BACKGROUND:Titanium implants are widely used in clinical practice because of their high strength and good biocompatibility.However,during implantation,bacterial infection and tissue damage environment produce a large number of reactive oxygen species,which can easily lead to delayed tissue healing and surgical failure.Consequently,the development of titanium implants with antimicrobial and antioxidant properties becomes paramount. OBJECTIVE:Considering the potent antimicrobial attributes of copper ions and the remarkable antioxidant qualities of polyphenols,we proposed the fabrication of polyphenol-mediated copper ion coatings on titanium surfaces.These coatings were subsequently assessed for their in vitro antimicrobial and antioxidant properties. METHODS:Nanostructures were generated on the titanium surface using the alkali thermal method.The titanium was immersed in a solution containing tannic acid and copper ions to achieve polyphenol-mediated copper ion coatings.The surface morphology and water contact angle were detected.The loading and release of copper ions were examined using atomic absorption spectroscopy.Staphylococcus aureus was inoculated on the surface of pure titanium sheet(blank group),alkali heat treated titanium sheet(control group),and polyphenol mediated copper ion modified titanium sheet(experimental group)to observe the bacterial survival status.Osteoblast precursor cells MC3T3-E1 were co-cultivated on the surface of three groups of titanium sheets to assess their antioxidant properties and bioactivity. RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that the polyphenol-mediated copper ion modified titanium sheet had rod-like nanostructures and no cracks on the surface.The surface hydrophilicity of copper ion modified titanium sheet mediated by polyphenol was close to that of pure titanium sheet.Atomic absorption spectrometry results showed a 51%increase in the loading capacity of copper ions after polyphenol mediation,with a uniform release of copper ions.(2)The antibacterial rates of titanium sheets in the blank group,control group,and experimental group were 0%,21.65%,and 93.75%,respectively.The live/dead staining and CTC staining showed that the live bacteria on the surface of titanium plates in the blank group were the most,and the live bacteria on the surface of titanium plates in the experimental group were the least.(3)The results of live/dead staining and CCK-8 assay showed that the three groups of titanium sheets had good cytocompatibility,and the titanium sheets in the experimental group were more conducive to the proliferation of MC3T3-E1 cells.Active oxygen fluorescence probe detection exhibited that compared with the other two groups,the fluorescence intensity of active oxygen on the surface of the experimental group was significantly reduced.The results of alkaline phosphatase and alizarin red S staining showed that the osteogenic differentiation and extracellular matrix mineralization of MC3T3-E1 cells on the surface of titanium sheets in the experimental group were stronger than those in the other two groups.(4)These results show that the polyphenol-mediated copper ion coating has strong antibacterial and antioxidant properties and promotes osteogenic differentiation.

This article systematically reviews the characteristics and trends of the writing, editing, publication and promotion of physiology textbooks in China from the late 19th century to the present, focusing on the introduction, development and innovation of Chinese physiology textbooks. The development of physiology textbooks in China is divided into four main stages: the introduction and initial development of physiology textbooks from the late 19th century to 1925; the localization and diversification of textbooks from 1926 to 1949, after the establishment of the Chinese Physiological Society; the exploratory phase of textbook construction after the founding of the People's Republic of China from 1949 to 1976; the formation and innovation of the textbook development process from 1977 to the present, following the restoration of the college entrance examination. For each phase, the article not only records the historical development of physiology textbooks, but also analyzes the evolution of their content, writing styles and the interaction with the social and political contexts. The article summarizes the characteristics and experiences of all these four phases. Special attention is given to the comprehensive statistical analysis of physiology textbooks published since the restoration of the college entrance examination and Economic Reform and Opening-up in 1977, revealing the changes in the number, publication trends and academic features of textbooks during this period. Finally, the article presets the future development of physiology textbooks in China, proposing that textbook writing should integrate aspects such as ideological and political education, medical humanities, basic and clinical medicine, health education, scientific research and international exchange and collaboration. The article also advocates for the application of new technologies and methods, such as artificial intelligence, virtual teaching models and knowledge graphs, to support "personalized learning". This research provides a systematic reference for the study of the history of medical education and offers theoretical support for the future innovation of physiology textbook in China.
Humans ; China ; History, 19th Century ; History, 20th Century ; History, 21st Century ; Physiology/education* ; Textbooks as Topic/history*

Idiopathic Pulmonary Fibrosis is a chronic interstitial lung disease of unknown etiology with a short survival period, poor prognosis, and difficult to completely cure. At present, the main diagnostic method of IPF is High Resolution CT (HRCT), which has the disadvantage of high subjective impact and low repeatability. Therefore, it is necessary to develop novel biomarkers to aid in the diagnosis and prognosis of IPF. In recent years, more and more studies have focused on exosomes, whose specific regulatory mechanisms for IPF have not been fully elucidated, although it has been extensively studied in the field of malignant tamors and cardiovascular disease. In addition, exosomes can be secreted by different cells and body fluids, having potential applications in suggesting IPF risk and diagnostic prognosis.

