Objective:To evaluate the clinical efficacy of 3D-printed patient-specific instrument (PSI) in assisting high tibial osteotomy (HTO).Methods:Clinical studies on 3D-printed PSI-assisted HTO were retrieved from various databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP, the Chinese Medical Journal Full-text Database, PubMed, Embase, and Web of Science. Key data extracted included the hip-knee-ankle (HKA) angle, weight-bearing line (WBL) ratio, mechanical medial proximal tibial angle (MPTA), number of intraoperative fluoroscopies, and operation time. Studies were categorized into a PSI group (using 3D-printed PSI for osteotomy) and a non-PSI group (without 3D-printed PSI assistance). Comparisons were made between pre- and post-operative radiographic improvements in the PSI group, as well as differences between post-operative outcomes and pre-operative planned values. Additionally, the number of fluoroscopies and operation time were compared between the PSI and non-PSI groups. Meta-analysis was performed using Stata 12.0 statistical softwar.Results:A total of 30 studies were included in the meta-analysis. The results indicated that in the PSI group, the post-operative WBL ratio [ WMD=-39.66, 95% CI(-43.19, -36.12), P<0.001], HKA [ WMD=-8.85, 95% CI(-10.17, -7.52), P<0.001], and MPTA [ WMD=-8.65, 95% CI(-9.61, -7.68), P<0.001] were significantly smaller compared to pre-operative values. However, there were no significant differences between the post-operative values and pre-operative planned values for the WBL ratio [ WMD=0.74, 95% CI(-0.17, 1.66), P=0.112], HKA [ WMD=0.20, 95% CI(-0.05, 0.45), P=0.116], or MPTA [ WMD=0.22, 95% CI(-0.04, 0.48), P=0.147] in the PSI group. Furthermore, the operation time [ WMD=-14.04, 95% CI(-17.66, -10.42), P<0.001] and the number of fluoroscopies [ WMD=-9.33, 95% CI(-12.36, -6.30), P<0.001] were significantly lower in the PSI group compared to the non-PSI group. Conclusion:3D-printed PSI-assisted HTO enhances precision, reduces operation time, and minimizes the number of intraoperative fluoroscopies.

Objective:To evaluate the clinical effectiveness of high tibial osteotomy (HTO) assisted by digital orthopedic techniques in the treatment of varus knee osteoarthritis secondary to tibial fracture malunion.Methods:The clinical data were retrospectively analyzed of the 16 patients who had been admitted to Clinical Application Center of Digital Orthopedic Technology, Tianjin Hospital for varus knee osteoarthritis secondary to tibial fracture malunion from April 2022 to October 2023. There were 6 men and 10 women, with an age of (56.3±1.6) years and a mean body mass index of (23.8±0.9) kg/m 2. HTO was performed for all the patients using patient-specific instrumentation integrated osteotomy and orthopedic guide which was designed and printed with digital orthopedic techniques. If preoperative imaging indicated symptomatic meniscus injury (tear), intraarticular free body, or intercondylar fossa stenosis in a patient, arthroscopic clearance was first conducted before subsequent performance of HTO at one stage. Clinical effectiveness was evaluated by measuring and comparing hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS), lower limb weight-bearing line (WBL) ratio, Western Ontario and McMaster University (WOMAC) osteoarthritis index, visual analogue scale (VAS) pain score and knee range of motion (ROM) before surgery and 12 months after surgery. Results:The operative time was (41.3±2.1) min and intraoperative fluoroscopy was performed only once in all the patients. All the wounds healed by the first stage with no such complications as hinge point fracture, wound infection, vascular injury, nerve injury, delayed union or nonunion of fracture, lower limb deep venous thrombosis, loosening of internal fixation, or plate rupture. The follow-up time for the 16 patients was (16.3±0.7) months. At 12 months after surgery, the HKA (179.5°±0.5°), MPTA (91.7°±0.5°), WBL ratio (61.2%±0.4%), WOMAC osteoarthritis index [(12.8±0.8) points], VAS pain score [(1.8±0.3) points] and knee ROM (121.8°±1.8°) were significantly better than those before surgery [166.6°±1.3°, 81.8°±0.4°, 29.6%±1.0%, (38.4±2.1) points, (4.8±0.3) points, and 110.5°±2.1°] ( P < 0.05). There was no significant difference in PTS between pre-surgery and 12 months after surgery ( P > 0.05). Conclusions:When HTO is used to treat varus knee osteoarthritis secondary to tibial fracture malunion, assistance of digital orthopedic techniques can improve HKA, MPTA, lower limb alignment, and knee ROM to reduce and recover knee function for the patients.

