BACKGROUND:3D-printed bone tissue engineering scaffolds have obvious advantages in the research and clinical treatment of bone defect repair.As one of the important raw materials for 3D printed bone scaffolds,poly-L-lactic acid has a great potential for application in performing bone defect repair,but clinical patients with different bone defect causative factors have different requirements for the comprehensive performance of poly-L-lactic acid bone scaffolds.OBJECTIVE:To summarize and review the development of 3D printing technology and poly-L-lactic acid scaffolds and the design strategies chosen for scaffolds for bone repair in the setting of bone diseases such as osteomyelitis,bone tumor,osteonecrosis,and osteoporosis.METHODS:Literature from CNKI,WanFang,PubMed,Science Direct,and Web of Science databases were searched and screened from 1994 to 2024.Search terms were"3D printing,polylactic acid,bone tissue engineering scaffold,osteomyelitis,bone tumor,osteonecrosis,osteoporosis,bone defect"in Chinese and English.The screened 62 articles were systematically summarized and analyzed.RESULTS AND CONCLUSION:(1)Poly-L-lactic acid is considered to be an ideal raw material for artificial bone scaffold design due to its non-toxicity,processability,biocompatibility,and ability to self-degrade in the human environment.The application of 3D printing technology has enabled poly-L-lactic acid bone scaffolds to meet the multilayered and porous structural design requirements of biomimetic artificial bone repair materials,and to optimize the mechanical properties for better bone repair.(2)According to different bone disease microenvironments,timely adjustment of the functional design of poly-L-lactic acid scaffolds is important for the comprehensive osteogenic efficacy of the scaffolds.The article discusses the application of poly-L-lactic acid scaffolds in bone disease environments such as osteomyelitis,bone tumor,osteonecrosis,and osteoporosis,and highlights the importance of rationally grasping the timing of bone disease treatment and bone tissue regeneration for bone defects caused by different bone diseases.(3)Although poly-L-lactic acid scaffolds show potential in bone repair,there are still some problems,such as the need to further optimize the structural design of the scaffolds to fit new bone regeneration,enhance the bioactivity of the scaffolds,and take into account other functions(e.g.,antimicrobial,anti-tumor,and anti-osteoporosis)in order to adapt to the needs of bone tissue repair in different pathological environments.

BACKGROUND:3D-printed bone tissue engineering scaffolds have obvious advantages in the research and clinical treatment of bone defect repair.As one of the important raw materials for 3D printed bone scaffolds,poly-L-lactic acid has a great potential for application in performing bone defect repair,but clinical patients with different bone defect causative factors have different requirements for the comprehensive performance of poly-L-lactic acid bone scaffolds.OBJECTIVE:To summarize and review the development of 3D printing technology and poly-L-lactic acid scaffolds and the design strategies chosen for scaffolds for bone repair in the setting of bone diseases such as osteomyelitis,bone tumor,osteonecrosis,and osteoporosis.METHODS:Literature from CNKI,WanFang,PubMed,Science Direct,and Web of Science databases were searched and screened from 1994 to 2024.Search terms were"3D printing,polylactic acid,bone tissue engineering scaffold,osteomyelitis,bone tumor,osteonecrosis,osteoporosis,bone defect"in Chinese and English.The screened 62 articles were systematically summarized and analyzed.RESULTS AND CONCLUSION:(1)Poly-L-lactic acid is considered to be an ideal raw material for artificial bone scaffold design due to its non-toxicity,processability,biocompatibility,and ability to self-degrade in the human environment.The application of 3D printing technology has enabled poly-L-lactic acid bone scaffolds to meet the multilayered and porous structural design requirements of biomimetic artificial bone repair materials,and to optimize the mechanical properties for better bone repair.(2)According to different bone disease microenvironments,timely adjustment of the functional design of poly-L-lactic acid scaffolds is important for the comprehensive osteogenic efficacy of the scaffolds.The article discusses the application of poly-L-lactic acid scaffolds in bone disease environments such as osteomyelitis,bone tumor,osteonecrosis,and osteoporosis,and highlights the importance of rationally grasping the timing of bone disease treatment and bone tissue regeneration for bone defects caused by different bone diseases.(3)Although poly-L-lactic acid scaffolds show potential in bone repair,there are still some problems,such as the need to further optimize the structural design of the scaffolds to fit new bone regeneration,enhance the bioactivity of the scaffolds,and take into account other functions(e.g.,antimicrobial,anti-tumor,and anti-osteoporosis)in order to adapt to the needs of bone tissue repair in different pathological environments.

