Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective To investigate the effect of elastic pants on coagulation function and deep vein thrombosis by examining blood coagulation function and deep vein thrombosis in patients with liposuction in the thigh before and after operation.Methods 80 patients with liposuction were randomly divided into Ankle-length elastic pants(Ankle group,A group,n=40)and Knee-length elastic pants(Knee group,K group,n=40)from October 2021 to October 2022.After liposuction surgery,the two groups of patients used elastic bandage to initially compress and bind the thigh.According to the length of the patients'thigh,the patients in A group wore appropriate ankle-length elastic pants and the patients in K group wore appropriate knee-length elastic pants.The index were recorded including the popliteal vein flow rate,the common femoral vein flow rate,the instep temperature,the incidence of deep vein thrombosis(DVT),the incidence of intramuscular vein thrombosis of leg and the coagulation indexes(APTT,PT,Fib,D-dimer).Results Compared with pre-operation,the blood flow rate of popliteal vein and common femoral vein in A group was significantly faster,while the blood flow rate of popliteal vein in K group was significantly slower(P＜0.05).There was no significant change in APTT and PT in the two groups after operation(P＞0.05),but the Fib and D-Dimer increased significantly on the first day after operation,and then decreased gradually(P＜0.05).Compared with K group,the blood flow of popliteal vein and common femoral vein in A group was significantly faster at each time point after operation(P＜0.05).The Fib and D-Dimer of patients in A group were significantly lower than those in K group on the 1st,3rd and 7th day after operation(P＜0.05),and the blood coagulation index between the two groups returned to normal around the 14th day.There was no statistically significant difference in the instep temperature between groups and within groups(P＞0.05).No deep venous thrombosis was found in A group after surgery,while there were 3 cases of deep venous thrombosis without clinical symptoms in K group on the 3rd and 7th day,with no statistical difference(P＞0.05).After surgery,patients in A group and K group had intramuscular venous thrombosis of the leg on the 1st,3rd and 7th day after surgery,and there was statistically significant difference on the 3rd and 7th day between the two groups(P＜0.05).Conclusion Thigh liposuction can lead to deep vein thrombosis without obvious clinical symptoms and intramuscular vein thrombosis of leg.Ankle-length elastic pants are more conducive to blood circulation of patients'legs,improve blood hypercoagulability,and reduce the risk of deep vein thrombosis after operation.

Pathological scars,primarily including hypertrophic scars and keloids,have long been a challenge for dermatology and burn plastic surgery.Despite numerous treatment methods being applied to basic and clinical research on pathological scarring,there is still no definitive scheme for its prevention and treatment.Botulinum Toxin Type A(BoNT-A),widely used in dermatology and aesthetic surgery since 2000 for improving scar appearance.In recent years,there have been a large number of basic and clinical experiments investigating the role of BoNT-A in the prevention and treatment of scars.This article reviews the progress of BoNT-A research on pathological scars to provide new perspectives for their prevention and treatment.

Breast implant surgery is a widely practiced cosmetic procedure,and while its safety and outcomes have improved with technological advancements,postoperative complications remain a major concern for both patients and physicians.Common complications associated with breast implants include pain,infection,bleeding/hematoma,seroma,prosthesis displacement,capsular contracture,and breast implant-associated anaplastic large cell lymphoma(BIA-ALCL).Furthermore,it summarizes the underlying mechanisms,risk factors,and prevention strategies of these complications,offering theoretical guidance for optimizing clinical practices.

Pathological scars,primarily including hypertrophic scars and keloids,have long been a challenge for dermatology and burn plastic surgery.Despite numerous treatment methods being applied to basic and clinical research on pathological scarring,there is still no definitive scheme for its prevention and treatment.Botulinum Toxin Type A(BoNT-A),widely used in dermatology and aesthetic surgery since 2000 for improving scar appearance.In recent years,there have been a large number of basic and clinical experiments investigating the role of BoNT-A in the prevention and treatment of scars.This article reviews the progress of BoNT-A research on pathological scars to provide new perspectives for their prevention and treatment.

