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 investigate the effects of Clostridium butyricum on ulcerative colitis（UC）in mice and its impact on gut microbiota and autophagy levels. Methods:Eighteen C57BL/6J mice were randomly divided into a control group，a model group，and a treatment group，with six mice in each group using simple random sampling. Mice in the model and treatment groups were freely given 2.5% dextran sulfate sodium salt（DSS）solution for 5 days to establish a UC model. After successful modeling，the control and model groups were gavaged with PBS，while the treatment group was gavaged with 5×10 8 CFU/ml of live Clostridium butyricum. After the intervention，changes in body weight，disease activity index（DAI），colonic length，and pathological conditions were compared among the groups. Fluorescence quantitative PCR was used to detect the expression levels of intestinal inflammatory cytokines IL-1β and TNF-α. Myeloperoxidase（MPO）levels were analyzed，and Western blot was employed to detect the expression levels of zonula occludens-1（ZO-1），Occludin，LC3Ⅱ/LC3I，p62，and AMP-activated protein kinase/mammalian target of rapamycin AMPK/mTOR proteins. High-throughput sequencing technology was utilized to analyze the intestinal microbiota of the mice. Results:Compared with mice in the control group，the mice in the model group exhibited significant weight loss，markedly increased DAI and inflammation levels（ P<0.01），destruction of colonic structure，decreased expression levels of intestinal tight junction proteins（ P<0.05），suppressed autophagy levels（ P<0.05），and dysbiosis of the intestinal microbiota. In contrast，mice in the treatment group had a slower weight decline compared to the model group（ P<0.000 1），reduced DAI（ P<0.01），down-regulated inflammation levels（ P<0.01），improved barrier function（ P<0.05），up-regulated autophagy levels（ P<0.01），and an improved intestinal microbiota composition. Conclusions:Clostridium butyricum may ameliorate UC by modulating the intestinal microbiota composition，and enhancing autophagy levels，thus improving intestinal barrier function and inhibiting inflammatory progression in UC mice.

AIM To establish a rapid quantitative analysis model for saponins in Paris polyphylla var.yunnanensis(PPY)by near infrared spectroscopy.METHODS The contents of polyphyllins Ⅰ,Ⅱ,Ⅶ and there total content in PPY were determined by HPLC,while spectral data within the range of 10 000 to 4 000 cm-1 were collected.A quantitative analysis model was established by combining these data with partial least squares regression(PLSR).Multivariate scatter correction(MSC)and vector normalization(SNV)were applied prior to further preprocessing the spectra with original,first-order derivative(1stD),or second-order derivative(2ndD)treatments.Lastly,the model was optimized through non-smoothing(NS),Norris Derivative filtering(Nd),and Savitzky-Golay filtering(S-G)method.Model stability was evaluated based on correlation coefficients and variance.The predicted contents of each saponin component in the validation set samples were calculated.RESULTS The contents of polyphyllins Ⅰ,Ⅱ,Ⅶ were 0.42-17.98,0.46-10.44,0.23-3.86 mg/g,respectively.The total content ranged from 2.91 to 22.1 mg/g.The optimal parameters of three saponins were achieved when selecting the MSC+2ndD+S-G pretreatment method.The corresponding ratio of line segment length to segment gap was 13∶5,15∶5,11∶5,with correlation coefficients of 0.982,0.930,0.958,respectively.The root mean square errors of calibration(RMSEC)were 0.702,0.797,0.238,and the root mean square errors of prediction(RMSEP)were 1.120,0.835,0.304,respectively.The optimal parameters for the total content were obtained when selecting the MSC+2ndD+NS pretreatment method,with a correlation coefficient of 0.970,a RMSEC of 1.090,and a RMSEP of 1.740.CONCLUSION This accurate and rapid method can be used for detection of saponin contents in P.Polyphylla.