Objective To explore the therapeutic effect of picroside Ⅱ(P Ⅱ)on diabetes nephropathy(DN)rats by regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway.Methods A DN rat model was constructed by combining high sugar and high-fat diet with streptozotocin(STZ)injection.DN rats were grouped into model group(DN group),low,medium and high dose picroside Ⅱ groups(P-L group,P-M group,P-H group),and high dose picroside Ⅱ+Fas recombinant protein group(P-H+rh-Fas group),with healthy rats as control group,and 18 rats in each group.Fasting blood glucose(FBG),body mass,24-hour urinary protein(24h UTP),and renal function(SCr,BUN)were measured in rats.Hematoxylin-eosin(HE)staining and Masson staining were applied to observe the pathological changes in renal tissue of rats;immunohistochemistry and Western blot were applied to detect the expression of RAGE,COL-Ⅳ and pathway proteins,respectively.Results Compared with the control group,rats in DN group showed thickening of the glomerular basement membrane,mesangial proliferation,tubular degeneration,dilation,atrophy,fatty degeneration,obvious collagen deposition,higher levels of FBG,24h UTP,SCr,BUN,TNF-α,IL-6 and IL-1β,body mass loss,and higher expression of RAGE,COL-Ⅳ,Fas and FasL(P＜0.05).Compared with the DN group,the glomerular and tubular lesions were reduced and collagen deposition was decreased in the P-L,P-M and P-H groups,furthermore,the FBG,24h UTP,SCr,BUN,TNF-α,IL-6,IL-1β levels were lower,body mass was higher,and the RAGE,COL-Ⅳ,Fas,FasL expression was lower(P＜0.05).Compared with the P-H group,the renal tissue lesions in the P-H+rh-Fas group worsened,the FBG,24 h UTP,SCr,BUN,TNF-α,IL-6,IL-1β levels were higher,body mass was lower,and the RAGE,COL-Ⅳ,Fas,FasL expression was higher(P＜0.05).Conclusion Picroside Ⅱ exerts therapeutic effects on DN rats by inhibiting the Fas/FasL signaling pathway.

Objective To explore the therapeutic effect of picroside Ⅱ(P Ⅱ)on diabetes nephropathy(DN)rats by regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway.Methods A DN rat model was constructed by combining high sugar and high-fat diet with streptozotocin(STZ)injection.DN rats were grouped into model group(DN group),low,medium and high dose picroside Ⅱ groups(P-L group,P-M group,P-H group),and high dose picroside Ⅱ+Fas recombinant protein group(P-H+rh-Fas group),with healthy rats as control group,and 18 rats in each group.Fasting blood glucose(FBG),body mass,24-hour urinary protein(24h UTP),and renal function(SCr,BUN)were measured in rats.Hematoxylin-eosin(HE)staining and Masson staining were applied to observe the pathological changes in renal tissue of rats;immunohistochemistry and Western blot were applied to detect the expression of RAGE,COL-Ⅳ and pathway proteins,respectively.Results Compared with the control group,rats in DN group showed thickening of the glomerular basement membrane,mesangial proliferation,tubular degeneration,dilation,atrophy,fatty degeneration,obvious collagen deposition,higher levels of FBG,24h UTP,SCr,BUN,TNF-α,IL-6 and IL-1β,body mass loss,and higher expression of RAGE,COL-Ⅳ,Fas and FasL(P＜0.05).Compared with the DN group,the glomerular and tubular lesions were reduced and collagen deposition was decreased in the P-L,P-M and P-H groups,furthermore,the FBG,24h UTP,SCr,BUN,TNF-α,IL-6,IL-1β levels were lower,body mass was higher,and the RAGE,COL-Ⅳ,Fas,FasL expression was lower(P＜0.05).Compared with the P-H group,the renal tissue lesions in the P-H+rh-Fas group worsened,the FBG,24 h UTP,SCr,BUN,TNF-α,IL-6,IL-1β levels were higher,body mass was lower,and the RAGE,COL-Ⅳ,Fas,FasL expression was higher(P＜0.05).Conclusion Picroside Ⅱ exerts therapeutic effects on DN rats by inhibiting the Fas/FasL signaling pathway.

