevention. Methods: Physical examination data during 2013 to 2018 of ten primary school students in Shenzhen were collected. Growth rate of height, weight and blood pressure by age and gender were calculated. The generalized estimating equation was used to analyze the association between overweight, obesity and hypertension. Results: Weight, body mass index (BMI) and systolic pressure of boys and girls increased with age ( t/Z =3.89-31.52, P <0.05). The height growth rate of girls was higher than that of boys at the age of 8-11, and reaches the peak of height growth at the age of 10, while boys were two years later than girls(boys:7.68 cm, gilrs:7.42 cm). Weight and blood pressure growth rates were similar. At the same time, the growth rate of height and blood pressure had a synchronous trend, and the peak of the growth rate of blood pressure was also at the peak stage of height growth. The OR value of obesity on childhood hypertension was 1.62(1.48-1.81), and the OR value of overweight on childhood hypertension was 2.01(1.75-2.30), both P <0.01. Conclusion There are gender differences in children s height, weight, and blood pressure, and the growth rate of height and blood pressure shows a synchronous trend. Overweight and obesity in children can increase the risk of high blood pressure and hypertension.

Objective: To investigate the associated factors of myopia among primary and secondary school students in Shenzhen, and to provide reference for the prevention and control of myopia. Methods: By stratified cluster sampling, 3 073 students of 14 schools including primary,junior,regular and vocational senior schools from two districts in Shenzhen were selected and investigated. Results: For primary school students, the time of using computer for 2-<3 hours per day (OR=2.23，95%CI=1.19-4.20) , and no physical education class(2 sections per week OR=0.34, 95%CI=0.13-0.91; 4 sections per week OR=0.23, 95%CI=0.08-0.62; 5 sections or more per week OR=0.33, 95%CI=0.11-0.97) were positively associated with myopia. Teachers finishing class on time at break (occasionally delaying OR=1.99, 95%CI=1.51-2.63; frequently delaying OR=2.07, 95%CI=1.29-3.30), taking 0.5-1 hour break when using eyes at close range (1-<2 hours OR=1.33，95%CI=1.03-1.70; ≥3 hours OR=1.87, 95%CI=1.17-3.00), no parents with myopia(one parent with myopia OR=1.69, 95%CI=1.32-2.17; two parents with myopia OR=2.13, 95%CI=1.50-3.02) were negatively associated with myopia. For junior high school students, without parents with myopia (one parent with myopia OR=3.27, 95%CI=2.17-4.94; two parents with myopia OR=5.38, 95%CI=2.78-10.42) was the protective factor of myopia. For senior high school students, male (female OR=1.52, 95%CI=1.07-2.14), doing eye exercises twice a day in school (OR=0.41, 95%CI=0.23-0.75), and accumulating outdoor activities for ≥2 hours a day (OR=0.70, 95%CI=0.49-1.00) were negatively associated with myopia. Conclusion There are different risk factors for myopia among different students in Shenzhen. Students with high risk factors are the key objects of prevention and control.

Objective: To investigate psychological sub-health status and its correlation with suicidal behaviors among middle school students in Shenzhen, so as to provide reference for early prevention of suicide. Methods: A total of 4 014 students from 5 junior high schools and 5 senior high schools in Shenzhen were selected as the subjects. The status of psychological sub-health and suicidal behaviors were assessed, and their correlation was analyzed. Results: The detection rates of psychological sub-health, suicide ideation, suicide plan and suicide attempts were 21.38%, 24.66%, 11.81% and 3.64% respectively. The detection rates of suicidal ideation, suicide plan and suicide attempts among students with high level of psychological sub-health status were significantly higher than those without psychological sub-health status(P<0.01). Correlation analysis showed that the number of psychological sub-health symptoms was positively correlated with the number of suicidal ideations, suicide plans and suicide attempts(P<0.01). Conclusion Psychological health status of adolescents in Shenzhen is not optimistic. There is a correlation between psychological sub-health status and suicidal behaviors. More attention should be paid to suicide prevention among students with psychological sub-health status.

Objective: To understand parent-child cohesion and problematic mobile phone use among middle school students in Shenzhen, and to provide a refevence for conducting the relevant control and prevention work . Methods: A total of 3 992 students from 5 junior high schools and 5 senior high schools in Shenzhen were selected by using stratified cluster sampling method. Problematic mobile phone use and parent-child cohesion were investigated, and their association was analyzed. Results: The average score of father-child cohesion and mother-child cohesion was (34.34±9.67) and (38.14±8.35), respectively. Mother-child cohesion score was higher than father-child cohesion score in both junior and senior middle school students(t=12.07, 14.41, P<0.01). Father-child cohesion (r=-0.20, P<0.01) and mother-child cohesion (r=-0.17, P<0.01) was negatively correlated with problematic mobile phone use. The lower the score of parent-child cohesion, the higher the score of problematic mobile phone use. Conclusion Family plays an important role in the prevention and control of problematic mobile phone use among middle school students. Improving parent-child cohesion and building a good parent-child relationship may help prevent problematic mobile phone use.