Objective:To explore the latent profiles of work withdrawal behaviors of junior nurses and their relationship with workplace social capital.Methods:Using the convenience sampling method, from July to August 2023, 348 junior nurses from five Class Ⅲ and seven ClassⅡ public hospitals in Ningxia Hui Autonomous Region were selected as the research objects. They were investigated with a General Information Questionnaire, the Work Withdrawal Behavior Scale, and the Workplace Social Capital Scale. Latent profile analysis was used to explore the categories of work withdrawal behaviors of junior nurses, and the differences in workplace social capital levels among junior nurses of different categories were compared.Results:A total of 348 questionnaires were recovered online in this survey, and 342 questionnaires were valid, with a valid rate of 98.3%. The work withdrawal behaviors of 342 junior nurses could be divided into three latent profiles, including 246 junior nurses (71.9%) in the low psychological-low behavioral withdrawal group, 81 junior nurses (23.7%) in the high psychological-low behavioral withdrawal group, and 15 junior nurses (4.4%) in the high psychological-high behavioral withdrawal group. The results of the unordered multinomial Logistic regression analysis showed that gender, whether they love nursing work or not, the average number of night shifts per month, the workplace social capital, and working years were the influencing factors of the work withdrawal behaviors of junior nurses ( P<0.05) . There were statistically significant differences in the workplace social capital among the three categories of junior nurses ( H=83.82, P<0.01) . Conclusions:There are three categories of work withdrawal behaviors among junior nurses, and there are differences in workplace social capital among junior nurses of different categories. Nursing managers should intervene and support junior nurses according to the characteristics of different categories to improve their workplace social capital levels.

AIM To establish a rapid quantitative analysis model for saponins in Paris polyphylla var.yunnanensis(PPY)by near infrared spectroscopy.METHODS The contents of polyphyllins Ⅰ,Ⅱ,Ⅶ and there total content in PPY were determined by HPLC,while spectral data within the range of 10 000 to 4 000 cm-1 were collected.A quantitative analysis model was established by combining these data with partial least squares regression(PLSR).Multivariate scatter correction(MSC)and vector normalization(SNV)were applied prior to further preprocessing the spectra with original,first-order derivative(1stD),or second-order derivative(2ndD)treatments.Lastly,the model was optimized through non-smoothing(NS),Norris Derivative filtering(Nd),and Savitzky-Golay filtering(S-G)method.Model stability was evaluated based on correlation coefficients and variance.The predicted contents of each saponin component in the validation set samples were calculated.RESULTS The contents of polyphyllins Ⅰ,Ⅱ,Ⅶ were 0.42-17.98,0.46-10.44,0.23-3.86 mg/g,respectively.The total content ranged from 2.91 to 22.1 mg/g.The optimal parameters of three saponins were achieved when selecting the MSC+2ndD+S-G pretreatment method.The corresponding ratio of line segment length to segment gap was 13∶5,15∶5,11∶5,with correlation coefficients of 0.982,0.930,0.958,respectively.The root mean square errors of calibration(RMSEC)were 0.702,0.797,0.238,and the root mean square errors of prediction(RMSEP)were 1.120,0.835,0.304,respectively.The optimal parameters for the total content were obtained when selecting the MSC+2ndD+NS pretreatment method,with a correlation coefficient of 0.970,a RMSEC of 1.090,and a RMSEP of 1.740.CONCLUSION This accurate and rapid method can be used for detection of saponin contents in P.Polyphylla.

