Objective Explored the clinical efficacy and mechanism of improved CO2 fractional laser on treatment for refractory wounds.Methods A total of 122 patients with refractory wounds who were admitted to the hospital from May 2022 to May 2024 were selected and randomly divided into a conventional group(conventional dressing change treatment+photodynamic therapy+conventional CO2 fractional laser treatment)and an improved group(conventional dressing change treatment+photodynamic therapy+improved CO2 fractional laser treatment)by lottery,with 61 cases in each group.The serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)levels,the number of wound bacteria before treatment and after 1,2,and 3 weeks of treatment were compared between the two groups.The wound healing rates after 1,2,and 3 weeks of treatment were compared between the two groups.The clinical efficacy of the two groups was compared.The levels of wound exudate basic fibroblast growth factor(bFGF)and angiopoietin-1(Ang-1)before treatment and after 1,2,and 3 weeks of treat-ment were compared.The adverse reactions of the two groups were compared.Results Repeated measures analy-sis of variance showed that there were an interaction effect between groups and over time in the serum CRP and ESR levels,the number of wound bacteria in both groups(P<0.05).There were no significant differences in the serum CRP and ESR levels and the number of wound bacteria between the two groups before treatment(P>0.05).The serum CRP and ESR levels and the number of wound bacteria in the improved group were lower than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the wound healing rates of both groups(P<0.05).The wound healing rates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).The total clinical effective rate of the improved group was higher than that of the conventional group(P<0.05).Repeated measures analysis of variance showed that there was an inter-action effect between groups and over time in the levels of bFGF and Ang-1 in wound exudates of both groups(P<0.05).There was no significant difference in the levels of bFGF and Ang-1 in wound exudates between the two groups before treatment(P>0.05).The levels of bFGF and Ang-1 in wound exudates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).There were no signifi-cant differences in the incidence of pain,pruritus and rash between the two groups(P>0.05).Conclusions In the treatment of refractory wounds,the combination of improved CO2 fractional laser and photodynamic therapy could promote the secretion of wound exudate growth factors,inhibit wound bacterial growth and inflammatory response,accelerate wound healing,and improve clinical efficacy,with high safety.The mechanism of action is related to the promotion of wound exudate growth factor secretion.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To explore the effects of camellia honey on intestinal inflammation and injury induced by a high-fat diet(HFD)in Drosophila.Methods A HFD model group of fruit flies was created by feeding with standard culture medium containing 30％lard.Each camellia honey groups were fed the same high-fat medium containing different concentrations of camellia honey.The body mass,eclosion rate,climbing ability,size of lipid droplets,and levels of intestinal reactive oxygen species in adult flies were measured and analyzed.Results Compared with the model group,each camellia honey groups showed significant improvements.Specifically,camellia honey ameliorated the following HFD-induced alterations:decline in eclosion rate,increase in pupal volume,increase in adult average body mass,decrease in adult climbing ability,enlargement of the lipid droplet area,elevation in intestinal ROS levels,and intestinal damage.Conclusions Camellia honey improved the growth and development,intestinal inflammation,and injury induced by a HFD in Drosophila.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Metanephric adenoma is a rare renal epithelial tumor with a low incidence and lack of specific clinical manifestations，resulting in a lack of uniformity in clinical understanding and treatment. Its etiology and pathogenesis are still unclear，and it may be related to the abnormal number and structure of chromosomes 2，7，and 17，as well as mutations in genes such as BRAF V600E，NF1，and NOTCH1，etc. There may be a transformed relationship between this tumor and Wilms’ tumor and papillary renal cell carcinoma. For diagnosis，it has diverse but non-specific clinical manifestations，and it is difficult to accurately differentiate it from other tumors in the imaging examination，and the confirmation of diagnosis relies on pathological and immunohistochemical staining. Treatment is mainly based on surgery to preserve the renal unit，such as partial nephrectomy，etc.，but the difficulty of preoperative diagnosis often leads to over-treatment，and there is a lack of standardized treatment protocols for metastatic posterior renal adenoma. The aim of this article is to provide a reference for the in-depth understanding of posterior renal adenomas and to optimize the clinical diagnosis and treatment strategies.

