Objective To analyze the relationship between the expression of TSP-1, VEGF, and Th17-related inflammatory factors and early acute lung injury (ALI) in COPD. Methods The clinical data of 140 randomly selected patients with COPD in our hospital from May 2016 to June 2018 were retrospectively analyzed. According to the condition of the disease, they were divided into control group (n = 70) and observation group (n = 70). The related indicators were determined by flow cytometry and enzyme-linked immunosorbent assay (ELISA). Statistical analysis of data was carried out by Pearson linear correlation analysis and logistic regression analysis. Results Compared with the control group, the levels of FEV1 and FEV1/FVC in the patients with COPD complicated with early ALI were significantly lower, while the ratio of Th17/Treg in peripheral blood was significantly higher in the observation group. The plasma levels of TSP-1, VEGF and related inflammatory factors were significantly higher in the observation group than those in the control group. Pearson correlation analysis showed that TSP-1 and VEGF were positively correlated with CD4+Th17 cell ratio. Logistic regression analysis showed that IL-17 was an independent risk factor for early acute lung injury in COPD. Conclusion The increased release of Th17-related inflammatory cytokines will aggravate the airway inflammatory response, cause abnormal expression of TSP-1 and VEGF, and lead to vascular endothelial dysfunction, which will further aggravate the condition of patients, and increase the risk of acute lung injury in patients with COPD.

Objective:To explore the effectiveness of stratified teaching in improving the efficiency and quality of clinical teaching in the standardized training of residents in the department of prosthodontics.Methods:We enrolled a total of 297 participants who accomplished the standardized residency training in the Department of Prosthodontics of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to May 2023. They were divided into stratified group (141 trainees from September 2021 to May 2023) and control group (156 trainees from January 2020 to August 2021). The stratified group received stratified teaching at three levels according to the trainees' major, training stage, and identity category, and the teaching theme and teaching method were set according to teaching objectives. The control group used a traditional teaching mode. The two groups were compared in terms of medical history taking, oral examination, case analysis, skill practice, and case report scores. SPSSAU was used to perform the t test and chi-squared test for data analysis. Results:The stratified group showed better performance in the final assessment: the case analysis score of the first-level trainees was significantly higher than that of the control group (85.72±4.14 vs. 83.00±6.38, P=0.003); the second-level trainees had a higher medical history taking score than the control group (88.20±7.14 vs. 85.38±5.63); the proportions of trainees rated as excellent in case report in the stratified group (the first level, 54.02%; the second level, 52.63%; the third level, 75.00%) were higher than those in the control group (the first level, 42.65%; the second level, 45.33%; the third level, 46.15%). Conclusions:In standardized residency training, the stratified teaching method can effectively improve trainees' case analysis, medical history taking, and case report abilities, and the effects in improving the skill practice level of trainees majoring in prosthodontics need to be further explored.