Objective:To explore the latent profiles of work withdrawal behaviors of junior nurses and their relationship with workplace social capital.Methods:Using the convenience sampling method, from July to August 2023, 348 junior nurses from five Class Ⅲ and seven ClassⅡ public hospitals in Ningxia Hui Autonomous Region were selected as the research objects. They were investigated with a General Information Questionnaire, the Work Withdrawal Behavior Scale, and the Workplace Social Capital Scale. Latent profile analysis was used to explore the categories of work withdrawal behaviors of junior nurses, and the differences in workplace social capital levels among junior nurses of different categories were compared.Results:A total of 348 questionnaires were recovered online in this survey, and 342 questionnaires were valid, with a valid rate of 98.3%. The work withdrawal behaviors of 342 junior nurses could be divided into three latent profiles, including 246 junior nurses (71.9%) in the low psychological-low behavioral withdrawal group, 81 junior nurses (23.7%) in the high psychological-low behavioral withdrawal group, and 15 junior nurses (4.4%) in the high psychological-high behavioral withdrawal group. The results of the unordered multinomial Logistic regression analysis showed that gender, whether they love nursing work or not, the average number of night shifts per month, the workplace social capital, and working years were the influencing factors of the work withdrawal behaviors of junior nurses ( P<0.05) . There were statistically significant differences in the workplace social capital among the three categories of junior nurses ( H=83.82, P<0.01) . Conclusions:There are three categories of work withdrawal behaviors among junior nurses, and there are differences in workplace social capital among junior nurses of different categories. Nursing managers should intervene and support junior nurses according to the characteristics of different categories to improve their workplace social capital levels.

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 investigate the effects of Clostridium butyricum on ulcerative colitis（UC）in mice and its impact on gut microbiota and autophagy levels. Methods:Eighteen C57BL/6J mice were randomly divided into a control group，a model group，and a treatment group，with six mice in each group using simple random sampling. Mice in the model and treatment groups were freely given 2.5% dextran sulfate sodium salt（DSS）solution for 5 days to establish a UC model. After successful modeling，the control and model groups were gavaged with PBS，while the treatment group was gavaged with 5×10 8 CFU/ml of live Clostridium butyricum. After the intervention，changes in body weight，disease activity index（DAI），colonic length，and pathological conditions were compared among the groups. Fluorescence quantitative PCR was used to detect the expression levels of intestinal inflammatory cytokines IL-1β and TNF-α. Myeloperoxidase（MPO）levels were analyzed，and Western blot was employed to detect the expression levels of zonula occludens-1（ZO-1），Occludin，LC3Ⅱ/LC3I，p62，and AMP-activated protein kinase/mammalian target of rapamycin AMPK/mTOR proteins. High-throughput sequencing technology was utilized to analyze the intestinal microbiota of the mice. Results:Compared with mice in the control group，the mice in the model group exhibited significant weight loss，markedly increased DAI and inflammation levels（ P<0.01），destruction of colonic structure，decreased expression levels of intestinal tight junction proteins（ P<0.05），suppressed autophagy levels（ P<0.05），and dysbiosis of the intestinal microbiota. In contrast，mice in the treatment group had a slower weight decline compared to the model group（ P<0.000 1），reduced DAI（ P<0.01），down-regulated inflammation levels（ P<0.01），improved barrier function（ P<0.05），up-regulated autophagy levels（ P<0.01），and an improved intestinal microbiota composition. Conclusions:Clostridium butyricum may ameliorate UC by modulating the intestinal microbiota composition，and enhancing autophagy levels，thus improving intestinal barrier function and inhibiting inflammatory progression in UC mice.

The purpose of this study was to enrich the genomic information and provide a basis for further development and utilization of Polygonatum kingianum. The fresh rhizome of P. kingianum was used as the experimental material, and the full-length transcriptome was sequenced by PacBio Sequel platform. The final measured polymerase reads were 1 120 485, with a total of 77.73 GB of data. In NR database, 41 864 homologous sequence alignments were aligned to 5 species; 40 506 were annotated in the KOG database and classified into 26 categories based on their functionality; 69 060 GO annotated 32 functional groups divided into 3 categories: cellular components, molecular functions, and biological processes; 45 779 annotations were added to 145 metabolic pathways in the KEGG database. Among them, there are 127 identified transcripts related to polysaccharide synthesis in the glycolysis/gluconeogenesis metabolic pathway, 144 in the starch and sucrose metabolic pathway, 85 in the amino acid sugar and nucleotide sugar metabolic pathway, and 69 in the fructose and mannose metabolic pathway. In addition, 1 781 transcription factors were detected, distributed in 37 transcription factor families; 180 293 SSR loci were detected, among which single base repeats accounted for the most, accounting for 30.48% of all base repeats, and at least five base repeats, accounting for only 0.14% of single base repeats. The results of this study provide important data supporting for enriching the genomic information of P. kingianum and exploring its effective biosynthetic pathway.