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 explore the effects of camellia honey on intestinal inflammation and injury induced by a high-fat diet(HFD)in Drosophila.Methods A HFD model group of fruit flies was created by feeding with standard culture medium containing 30％lard.Each camellia honey groups were fed the same high-fat medium containing different concentrations of camellia honey.The body mass,eclosion rate,climbing ability,size of lipid droplets,and levels of intestinal reactive oxygen species in adult flies were measured and analyzed.Results Compared with the model group,each camellia honey groups showed significant improvements.Specifically,camellia honey ameliorated the following HFD-induced alterations:decline in eclosion rate,increase in pupal volume,increase in adult average body mass,decrease in adult climbing ability,enlargement of the lipid droplet area,elevation in intestinal ROS levels,and intestinal damage.Conclusions Camellia honey improved the growth and development,intestinal inflammation,and injury induced by a HFD in Drosophila.

Objective Explored the clinical efficacy and mechanism of improved CO2 fractional laser on treatment for refractory wounds.Methods A total of 122 patients with refractory wounds who were admitted to the hospital from May 2022 to May 2024 were selected and randomly divided into a conventional group(conventional dressing change treatment+photodynamic therapy+conventional CO2 fractional laser treatment)and an improved group(conventional dressing change treatment+photodynamic therapy+improved CO2 fractional laser treatment)by lottery,with 61 cases in each group.The serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)levels,the number of wound bacteria before treatment and after 1,2,and 3 weeks of treatment were compared between the two groups.The wound healing rates after 1,2,and 3 weeks of treatment were compared between the two groups.The clinical efficacy of the two groups was compared.The levels of wound exudate basic fibroblast growth factor(bFGF)and angiopoietin-1(Ang-1)before treatment and after 1,2,and 3 weeks of treat-ment were compared.The adverse reactions of the two groups were compared.Results Repeated measures analy-sis of variance showed that there were an interaction effect between groups and over time in the serum CRP and ESR levels,the number of wound bacteria in both groups(P<0.05).There were no significant differences in the serum CRP and ESR levels and the number of wound bacteria between the two groups before treatment(P>0.05).The serum CRP and ESR levels and the number of wound bacteria in the improved group were lower than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the wound healing rates of both groups(P<0.05).The wound healing rates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).The total clinical effective rate of the improved group was higher than that of the conventional group(P<0.05).Repeated measures analysis of variance showed that there was an inter-action effect between groups and over time in the levels of bFGF and Ang-1 in wound exudates of both groups(P<0.05).There was no significant difference in the levels of bFGF and Ang-1 in wound exudates between the two groups before treatment(P>0.05).The levels of bFGF and Ang-1 in wound exudates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).There were no signifi-cant differences in the incidence of pain,pruritus and rash between the two groups(P>0.05).Conclusions In the treatment of refractory wounds,the combination of improved CO2 fractional laser and photodynamic therapy could promote the secretion of wound exudate growth factors,inhibit wound bacterial growth and inflammatory response,accelerate wound healing,and improve clinical efficacy,with high safety.The mechanism of action is related to the promotion of wound exudate growth factor secretion.

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.

Metanephric adenoma is a rare renal epithelial tumor with a low incidence and lack of specific clinical manifestations，resulting in a lack of uniformity in clinical understanding and treatment. Its etiology and pathogenesis are still unclear，and it may be related to the abnormal number and structure of chromosomes 2，7，and 17，as well as mutations in genes such as BRAF V600E，NF1，and NOTCH1，etc. There may be a transformed relationship between this tumor and Wilms’ tumor and papillary renal cell carcinoma. For diagnosis，it has diverse but non-specific clinical manifestations，and it is difficult to accurately differentiate it from other tumors in the imaging examination，and the confirmation of diagnosis relies on pathological and immunohistochemical staining. Treatment is mainly based on surgery to preserve the renal unit，such as partial nephrectomy，etc.，but the difficulty of preoperative diagnosis often leads to over-treatment，and there is a lack of standardized treatment protocols for metastatic posterior renal adenoma. The aim of this article is to provide a reference for the in-depth understanding of posterior renal adenomas and to optimize the clinical diagnosis and treatment strategies.