Objective:To evaluate the clinical efficacy of 3D-printed patient-specific instrument (PSI) in assisting high tibial osteotomy (HTO).Methods:Clinical studies on 3D-printed PSI-assisted HTO were retrieved from various databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP, the Chinese Medical Journal Full-text Database, PubMed, Embase, and Web of Science. Key data extracted included the hip-knee-ankle (HKA) angle, weight-bearing line (WBL) ratio, mechanical medial proximal tibial angle (MPTA), number of intraoperative fluoroscopies, and operation time. Studies were categorized into a PSI group (using 3D-printed PSI for osteotomy) and a non-PSI group (without 3D-printed PSI assistance). Comparisons were made between pre- and post-operative radiographic improvements in the PSI group, as well as differences between post-operative outcomes and pre-operative planned values. Additionally, the number of fluoroscopies and operation time were compared between the PSI and non-PSI groups. Meta-analysis was performed using Stata 12.0 statistical softwar.Results:A total of 30 studies were included in the meta-analysis. The results indicated that in the PSI group, the post-operative WBL ratio [ WMD=-39.66, 95% CI(-43.19, -36.12), P<0.001], HKA [ WMD=-8.85, 95% CI(-10.17, -7.52), P<0.001], and MPTA [ WMD=-8.65, 95% CI(-9.61, -7.68), P<0.001] were significantly smaller compared to pre-operative values. However, there were no significant differences between the post-operative values and pre-operative planned values for the WBL ratio [ WMD=0.74, 95% CI(-0.17, 1.66), P=0.112], HKA [ WMD=0.20, 95% CI(-0.05, 0.45), P=0.116], or MPTA [ WMD=0.22, 95% CI(-0.04, 0.48), P=0.147] in the PSI group. Furthermore, the operation time [ WMD=-14.04, 95% CI(-17.66, -10.42), P<0.001] and the number of fluoroscopies [ WMD=-9.33, 95% CI(-12.36, -6.30), P<0.001] were significantly lower in the PSI group compared to the non-PSI group. Conclusion:3D-printed PSI-assisted HTO enhances precision, reduces operation time, and minimizes the number of intraoperative fluoroscopies.