Objective:To explore the correlation between gross tumor volume (GTV) and prognosis of patients with esophageal cancer undergoing radiotherapy.Methods:A retrospective cohort study was conducted. The clinical data of 130 newly diagnosed esophageal squamous cell carcinoma patients who received radiotherapy at Shanxi Province Cancer Hospital from February 2016 to June 2018 were analyzed. All patients underwent conformal intensity-modulated radiotherapy (IMRT) for esophageal lesions. Pinnacle planning system was used to calculate GTV, and GTV classification was performed: GTV ≤ 30 cm 3 was classified as grade Ⅰ, GTV > 30 cm 3 and ≤ 60 cm 3 was classified as grade Ⅱ, and GTV > 60 cm 3 was classified as grade Ⅲ. Kaplan-Meier method was used to analyze the progression free survival (PFS) and overall survival (OS) of patients, and the multivariate Cox proportional hazards model was used to analyze the independent influencing factors of poor PFS and OS. Results:The median age of 130 patients [ M ( Q1, Q3)] was 59 years old (56 years old, 69 years old), with 90 males and 40 females; Karnofsky performance scores were all ≥ 70 points; tumors were located in the neck in 10 cases, upper chest in 34 cases, middle chest in 55 cases, and lower chest in 31 cases; clinical staging for esophageal carcinoma treated with non-surgical methods: 3 cases in stage Ⅰ, 37 cases in stage Ⅱ, 79 cases in stage Ⅲ, and 11 cases in stage Ⅳ; 25 cases were classified as GTV grade Ⅰ, 62 cases as GTV grade Ⅱ, and 43 cases as GTV grade Ⅲ. The 1-year PFS rate of 130 patients was 55%, the 2-year PFS rate was 19%, and the median PFS time was 14 months; the 1-year OS rate was 76%, the 2-year OS rate was 32%, and the median OS time was 20 months. PFS and OS of patients in stages Ⅰ+Ⅱ, Ⅲ and Ⅳ deteriorated sequentially, and the differences between the three groups were statistically significant (both P < 0.001); the PFS and OS of patients with GTV grades Ⅰ, Ⅱ and Ⅲ deteriorated sequentially, and the differences in PFS and OS between the three groups were statistically significant (both P < 0.001); there were no statistically significant differences in PFS and OS among patients of different genders, ages, and tumor locations (all P > 0.05). The results of multivariate Cox regression analysis showed that high clinical staging (stage Ⅳ vs. stage Ⅰ, HR = 8.34, 95% CI: 3.88-17.94, P < 0.001) and high GTV grading (grade Ⅱ vs. grade Ⅰ: HR = 6.81, 95% CI: 3.39-13.67, P < 0.001; grade Ⅲ vs. grade Ⅰ: HR = 23.97, 95% CI: 10.81-53.14, P < 0.001) were independent risk factors for poor PFS; high clinical staging (stage Ⅳ vs. stage Ⅰ: HR = 9.94, 95% CI: 4.50-21.97, P < 0.001) and high GTV grading (grade Ⅱ vs. grade Ⅰ: HR = 13.55, 95% CI: 5.58-32.91, P < 0.001; grade Ⅲ vs. grade Ⅰ: HR = 35.01, 95% CI: 13.57-90.34, P < 0.001) were independent risk factors for poor OS. Conclusions:GTV is associated with the prognosis of patients with esophageal cancer undergoing radiotherapy.