Breast implant surgery is a widely practiced cosmetic procedure,and while its safety and outcomes have improved with technological advancements,postoperative complications remain a major concern for both patients and physicians.Common complications associated with breast implants include pain,infection,bleeding/hematoma,seroma,prosthesis displacement,capsular contracture,and breast implant-associated anaplastic large cell lymphoma(BIA-ALCL).Furthermore,it summarizes the underlying mechanisms,risk factors,and prevention strategies of these complications,offering theoretical guidance for optimizing clinical practices.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective:To explore the application effect of BOPPPS teaching model and "Internet + WeChat" platform in the teaching of Clinical Pharmacology.Methods:Undergraduate students from two consecutive batches of clinical medicine in Wuhan University were selected as the control group and the experimental group. The control group adopted the traditional teaching method, and the experimental group adopted the BOPPPS teaching model combined with the "Internet + WeChat" platform. SPSS 12.0 was used for t test. Results:The scores of the final test in the experimental group and the control group were (86.34±7.36) and (80.77±9.21), respectively, with statistical significance ( P<0.05). For the questions of clinical case analysis, with a total score of 20 points, the scores of the experimental group students (13.31±2.25) were significantly higher than those of the control group (10.58±3.04), with significant difference ( P<0.001). Conclusion:The application of BOPPPS model and "Internet + WeChat" platform in the undergraduate teaching of Clinical Pharmacology could improve students' examination performance, and especially the ability of solving clinical problems comprehensively.

Objective To investigate the mechanism of sleeve gastrectomy combined with modified jejunoileal bypass (SG/MJIB) in improving the blood glucose of Goto-kakizaki (GK) rats.Methods According to the random meter method,the 28 GK rats were divided into 4 groups:sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB),sleeve gastrectomy (SG),modified jejunoileal bypass (MJIB) and sham operation (SHAM).The changes of weight,food intake,fasting blood glucose,oral glucose tolerance test (OGTT),insulin tolerance test (ITT),plasma insulin and gastrointestinal hormonal (ghrelin and GLP-1) were monitored before and 16 weeks after surgery respectively.Results After surgery,the fasting blood glucose level in SG/MJIB group was obviously lower than that in SG,MJIB and SHAM groups (P＜0.05).From the 2nd week after surgery,OGTT of the SG/MJIB group was obviously improved compared to SG,MJIB,and SHAM groups (P＜0.02).In our post-op erative study,the insulin levels in SG/MJIB group were lower than those in SG,and SHAM groups (P＜0.05).Compared to MJIB and SHAM groups,ghrelin levels of SG/MJIB group were significantly decreased (P＜0.001),while GLP-1 levels of SG/MJIB group were higher than those of SG and SHAM groups (P＜0.01).Conclusions SG/ MJIB can improve insulin sensitivity and insulin secretion,and this effect is independent of the body weight and food intake.This study further validates that the gastrointestinal hormones play an important role in the pathogenesis and treatment mechanisms of type 2 diabetes mellitus.

Objective To explore the aging mechanisms of human adult adipose-derived stem cells (hADSCs) in vitro.Methods The hADSCs came from the production of normal patients with liposuction.The hADSCs were cultured in the 37℃ incubator and passed until the cells were senescent.The senescence-associated β-gal staining (SA-β-gal) and histone protein γH2AX staining were carried out in both young and old hADSCs.The quantitative real-time PCR (qRT-PCR) was conducted to check the difference of the transcription function of the young and old hADSCs.Results The cultured hADSCs would be the senescent cells when the PD number was more than 35.The aging cells became big and had large flat nuclei and much more lososomes in the cytoplasm.The SA-β-gal staining and γH2AX staining were mostly positive in the aging hADSCs (PD>35) compared with the self-renewing hADSCs (PD<20).The qRT-PCR results showed that the transcription levels of Nanog and Oct4 gene were very low in aging hADSCs compared with the self-renewing ones.Conclusions The hADSCs will be senescent (SEN) when cultured and passed in vitro for long time and the aging process is similar to that of stem cells in vivo.The aging model of hADSCs can be established by this method and will be very useful in the anti-aging drug, regeneration medicine, tissue engineering and stem cell therapy.