Objective:To construct of 3-dimensional finite element models of mandibular first molar with structure defect restoration.Methods:Reverse engineering technology was used. Geometric models were built by the use of advanced 3-dimensional laser scanning and computer assisted 3-dimensional design technique. The geometric data were introduced into the finite element software for establishing the finite element mesh after being processed.Results:The 3-dimensional finite element models of the minimum distal occlusal structure defect with restoration were created, which included metal crown with exterior anatomic morphology of the mandibular first molar, tooth preparation, filling material and the structure of periodontal membrane.Conclusion: The method may be a useful approach for building models of teeth and relative tissues.

Objective:To compare and explore the clinical efficacy and safety of endoscopic thyroidectomy by gasless unilateral axillary approach for the treatment of papillary thyroid microcar cinoma (PTMC) .Methods:One hundred and ten patients with unilateral PTMC admitted to the Department of Thyroid and Breast Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, from Jan.3 2019 to Mar. 2022 were used as clinical study subjects, and according to the patients' choice of surgical modality, they were divided into 30 cases in the endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) group and 80 cases in the minimally invasive video-assisted thyroidectomy (MIVAT) group. We retrospectively compared and analyzed the differences in the surgery-related indexes, aesthetic satisfaction rate at 3 months postoperatively and functional status of the anterior cervical region between the 2 groups. SPSS 26.0 statistical software was used to process the data, analyze and draw conclusions. P<0.05 was considered a statistically significant difference. Results:The number of lymph nodes cleared in the study group (6.60±4.41) was less than that in the control group (9.63±6.25) ( P<0.05) ; the total operative time (169.83±28.76) min, postoperative drainage (173.60±94.33) ml, and time to remove drainage tubes after surgery (5.73±1.86 ) d was significantly higher than the total operative time (145.56±33.89) min, postoperative drainage (107.28±53.82) ml, and time to remove drainage tubes after surgery (2.88±1.07) d in the control group ( P<0.01) ;the intraoperative bleeding, number of positive lymph nodes, and postoperative hospital stay were not statistically significant between the two groups ( P>0.05) .The aesthetic satisfaction rate of the study group had a significant advantage over the control group (90% vs 70%) ( P<0.01) .Comparing the functional status of the anterior cervical region between the two groups after surgery,the occurrence of swallowing discomfort or with pulling sensation was better in the study group than in the control group 1 week after surgery ( P<0.05), and there was no statistically significant difference between the two groups in the occurrence of neck pain score, abnormal sensory function (neck pressure, foreign body sensation, numbness and pins and needles) and vocal difficulty ( P>0.05) ; 3 months after surgery, abnormal sensory function of the neck in the study group (at 3 months postoperatively, the occurrence of abnormal neck sensory function (neck pressure, foreign body sensation, numbness and pins and needles sensation) and swallowing discomfort or pulling sensation were better in the study group than those in the control group ( P<0.05). There were no signs of local recurrence or distant metastasis in both groups at follow-up to date. Conclusions:Both minimally endoscopic thyroidectomy procedures were safe, feasible, and effective in the treatment of unilateral PTMC. Among them, the ETGUA is more suitable for patients with strong cosmetic needs within the indications because of its concealed incision and its ability to protect the function of the anterior cervical region, and can be the preferred option.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

Objective To investigate the correlation between salivary cystatin D level and salivary gland injury in patients with primary Sj?gren syndrome(pSS).Methods A total of 51 pSS patients admitted in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Xi'an Jiaotong University from September 1,2022 to June 30,2023,and 51 age-and gender-matched healthy individuals who took physical examination in the hospital during same period were enrolled in the study.The level of salivary cystatin D was detected,and the difference in the level between the 2 groups was compared using an independent-samples t test.Pearson correlation analysis was applied to analyze the correlation between salivary cystatin D and clinical parameters in the patients.Results The pSS patients had significantly lower cystatin D level than the healthy controls(206.55±108.11 vs 374.32±172.24 pg/mL,P＜0.01).The cystatin D level in the pSS patients was positively correlated with both static(r=0.433,P=0.002)and dynamic salivary flow rates(r=0.363,P=0.009).The patients with higher score of salivary gland ultrasonography(SGUS)had obviously lower cystatin D than those with lower SGUS score(parotid gland:160.75±85.56 vs 290.53±95.17 pg/mL,P＜0.01;submandibular gland:157.76±87.59 vs 276.25±97.06 pg/mL,P＜0.01).The cystatin D level was also negatively correlated with peripheral blood IL-6 level(r=-0.453,P=0.001)and CD4+T cell count(r=-0.396,P=0.005)in the pSS patients.Conclusion Salivary cystatin D level can be used as an indicator of salivary gland damage for pSS patients.