Orthopedics is a medical specialty that focuses on the clinical treatment and care of the musculoskeletal system. Orthopedics is a medical specialty which specializing in the clinical treatment and nursing of musculoskeletal system. The education of orthopedics is often serious and difficult because of the high technical requirements, complicated anatomical knowledge and long study process. However, medical students or junior residents rarely have the opportunity to see such orthopedic surgery or attend preclinical practice, which limits the opportunities for training clinicians. Hopefully, with the increasing use of three-dimensional (3D) technologies in medical teaching, this situation can be alleviated. In this study, we demonstrate that different 3D technologies can effectively simulate orthopedic surgery with very high accuracy. We carefully evaluated the use of 3D technologies in primary medical teaching and proposed a vision for the future. We searched and screened 3,997 publications from the Web of Science Core Collection (WoSCC) on 22 Oct 2021 with (trauma) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)), (Joint) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)), (spine) AND ((education) OR (training) OR (teaching) OR (learning)) AND ((3D) OR (Three Dimensional)) as the search strategy. Then, we eliminated the publications irrelevant to “orthopedics” AND/OR “orthopaedic” (in United Kingdom English), the final number of publications are 440 for trauma surgery, 716 for joint surgery and 363 for spine surgery, a visual display of comprehensive information analysis was made by VOSviewer. Next, we read and analyzed retrieved articles extensively according to the selection criteria, 11 highly cited publications on three major branches of orthopedics were chosen. The extracted data included the authors, purpose, methods, results and benefits/limitations. The evaluation of these studies directly and objectively proved the superiority of 3D technologies in orthopedics. Furthermore, the material usage and strength of 3D technologies can be closer to the real situation, which will help improve their effectiveness in teaching. We hope that more relevant studies will be conducted to continue examining the effects of 3D technologies on orthopedic medical education as well as orthopedic surgery training, and we hope that this technique can be more widely used in the clinical teaching of orthopedics to train clinicians on learning medical theory and surgical technology quickly and efficiently.

Fractures of complex body parts are often serious and difficult to handle, and they have high technical and training requirements. However, the realistic situation is that there are few opportunities for the junior residents, trainee doctors, and especially medical students to contact enough clinical practice and see such fracture patients. Fortunately, with the rapid development and continuous progress of 3D printing and related technologies, this situation has gradually gotten better and better. In this research, we confirmed that 3D printing technology could improve the effectiveness of fracture teaching and medical learning from multiple dimensions. We comprehensively screened and assessed 223 papers from the Web of Science (WoS) Core Collection on October 3, 2021, with “((3D) AND ((printing) OR (printed)) AND (fracture)) AND ((education) OR (training) OR (teaching))” as the retrieval strategy. Additionally, we used the VOSviewer software to analyze the keywords and countries and the organizations of the publications, then a series of scientometric and visualized analyses were made based on the retrieval results. Afterward, multiple databases were retrieved according to our selection criteria, we selected eight studies for the extensive literature analysis. The extracted data contained information of authors, problems solved, participants, methods, assessments, results, and benefits/limitations. These intuitive and in-depth analyses further confirmed and appraised the advantages of 3D printing in complex fracture models more objectively. In conclusion, 3D printing could improve the effectiveness and extension of fracture teaching, as well as medical learning, by providing the powerful interaction with 3D effect, wakening students learning interest, and allowing the junior residents, trainee doctors to have as realistic a virtual practice experience as possible. Through this research, it is expected that more researchers could be attracted to conduct more comprehensive and thorough studies on the application of 3D printing for training and educational propose, to promote the development of 3D technology-based medical education practice and further deepen the reform of medical education and improve the quality of fracture education and learning.

Metabolic syndrome (MetS) is characterized by chronic low-grade inflammation and immune dysregulation, which may increase susceptibility to sepsis. However, epidemiologic evidence remains limited. This study aimed to evaluate the association of MetS with the risk of sepsis and sepsis-related mortality. This study included 359,633 participants from the UK Biobank and 152,317 participants from the Kailuan Study. MetS was defined as the presence of ≥3 metabolic abnormalities. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of MetS with risk of sepsis and 28-day mortality following sepsis. Stratified analyses were conducted to assess potential effect modification. In the UK Biobank, we further evaluated the dose-response relationship between the number of MetS components and sepsis outcomes, explored potential mediation by inflammatory and immune biomarkers, and investigated the joint effect of MetS and lifestyle; in the Kailuan Study, we further investigated the impact of MetS evolution on sepsis risk. Sensitivity analyses were performed to evaluate the robustness of the results. During a median follow-up of 13.7 years, 11,040 sepsis cases were identified in the UK Biobank, whereas 5672 cases were documented in the Kailuan Study during a median follow-up of 16.4 years. After multivariable adjustment, MetS was associated with higher risks of sepsis (HR=1.55, 95% CI 1.49–1.61) and 28-day mortality following sepsis (HR=1.51, 95% CI 1.37–1.65) in the UK Biobank; corresponding HRs were 1.32 (95% CI 1.25–1.40) and 1.49 (95% CI 1.32–1.69) in the Kailuan Study, respectively (all P<0.001). These associations were generally consistent across stratified analyses. Moreover, the risk of sepsis outcomes increased with the number of MetS components and was partly mediated by inflammation. Compared with individuals free of MetS, individuals with MetS and an unfavorable lifestyle had substantially higher risks of sepsis (HR=1.91, 95% CI 1.81–2.00) and 28-day mortality following sepsis (HR=1.84, 95% CI 1.64–2.07), whereas those with MetS but a favorable lifestyle showed only a modestly increased risk of sepsis and no excess risk of 28-day mortality (HR=1.18, 95% CI 1.09–1.28 and HR=1.05, 95% CI 0.88–1.27, respectively). In analyses of MetS evolution, using individuals with persistently normal metabolic status as the reference, those with a persistent MetS demonstrated the highest risks of sepsis (HR=1.46, 95% CI 1.32–1.61) and 28-day mortality following sepsis (HR=1.88, 95% CI 1.50–2.35), followed by individuals with progressive MetS (HR=1.17, 95% CI 1.05–1.31 and HR=1.36, 95% CI 1.04–1.77, respectively), whereas those who recovered from MetS did not show a significantly increased risk (HR=1.09, 95% CI 0.96–1.25 and HR=1.19, 95% CI 0.87–1.61, respectively). Sensitivity analyses confirmed the robustness of the findings. This study demonstrated that MetS was associated with an increased risk of sepsis and sepsis-related mortality. These associations were partially mediated through inflammatory responses. The findings highlight the importance of maintaining metabolic health as well as promoting healthy lifestyles as strategies to reduce its burden.