Objective To explore the correlation between lymph node metastasis and clinicopathological features of lung adenocarcinoma with diameter≤3 cm. Methods The clinicopathologic data of the patients with lung adenocarcinoma≤3 cm in diameter were retrospectively analyzed. The relationship between lymph node metastasis and age, gender, smoking history, pathological subtype, tumor diameter, pleural invasion, vascular invasion and other factors was analyzed. The risk factors of lymph node metastasis were analyzed by univariate and multivariate logistic regression. Results Finally 1 718 patients were collected, including 697 males and 1 021 females with an average age of (58.89±9.85) years. The total lymph node metastasis rate was 12.9%, among whom 452 patients of adenocarcinoma in situ and minimally invasive adenocarcinoma did not have lymph node metastasis, and the lymph node metastasis rate of invasive lung adenocarcinoma was 17.5%. Multivariate analysis showed that tumor diameter, micropapillary subtype, solid subtype, micropapillary component, solid component, vascular invasion and pleural invasion were independent risk factors for lymph node metastasis of invasive lung adenocarcinoma with diameter≤3 cm (P<0.05). While age, lepidic subtype and lepidic component were independent protective factors for lymph node metastasis (P<0.05). Conclusion Clinicopathological features can help predict lymph node metastasis of lung adenocarcinoma with diameter≤3 cm.

ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis， as well as independent risk factors for the degree of calcium salt deposition in lesions， and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025， and according to the volume of calcium salt deposition， they were divided into non-deposition group with 16 patients， mild deposition group with 52 patients， moderate deposition group with 16 patients， and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups， and the χ² test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group （no/mild deposition） and the high deposition group （moderate/severe deposition）. A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition， and a predictive model was established. The receiver operating characteristic （ROC） curve was used to assess the predictive performance of the model， and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.05）. The univariate analysis showed that there were significant differences between the four groups in sex， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， alanine aminotransferase， albumin， creatinine， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.1）. The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760， suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex， involvement of other sites， calcium ion， lymphocyte percentage， and uric acid. The multivariate analysis showed that lymphocyte percentage （odds ratio ［OR］=1.106， 95% confidence interval ［CI］： 1.041 — 1.174， P=0.001） and blood calcium level （OR=0.005， 95%CI： 0.000 —0.230， P=0.007） were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit（P）=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716， with a Youden index of 0.353， a sensitivity of 1.000， and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration （χ²=20.688， P=0.008）. The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage （OR=1.106， 95%CI： 1.049 — 1.186， P=0.002） and calcium ion （OR=0.005， 95%CI： 0.000 — 0.214， P=0.010） were consistent with the original model， and the confidence intervals did not include 1， which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis， and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.

OBJECTIVE To evaluate the cost-effectiveness of lecanemab for early Alzheimer disease （AD） from a whole-society perspective. METHODS Based on data from the Clarity AD study， a global multicenter， randomized， double-blind， placebo-controlled study of lecanemab for early AD， a Markov model was developed according to the disease progression of AD， with a monthly cycle and a time horizon extending to 99% patient mortality. Quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER） were used as outcome indicators， with a willingness-to-pay （WTP） threshold set at twice China’s per capita gross domestic product （GDP） for 2025 （199 330.00 yuan/QALY）. The model simulated the cost-effectiveness of lecanemab plus standard of care （SoC） versus placebo plus SoC for early AD. One-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis were employed to test the robustness of the results. RESULTS Compared with placebo plus SoC， the ICER for lecanemab plus SoC was 4 364 711.54 yuan/QALY. One-way sensitivity analysis showed that the hazard ratio for disease progression， the price of lecanemab， body weight， the monthly progression probability of mild cognitive impairment， and the discount rate were key parameters affecting model robustness. Results of the probabilistic sensitivity analysis showed that the probability of lecanemab being cost-effective was 0 at the current WTP threshold. Scenario analysis indicated that a price reduction of at least 94.88% would be required for lecanemab to fall below the WTP threshold. CONCLUSIONS At the current WTP threshold， lecanemab plus SoC is not cost-effective compared with placebo plus SoC for early AD.

