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.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

Food wastes are rich in nutrients and can be used for producing useful chemicals through biotransformation. Some oleaginous microorganisms can use food wastes to produce lipids and high value-added metabolites such as polyunsaturated fatty acids, squalene, and carotenoids. This not only reduces the production cost, but also improves the economic value of the products, thus has large potential for commercial production. This review summarized the advances in food waste treatment, with a focus on the lipid production by oleaginous microorganisms using food wastes. Moreover, challenges and future directions were prospected with the aim to provide a useful reference for related researchers.
Biofuels ; Biotransformation ; Food ; Lipids ; Refuse Disposal

Chongqing Medical University and University of Dundee have explored the "4+ 1" integration training mode combining undergraduate and postgraduate for biomedical engineering major in 2018, including mode of education, curriculum linkage and credit recognition, contract signing and publicity, process assessment and management, and degree awarding. After repeated communication and argument, Chongqing Medical University and University of Dundee signed the contract of the "4+ 1" integration training mode in 2019. One junior student participated in the "Summer Camp of University of Dundee" in the same year, and one senior student participated in this integration training mode program in 2020. According to the feedback of the first batch of students, the "4+ 1" integration training mode can guide students from different angles, which is conducive to broadening students' international vision and injecting strong power into the cultivation of biomedical engineering talents.

Objective:To evaluate the application of ERAS concept in the treatment of tibial plateau fractures with minimally invasive double reverse tractions (MIDRT).Methods:A retrospective study was conducted of the 39 patients with tibial plateau fracture who had been treated at Department of Orthopedics, Union Hospital from February 2018 to June 2020. They were 20 males and 19 females, aged from 27 to 47 years. All cases were treated with the same MIDRT but with different perioperative management protocols. Of them, 20 received conventional perioperative management (control group) and 19 perioperative ERAS management (ERAS group). The 2 groups was compared in terms of visual analogue scale (VAS) at 24 hours postoperation, drainage volume, time for removal of drainage tube, hospital stay, patient’s satisfaction, incidence of complications, and American Special Surgery Hospital (HSS) scores at discharge and 1, 3, 6 and 9 months postoperation.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between groups ( P>0.05). All cases obtained complete follow-up (mean, 10.9 months). No statistically significant difference was found between the 2 groups in drainage volume, time for removal of drainage tube or HSS scores at discharge or one month after discharge ( P>0.05). The VAS score at 24 hours after operation, hospital stay [(9.4±4.8) d], patient's satisfaction, HSS scores [(90.8±3.8), (93.5±4.3) and (95.6±3.7)] in the ERAS group were significantly better than those in the control group [(13.3±1.9) d, (87.5±5.1), (88.1±4.4) and (88.8±4.4)] ( P<0.05). None of the patients had such serious complications as wound infection, breakage or failure of internal fixation, or fracture nonunion. Conclusion:The perioperative management protocols designed according to the ERAS concept may enhance the clinical efficacy of MIDRT in the treatment of tibial plateau fractures and thus raise the patient’s satisfaction.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

With the outbreak of novel coronavirus pneumonia (NCP) induced by 2019 novel coronavirus (2019-nCoV) in Wuhan, Hubei Province in December 2019, more and more suspected or confirmed cases have been found in various regions of China. Although China has adopted unprecedented strict quarantine and closed management measures to prevent the spreading of the disease, Department of Traumatic Orthopedics may still have to manage NCP patients with open fractures or severe trauma that require emergency surgery. Therefore, the identification and management of 2019-nCoV infection as soon as possible as well as the protection of all medical staff involved in the emergency treatment of patients are the severe challenges faced by orthopedic traumatologists during the prevention and control of NCP. Based on the characteristics of such patients and related diagnosis and treatment experiences during the epidemic of NCP, the authors formulate the surgical management strategies for orthopedic trauma patients.

Focused ultrasound surgery (FUS) technology has been used for clinical treatment more than 20 years. Since 2011, relying on the "high intensity focused ultrasound tumor therapy training base", focusing ultrasound surgeons on the treatment of uterine fibroids, based on the basic theories and skills provided by interns who have just access to the qualification of licensed physicians, the training courses are set such as engineering technology principles, biological effects and mechanisms, micro and non-invasive concepts and clinical thinking, image recognition ability, operation training, and postoperative complications management etc.. After strict quality training and performance evaluation, the initial training of focused ultrasound surgeons has been completed. Moreover, the training object can consolidate learning effect through continuing education in order to acquire stable skills and skills.

Objective To investigate the effect of lipid encapsulated 1,1,2-trichlorotrifluoroethane phase change nanodroplets for high intensity focused ultrasound (HIFU) ablation.Methods The lipid encapsulated 1,1,2-trichlorotrifluoroethane phase change nanodroplets was prepared with membrane hydration method,and its physicochemical properties were examined.The synergistic effect of HIFU ablation was verified with experiments in vitro and in vivo experiments.For in vitro experiment,the isolated bovine liver tissues were irradiated with HIFU (250 W,10 s,continuous wave).For in vivo experiment,the livers of New Zealand rabbits were irradiated with HIFU (200 W,5 s,continuous wave).The volume of coagulative necrosis,energy efficiency factors (EEF) and the volume of the hyperechoic area after HIFU radiation were measured.And the statistical analysis was performed.Results Phase change nanoparticles were spherical in solution and uniform in size.For in vitro experiment,the coagulative necrosis volume,EEF and hyperechoic area of bovine liver tissue injected with nanodroplets were significantly higher than those of untreated bovine liver tissue (t=28.80,19.55,14.30;P=0.01,0.02,0.02) after HIFU.For in vivo experiment,the coagulative necrosis volume,EEF and hyperechoic area of rabbit liver tissue injected with nanodroplets were significantly higher than those of untreated rabbit liver tissue (t=9.41,13.52,15.67;P=0.02,0.01,0.01) after HIFU.Conclusion The lipid encapsulated 1,1,2-trichlorotrifluoroethane phase change nanodroplets can significantly improve the efficiency of HIFU ablation significantly.

OBJECTIVETo investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft.

METHODSMice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted.

RESULTSThe median survival time of the mice was 19.00 days (95% CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%.

CONCLUSIONHIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.