Objective:To evaluate the clinical effectiveness of high tibial osteotomy (HTO) assisted by digital orthopedic techniques in the treatment of varus knee osteoarthritis secondary to tibial fracture malunion.Methods:The clinical data were retrospectively analyzed of the 16 patients who had been admitted to Clinical Application Center of Digital Orthopedic Technology, Tianjin Hospital for varus knee osteoarthritis secondary to tibial fracture malunion from April 2022 to October 2023. There were 6 men and 10 women, with an age of (56.3±1.6) years and a mean body mass index of (23.8±0.9) kg/m 2. HTO was performed for all the patients using patient-specific instrumentation integrated osteotomy and orthopedic guide which was designed and printed with digital orthopedic techniques. If preoperative imaging indicated symptomatic meniscus injury (tear), intraarticular free body, or intercondylar fossa stenosis in a patient, arthroscopic clearance was first conducted before subsequent performance of HTO at one stage. Clinical effectiveness was evaluated by measuring and comparing hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS), lower limb weight-bearing line (WBL) ratio, Western Ontario and McMaster University (WOMAC) osteoarthritis index, visual analogue scale (VAS) pain score and knee range of motion (ROM) before surgery and 12 months after surgery. Results:The operative time was (41.3±2.1) min and intraoperative fluoroscopy was performed only once in all the patients. All the wounds healed by the first stage with no such complications as hinge point fracture, wound infection, vascular injury, nerve injury, delayed union or nonunion of fracture, lower limb deep venous thrombosis, loosening of internal fixation, or plate rupture. The follow-up time for the 16 patients was (16.3±0.7) months. At 12 months after surgery, the HKA (179.5°±0.5°), MPTA (91.7°±0.5°), WBL ratio (61.2%±0.4%), WOMAC osteoarthritis index [(12.8±0.8) points], VAS pain score [(1.8±0.3) points] and knee ROM (121.8°±1.8°) were significantly better than those before surgery [166.6°±1.3°, 81.8°±0.4°, 29.6%±1.0%, (38.4±2.1) points, (4.8±0.3) points, and 110.5°±2.1°] ( P < 0.05). There was no significant difference in PTS between pre-surgery and 12 months after surgery ( P > 0.05). Conclusions:When HTO is used to treat varus knee osteoarthritis secondary to tibial fracture malunion, assistance of digital orthopedic techniques can improve HKA, MPTA, lower limb alignment, and knee ROM to reduce and recover knee function for the patients.

In recent decades,the advent of coronaviruses has engendered multiple large-scale infectious outbreaks,leading to profound human casualties and posing a significant menace to global public health.At the crux of the coronavirus lifecycle,the assembly and release phases emerge as pivotal processes,necessitating meticulous investigation into the underlying mechanisms.This paper systematically expounds upon the intricate assembly and packaging mechanisms intrinsic to coronaviruses,scrutinizes the diverse release pathways employed by these viruses,and delves into the discourse surrounding targeted antiviral drugs.The comprehensive insights encapsulated in this exposition serve as valuable reference points for formulating effective strategies in the prevention and treatment of coronavirus infections.

Osteotomy around the knee includes medial opening wedge high tibial osteotomy (HTO), lateral closing wedge HTO, lateral opening wedge distal femoral osteotomy (DFO), medial opening wedge DFO, and double-site osteotomy. Osteotomy redistributes the knee joint pressure by correcting the lower limb alignment, which can effectively delay the progression of knee osteoarthritis. Currently, three methods are used to determine the intraoperative osteotomy angle: the pre-drilling method, wedge block insertion method, and angle-guided linkage method. Coronal plane accuracy is evaluated using the hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and ratio of lower limb weight-bearing line, while sagittal plane accuracy is assessed by measuring the posterior tibial slope (PTS). Individualized osteotomy guide plate can enhance osteotomy accuracy. The preparation process includes: (1) importing low-dose CT data of both lower limbs in DICOM format into reconstruction software to establish a 3D model of both lower limbs; (2) determining the osteotomy plane and distraction angle through threshold segmentation, importing the plate model, and establishing the length and position of each screw; (3) using fused deposition modeling to layer materials through a nozzle to create the 3D object. Individualized osteotomy guide plate in osteotomy around the knee can not only improve the accuracy of surgery, but also reduce the intraoperative fluoroscopy times and the incidence of complications. The operation efficiency and postoperative rehabilitation are better than those of traditional surgery. With the continuous upgrading of new materials and the improvement of design concepts, the accuracy and efficiency of individualized osteotomy guide will be further improved. Future research will focus on improving the degree of personalization of guide plate design and simplifying the manufacturing process.