OBJECTIVE To evaluate the cost-effectiveness of lecanemab for early Alzheimer disease （AD） from a whole-society perspective. METHODS Based on data from the Clarity AD study， a global multicenter， randomized， double-blind， placebo-controlled study of lecanemab for early AD， a Markov model was developed according to the disease progression of AD， with a monthly cycle and a time horizon extending to 99% patient mortality. Quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER） were used as outcome indicators， with a willingness-to-pay （WTP） threshold set at twice China’s per capita gross domestic product （GDP） for 2025 （199 330.00 yuan/QALY）. The model simulated the cost-effectiveness of lecanemab plus standard of care （SoC） versus placebo plus SoC for early AD. One-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis were employed to test the robustness of the results. RESULTS Compared with placebo plus SoC， the ICER for lecanemab plus SoC was 4 364 711.54 yuan/QALY. One-way sensitivity analysis showed that the hazard ratio for disease progression， the price of lecanemab， body weight， the monthly progression probability of mild cognitive impairment， and the discount rate were key parameters affecting model robustness. Results of the probabilistic sensitivity analysis showed that the probability of lecanemab being cost-effective was 0 at the current WTP threshold. Scenario analysis indicated that a price reduction of at least 94.88% would be required for lecanemab to fall below the WTP threshold. CONCLUSIONS At the current WTP threshold， lecanemab plus SoC is not cost-effective compared with placebo plus SoC for early AD.

Objective To investigate the effects of Ras-related protein Rab-2B(RAB2B)on the biological behaviors of pancreatic cancer cells and elucidate its underlying mechanism.Methods PANC-1 cells,which exhibit relatively high RAB2B expression,and BXPC-3 cells,which display relatively low RAB2B expression,were selected from five pancreatic cancer cell lines.RAB2B-siRNA and pcDNA3.1-RAB2B plasmids were transfected into PANC-1 and BXPC-3 cells using a cell transfection technique.The CCK-8 assay was employed to evaluate the prolif-erative capacity of pancreatic cancer cells following RAB2B intervention.Wound healing and Transwell chamber assays were utilized to assess the migratory and invasive capabilities of pancreatic cancer cells.Additionally,the mRNA and protein expression levels of RAB2B,NF-κB,and Fibronectin 1(FN1)were analyzed by qRT-PCR and Western blot(WB),respectively.Results RAB2B mRNA and protein expression levels were significantly down-regulated in PANC-1 cells following transfection(P<0.05).CCK-8 assay results demonstrated that the proliferative capacity of PANC-1 cells was markedly reduced(P<0.05),and the wound-healing ability was substantially impaired(P<0.01)upon RAB2B knockdown.Transwell assays revealed a significant decrease in cell migration(P<0.01),while Western blot analysis indicated that the expression levels of phosphorylated p65 and FN1 were notably diminished(P<0.01).Conversely,overexpression of RAB2B reversed these aforementioned alterations.Conclusions Knockdown of RAB2B in PANC-1 cells significantly suppresses cell proliferation and migration,whereas overexpression of RAB2B in BXPC-3 cells markedly promotes these processes.This effect is likely mediated through the activation of the NF-κB signaling pathway and the subsequent regulation of FN1 expression.