Objective To compare the clinical efficacy of intraoperative slide rail CT combined with C-arm X-ray assis-tance and just C-arm for percutaneous screw in the treatment of pelvic posterior ring injury.Methods A retrospective analysis was performed on the patient data of 76 patients with posterior pelvic ring injury admitted to the Department of Orthopedic Trauma from December 2018 to February 2022.Among them,39 patients in the CT group were treated with C-arm combined with slide rail CT-assisted inline fixation including 23 males and 16 females with an average age of(44.98±7.33)years old;and the other 37 patients in the C-arm group were treated with intraline fixation treatment under only C-arm fluoroscopy in-cluding 24 males and 13 females with an average age of(44.37±10.82)years old.Among them,42 patients with anterior ring fractures were treated with percutaneous inferior iliac spines with internal fixation(INFIX)or suprapubic support screws to fix the anterior pelvic ring.Postoperative follow-up time,operation time,complications of the two groups were compared.Results of Matta reduction criteria,Majed efficacy evaluation,the CT grading and the rate of secondary surgical revision were com-pared.Results The nailing time of(32.63±7.33)min in CT group was shorter than that of(52.95±10.64)min in C-arm group(t=-9.739,P＜0.05).The follow-up time between CT group(11.97±1.86)months and C-arm group(12.03±1.71)months were not statistically significant(P＞0.05).The postoperative complication rates between two groups were not statistically significant(x2=0.159,P＞0.05).Results of Matta reduction criteria(Z=2.79,P＜0.05),Majeed efficacy evaluation(Z=2.79,P＜0.05),CT grading(Z=2.83,P＜0.05)in CT group were better than those in C-arm group(P＜0.05);the secondary surgical revision rate in the CT group was significantly lower than that in the C-arm group(x2=5.641,P＜0.05).Conclusion Compared with traditional C-arm fluoroscopy,intraoperative slide rail CT combined with C-arm assisted percutaneous sacroiliac joint screw placement surgery has the characteristics of short operation time,high accuracy and safety,and significant decrease in postoperative sec-ondary revision rate,and is one of the effective methods for re-establishing the stability of the posterior ring of pelvic fracture.

Objective:To analyze the safety and efficacy of ultrasound-guided percutaneous thermal ablation treatment for multiple T1N0M0 papillary thyroid carcinoma(PTC)with over 5 years follow-up.Methods:From January 2014 to January 2019,a retrospective analysis was conducted on patients with multiple T1N0M0 PTC who underwent ultrasound-guided thermal ablation.Patients with bilateral or unilateral lobes with isthmus PTC were enrolled in this study and were followed up at 1,3,6,12,24,36,48,and 60 months after ablation.The clinical data,ultrasound characteristics and ablation parameters of recurrent and non-recurrent patients were compared,and the efficacy and influencing factors of thermal ablation for multiple T1N0M0 PTC were analyzed.Results:After over 5 years follow-up,a total of 11 patients(16.18％)relapsed,57 patients(83.82％)did not re-lapse.No lymph node and distant metastasis were found.No significant correlation was detected between the recurrence and clinical features,ultrasound findings and ablation parameters(P＞0.05).Among the patients with recurrence,1 patient underwent observation,2 patients underwent total thyroidectomy,and the other 8 patients successfully underwent secondary ablation,all of which had no obvious adverse reactions.Conclusion:The ablation of multiple PTC in T1N0M0 stage is safe and effective,with a recurrence rate of 16.18％over 5 years follow-up,and ablation has no effect on second treatment for recurrent patients.

