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.

Objective Under the operation background of Diagnosis-Intervention Packet(DIP),whether there is interaction between reducing medical cost and average length of stay combined with pre-hospitalization mode,and whether there is difference between different departments and diseases in interaction.Methods Based on real-world data from 71 453 patients admitted to Guizhou Provincial People's Hospital from July to December 2021,a two-way analysis of variance was employed.When the interaction effect was statistically significant,parameter estimation was used to determine the magnitude and direction of the interaction effect,followed by subgroup analyses by department and disease.Results Without adjustment,both total medical costs and average length of stay exhibited a negative interaction effect(P＜0.05).Subgroup analyses revealed that in terms of total medical costs,the effect size for the surgical system was 0.18％,lower than that for the internal medicine system(0.70％);for core diseases,it was 6.62％,lower than that for comprehensive diseases(7.71％).Regarding average length of stay,the effect size for the surgical system was 0.55％,better than that for the internal medicine system(0.22％);for core diseases,it was 8.70％,higher than that for comprehensive diseases(2.90％).Conclusion The combination of DIP payment reform and pre-admission management model demonstrates a synergistic effect,effectively reducing patients' medical costs and length of stay.This effect is influenced by disease complexity and the standardization of diagnostic and treatment processes.

Objective Under the operation background of Diagnosis-Intervention Packet(DIP),whether there is interaction between reducing medical cost and average length of stay combined with pre-hospitalization mode,and whether there is difference between different departments and diseases in interaction.Methods Based on real-world data from 71 453 patients admitted to Guizhou Provincial People's Hospital from July to December 2021,a two-way analysis of variance was employed.When the interaction effect was statistically significant,parameter estimation was used to determine the magnitude and direction of the interaction effect,followed by subgroup analyses by department and disease.Results Without adjustment,both total medical costs and average length of stay exhibited a negative interaction effect(P＜0.05).Subgroup analyses revealed that in terms of total medical costs,the effect size for the surgical system was 0.18％,lower than that for the internal medicine system(0.70％);for core diseases,it was 6.62％,lower than that for comprehensive diseases(7.71％).Regarding average length of stay,the effect size for the surgical system was 0.55％,better than that for the internal medicine system(0.22％);for core diseases,it was 8.70％,higher than that for comprehensive diseases(2.90％).Conclusion The combination of DIP payment reform and pre-admission management model demonstrates a synergistic effect,effectively reducing patients' medical costs and length of stay.This effect is influenced by disease complexity and the standardization of diagnostic and treatment processes.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Humans ; COVID-19 Vaccines/therapeutic use* ; COVID-19/prevention & control* ; SARS-CoV-2 ; China ; Antibodies, Viral

BACKGROUNDAlthough that glomerulonephritis is the major cause of end-stage renal disease in developing countries such as China, the increasing prevalence of diabetes has contributed to the changing spectrum of predialysis chronic kidney disease. Recent studies have revealed an increased proportion of patients with diabetic kidney disease (DKD) in hemodialysis populations in large cities in China. However, studies regarding the clinical phenotype of DKD in China are extremely limited. The incidence, development, and prognosis of diabetic kidney disease (INDEED) study aims to investigate the incidence, progression, and prognosis of DKD, as well as the associated genetic, behavioral, and environmental factors and biomarkers in patients with DKD in China.

METHODSINDEED study is a prospective cohort study based on all participants with diabetes in the Kailuan study, which is a general population-based cohort study in northern China. Altogether, over 10,000 participants with diabetes will be followed biennially. Questionnaires documenting general characteristics, behavioral and environmental factors, and medical history will be administrated. Anthropometric measurements and a series of laboratory tests will be performed in one central laboratory. The DNA, plasma, and urine samples of every participant will be stored in a biobank for future research.

CONCLUSIONSINDEED study will provide essential information regarding the clinical phenotype and prognosis of patients with DKD in China and will be valuable to identify factors and biomarkers associated with patients with DKD in China.

Biomarkers ; China ; epidemiology ; Diabetic Nephropathies ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Male ; Prognosis ; Prospective Studies ; Surveys and Questionnaires

Purpose To discuss the correlation between ultrasonic structural malformation and chromosomal microarray analysis (CMA) to provide a reliable basis for establishment of a prenatal diagnosis process of fetal malformation.Materials and Methods 104 pregnant women with structural malformation,who received prenatal ultrasonic screening in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University,were subjected to CMA detection.According to the results,they were divided into pathogenic group,Vous group and normal group,and the ultrasonic results and CMA results were compared and analyzed.Results Fifteen cases (14.42％) in the pathogenic group,including 9 cases of fetal aneuploidy,and 6 cases of microdeletion or mirco repetitive fetuses;28 cases (26.92％) in the Vous group and 61 cases (58.65％) in the normal group.There were 12 cases of two or more systems of deformity in the pathogenic group,in which the most common was complex congenital heart disease (9 cases),followed by nasal bone loss (4 cases);in the normal group and Vous group,most were single-system malformation,and the difference among three groups was statistically significant (x2=17.34,P＜0.01).There were 4 cases of pathogenic chromosomal abnormalities in the 17 cases of high risk pregnant women.Conclusion In prenatal counseling,if the fetus is found to have the malformation of two or more systems;the malformation variety contains complex congenital heart disease,nasal bone loss or malformation of other parts;high risk pregnant women combined with fetal structural malformation should be proposed to receive CMA detection to eliminate pathogenic chromosomal abnormalities.

Objective:To explore the relationship among the self-concept clarity,social support,self-esteem and subjective well-being in secondary vocational school students.Methods:Totally 308 students were selected from one secondary vocational school in Guangzhou (196 males and 112 females).They were measured with the Self-concept Clarity Scale (SCCS),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Well-being Index Scale (WBIS).Results:The scores of the SCCS,PSSS,SES and WBIS were positively correlated with each other (r =0.15-0.53,Ps ＜ 0.01).Results of path analysis showed that self-concept clarity had a positive effect on social support,self-esteem and subjective well-being (β =0.21,0.47,0.20).Social support and self-es teem both had a positive effect on subjective well-being (β =0.30,0.37),social support had a positive effect on self-esteem (β =0.38).Conclusion:There may be close relationship among self-concept clarity,social support,selfesteem and subjective well-being.The role of self-concept clarity in improving subjective well-being should be paid more attention in educational practices.

OBJECTIVE: To determine the allelic frequency distribution and genetic parameters of nine non-CODIS DNA index systems of the short tandem repeat (STR) loci (D2S1772, D6S1043, D7S3048, D8S1132, D11S2368, D12S391, D13S325, D18S1364, and GATA198B05). METHODS: A total of 353 blood samples were collected, extracted, amplified, and analyzed from unrelated healthy individuals of Han nationality in Hunan Province, China. RESULTS: One hundred and fourteen alleles were observed in the population with corresponding allelic frequencies ranged from 0.001 0 to 0.323 0. For all the nine non-CODIS STR loci, the observed genotypic data showed no significant deviations from the Hardy-Weinberg equilibrium. The Ho, He, PIC, DP, and PE of the studied non-CODIS STR loci ranged from 0.1080 to 0.1950, 0.8050 to 0.8920, 0.7700 to 0.8600, 0.9250 to 0.9660 and 0.6070 to 0.7800, respectively. CONCLUSION Nine non-CODIS STR loci have high degrees of polymorphisms, which may be useful in individual forensic identification and parentage testing in forensic practice.
Alleles ; Asian People/genetics* ; China ; Ethnicity/genetics* ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Male ; Microsatellite Repeats/genetics* ; Polymorphism, Genetic