Objective To explore the protective effect of Bilobalide on retinal ganglion cells(RGCs)in rats with op-tic nerve injury and its mechanism.Methods Sixty rats were randomly selected from 75 Sprague-Dawley rats to establish an optic nerve crush injury model.The 60 successfully modeled rats were then randomly divided into a model group,and low-,medium-,and high-dose Bilobalide groups,with 15 rats in each group.Another 15 rats served as the sham-operated group,undergoing optic nerve exposure without crushing.Rats in the low-,medium-,and high-dose Bilobalide groups were intraperitoneally injected with 5,10 and 20 mg·kg-1 Bilobalide,respectively,once daily for 7 days.Rats in the sham-operated and model groups were intraperitoneally injected with an equal volume of normal saline once daily for 7 days.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in the retinal tissue of rats in each group were measured.Immunofluorescence staining was used to assess RGCs proliferation.Hematoxylin-eosin(HE)stai-ning was used to observe histopathological changes in the retinal structure.TUNEL staining was used to detect RGCs apop-tosis.Immunofluorescence staining was used to observe the activation state of retinal microglia.Western blot was used to detect the expression of growth-associated protein 43(GAP43)and proteins related to the extracellular signal-regulated ki-nase 1/2(ERK1/2)pathway.Results Compared with the sham-operated group,the model group showed significantly decreased SOD activity and increased MDA content in the retinal tissue(all P＜0.05),a significant decrease in RGCs densi-ty(P＜0.05),significant increases in the apoptosis rate and microglial activation ratio(all P＜0.05),and significant downregulation of p-ERK1/2 and GAP43 protein expression(all P＜0.05).Histomorphology revealed edema and vacuola-tion in the ganglion cell layer,disordered arrangement of RGCs,and thinning of the inner nuclear layer and outer nuclear layer in the model group.After intervention with various doses of Bilobalide,all the above indices were significantly im-proved(all P＜0.05):SOD activity increased,MDA content decreased,RGCs density recovered,RGCs apoptosis rate and microglial activation decreased,the expressions of p-ERK1/2 and GAP43 were upregulated,the structural damage to each retinal layer was alleviated,showing a dose-dependent recovery.Conclusion Bilobalide can exert a protective effect on RGCs after optic nerve injury through multiple mechanisms,including alleviating oxidative stress,inhibiting apoptosis and microglial overactivation,promoting axonal regeneration,and activating the ERK1/2 signaling pathway.

Objective:To investigate the effects of preoperative visit in operating room based on"internet plus"on perioperative negative emotion,sleep quality and stress response of elderly patients.Methods:142 elderly patients who underwent surgery in the Yancheng No.1 People's Hospital from From February 2022 to February 2024 were selected,the patients were randomly divided into observation group(n=71,preoperative visit in operating room based on"internet plus")and control group(n=71,traditional preoper ative visit).The perioperative indicators(heart rate,systolic blood pressure,diastolic blood pressure),negative emotions[Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)score],stress response indicators[C-reactive protein(CRP),cortisol(Cor),norepinephrine(NE),epinephrine(E)]were compared between the two groups.Results:Heart rate after intervention increased,systolic blood pressure,diastolic blood pressure,SAS,SDS scores,PSQI scores,CRP,Cor,NE and E decreased,and the change range of observation group was greater than that of control group(P＜0.05).Conclusion:Preoperative visit in operating room based on"internet plus"can effectively reduce the negative emotions of elderly patients,improve the quality of sleep,and alleviate the stress reaction through early communication,rich information,convenient,efficient and personalized service.

Objective To retrospectively analyze the distribution and differences of oral behavior among patients with acute and chro-nic painassociated with temporomandibular disorders(TMD).Methods A total of 212 patients with pain TMD in West China Hospital of Stomatology completed oral behaviors checklist(OBC).SPSS statistical software was used to analyze all the data.Results The pa-tients with pain-related TMD had specific oral behaviors,such as"pressure on the jaw during sleep"(49.5%),"unilateral chewing"(49.5%),"upper and lower teeth contact when not eating"(37.7%),etc.Scores of"upper and lower teeth contact when not eating"and"muscle tension when teeth are not clenched or teeth are not in contact"in patients with chronic pain TMD were higher than those of acute patients,and the difference was statistically significant(P＜0.05).The total OBC scores and daytime OBC scores of chronic pain TMD patients were higher than those of acute pain patients,and the difference was statistically significant(P＜0.05).There was no significant difference in OBC scores of patients with acute and chronic pain TMD during sleep(P＞0.05).Conclusion Pain-related TMD patients had specific oral behaviors,and patients with chronic pain TMD exhibited higher levels of total OBC,daytime OBC,"upper and lower teeth contact when not eating"and"muscle tension when teeth do not bite or teeth are not in contact"oral behavior than acute pain TMD patients.In the treatment of patients with painful TMD,correcting the patient's bad oral behavior can help the treatment of pain-related TMD.