Objective:To explore the feasibility of 60 kV low-dose scanning technique on chest combined with ClearInfinity deep learning reconstruction algorithm in the diagnosis of pediatric mycoplasma pneumonia.Methods:A total of 132 pediatric patients,who admitted to Taihe Hospital Affiliated to Hubei Medical College and were diagnosed as mycoplasma pneumonia,were selected,and all of them underwent computed tomography(CT)scans on chest.They were randomly divided into routine dose group(66 cases),low dose ClearView and ClearInfinity group(66 cases).In the routine dose group,the tube voltage of CT scan on chest was 100 kV,and 50%ClearView iterative algorithm was adopted in this group.The tube voltage of CT scan on chest was 60kV in low dose ClearView and ClearInfinity group,and 50%ClearView iterative algorithm and 50%ClearInfinity deep learning reconstruction algorithm were used respectively to conduct reconstruction.The difference of radiation dose among the three groups was compared.The CT values and standard deviation(SD)values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the region of interest(ROI)of the images of 3 groups were measured and calculated.The images were subjectively evaluated by two diagnostic attending physicians with 10 years of work experience,and the Kappa test was adopted to analyze the consistency of the score results.Results:Compared with the routine dose group,the volume CT dose index(CTDIvol)values,dose-length product(DLP)values and effective radiation dose(ED)values of the low dose ClearView group and ClearInfinity group reduced respectively by 87.58%,87.24%and 88.00%,and the differences were statistically significant(t=4 584.07,63.73,61.27,P<0.01).The noise values of left and right lung of the routine dose group were significantly lower than those of the low dose ClearView group,while were significantly higher than those of ClearInfinity group,and the differences were significant(Z=-9.912,-7.013,P<0.01),and the difference of them between low dose ClearView group and ClearInfinity group was significant(Z=-9.912,P<0.01).The SNR and CNR of left and right lung of low dose ClearView group were significantly lower than those of the routine dose group,with statistically significant(t=-34.810,5.522,P<0.01),while these of the low dose ClearInfinity group were significant higher than them of the routine dose group(t=3.544,-8.674,P<0.05),respectively.The two attending physicians had favorable consistency in the subjective evaluation for images(Kappa>0.75,P<0.01).The subjective score of the routine dose group was not significantly different with that of the low dose ClearInfinity group(P>0.05),but was significantly better than that of the low dose ClearView group(Z=-6.425,P<0.01).Conclusion:For pediatric patients with mycoplasma pneumonia,the 60 kV low dose CT on chest combined with ClearInfinity deep learning reconstruction algorithm can ensure image quality on the premise of reducing radiation,which can ensure the diagnostic effect.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To investigate the influences and mechanism of extracellular vesicles from dermal papilla cells (DPC-EVs) of mice on human hypertrophic scar fibroblasts (HSFs).Methods:The study was an experimental research. The primary dermal papilla cells (DPCs) of whiskers were extracted from 10 6-week-old male C57BL/6J mice and identified successfully. The DPC-EVs were extracted from the 3 rd to 5 th passage DPCs by ultracentrifugation, and the morphology was observed through transmission electron microscope and the particle diameter was detected by nanoparticle tracking analyzer ( n=3) at 24 h after culture. The 3 rd passage of HSFs were divided into DPC-EV group and phosphate buffer solution (PBS) group, which were cultured with DPC-EVs and PBS, respectively. The cell scratch test was performed and cell migration rate at 24 h after scratching was calculated ( n=5). The cell proliferation levels at 0 (after 12 h of starvation treatment and before adding DPC-EVs or PBS), 24, 48, 72, and 96 h after culture were detected by using cell counting kit 8 ( n=4). The protein expressions of α-smooth muscle actin (α-SMA) and collagen typeⅠ (ColⅠ) in cells at 24 h after culture were detected by immunofluorescence method and Western blotting, and the protein expression of Krüppel-like factor 4 (KLF4) in cells at 24 h after culture was detected by Western blotting. After the 3 rd passage of HSFs were cultured with DPC-EVs for 24 h, the cells were divided into blank control group, KLF4 knockdown group, and KLF4 overexpression group according to the random number table. The cells in blank control group were only routinely cultured for 48 h. The cells in KLF4 knockdown group and KLF4 overexpression group were incubated with KLF4 knockdown virus for 24 h, then the cells in KLF4 knockdown group were routinely cultured for 24 h while the cells in KLF4 overexpression group were incubated with KLF4 overexpression virus for 24 h. The protein expressions of KLF4, α-SMA, and ColⅠ in cells were detected by Western blotting at 48 h after culture. Results:At 24 h after culture, the extracted DPC-EVs showed vesicular structure with an average particle diameter of 108.8 nm. At 24 h after scratching, the migration rate of HSFs in PBS group was (54±10)%, which was significantly higher than (29±8)% in DPC-EV group ( t=4.37, P<0.05). At 48, 72, and 96 h after culture, the proliferation levels of HSFs in DPC-EV group were significantly lower than those in PBS group (with t values of 4.06, 5.76, and 6.41, respectively, P<0.05). At 24 h after culture, the protein expressions of α-SMA and ColⅠ of HSFs in DPC-EV group were significantly lower than those in PBS group, while the protein expression of KLF4 was significantly higher than that in PBS group. At 48 h after culture, compared with those in blank control group, the protein expression of KLF4 of HSFs in KLF4 knockdown group was down-regulated, while the protein expressions of α-SMA and ColⅠ were both up-regulated; compared with those in KLF4 knockdown group, the protein expression of KLF4 of HSFs in KLF4 overexpression group was up-regulated, while the protein expressions of ColⅠ and α-SMA were down-regulated. Conclusions:The DPC-EVs of mice can inhibit the proliferation and migration of human HSFs and significantly inhibit the expressions of fibrosis markers α-SMA and ColⅠ in human HSFs by activating KLF4.

Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.