Objective:To investigate the current situation of occupational hazards in automobile manufacturing enterprises in Shandong Province.Methods:From February to May 2019, the convenience sampling method was adopted to conduct on-site occupational health surveys with 20 automobile manufacturing enterprises in Shandong Province as the survey subjects, to detect the occupational hazard factors in the workplaces and individual exposure levels, and to analyze the occupational health check results of operators.Results:There were 13 small-sized, 4 medium-sized and 3 large-sized enterprises among the 20 automobile manufacturing enterprises. The detection results of benzene and toluene in the workplaces met the occupational exposure limits, and the detection results of welding fumes, manganese and its compounds, and xylene exceed the occupational exposure limits. The maximum short-term exposure concentration ( CSTE) of welding fume in the air of workplaces was 24.23 mg/m 3, and the over-standard rate was 11.0% (16/146) . The maximum time-weighted average concentration ( CTWA) of welding fume of operators is 10.60 mg/m 3, and the over-standard rate was 11.0% (8/73) . The maximum CSTE of manganese and its compounds in the air of workplaces was 0.879 mg/m 3, and the of manganese and its compounds of operators was 0.175 mg/m 3, and the over-standard rate was 5.7% (4/70) . The maximum xylene CSTE in the air of workplaces was 230.00 mg/m 3, and the over-standard rate was 3.9% (2/51) . The maximum xylene CTWA of operators was 70.40 mg/m 3, the over-standard rate was 3.6% (1/28) . Among the 4775 workers exposed to occupational hazards, 38 (0.80%) were suspected of electric welder's pneumoconiosis, 27 (0.57%) were suspected of manganese poisoning and 31 (0.65%) were suspected of chronic low-concentration benzene and benzene series poisoning. The detection rates of suspected occupational diseases among workers in small and medium-sized enterprises were relatively high, 2.86% (30/1048) and 4.51% (51/1132) respectively. There was a statistically significant difference in the detection rates of suspected occupational diseases among the operators of different scale automobile manufacturers ( P<0.05) . Conclusion:The exposure levels of electric welding fumes, manganese and its compounds in welding jobs and xylene exposure levels in spray painting jobsin Shandong Province's automobile manufacturing enterprises are more serious. The supervision and management of occupational hygiene should be strengthened, the working environment should be improved, and the health of welding and painting workers should be protected.

Objective:To investigate the current situation of occupational hazards in automobile manufacturing enterprises in Shandong Province.Methods:From February to May 2019, the convenience sampling method was adopted to conduct on-site occupational health surveys with 20 automobile manufacturing enterprises in Shandong Province as the survey subjects, to detect the occupational hazard factors in the workplaces and individual exposure levels, and to analyze the occupational health check results of operators.Results:There were 13 small-sized, 4 medium-sized and 3 large-sized enterprises among the 20 automobile manufacturing enterprises. The detection results of benzene and toluene in the workplaces met the occupational exposure limits, and the detection results of welding fumes, manganese and its compounds, and xylene exceed the occupational exposure limits. The maximum short-term exposure concentration ( CSTE) of welding fume in the air of workplaces was 24.23 mg/m 3, and the over-standard rate was 11.0% (16/146) . The maximum time-weighted average concentration ( CTWA) of welding fume of operators is 10.60 mg/m 3, and the over-standard rate was 11.0% (8/73) . The maximum CSTE of manganese and its compounds in the air of workplaces was 0.879 mg/m 3, and the of manganese and its compounds of operators was 0.175 mg/m 3, and the over-standard rate was 5.7% (4/70) . The maximum xylene CSTE in the air of workplaces was 230.00 mg/m 3, and the over-standard rate was 3.9% (2/51) . The maximum xylene CTWA of operators was 70.40 mg/m 3, the over-standard rate was 3.6% (1/28) . Among the 4775 workers exposed to occupational hazards, 38 (0.80%) were suspected of electric welder's pneumoconiosis, 27 (0.57%) were suspected of manganese poisoning and 31 (0.65%) were suspected of chronic low-concentration benzene and benzene series poisoning. The detection rates of suspected occupational diseases among workers in small and medium-sized enterprises were relatively high, 2.86% (30/1048) and 4.51% (51/1132) respectively. There was a statistically significant difference in the detection rates of suspected occupational diseases among the operators of different scale automobile manufacturers ( P<0.05) . Conclusion:The exposure levels of electric welding fumes, manganese and its compounds in welding jobs and xylene exposure levels in spray painting jobsin Shandong Province's automobile manufacturing enterprises are more serious. The supervision and management of occupational hygiene should be strengthened, the working environment should be improved, and the health of welding and painting workers should be protected.