Objective:The aim of the study was to evaluate the effect of Sr2+doped micro arc oxidation treated surface on osteogen-ic differentiation of BMSCs and osseointegration in the femurs of type 2 diabetes mellitus rats.Methods:TC4 surface was treated by micro arc oxidation to create TiO2 coating,then Sr was incorporated to the coating by electrochemical treated in a strontium dichlo-ride solution.The surface topography was characterized using scanning electronic microscope.Chemical compositions were deter-mined by X-ray photoelectron spectroscopy.Type 2 diabetic rat was induced by feeding with high-fat diet and following injection of streptozotocin.BMSCs were isolated after diabetic rat was euthanized.To study the cells attachment to different samples,cells actin filaments were observed to evaluate cells attachment to different plates.MTT assay was used to evaluate the cell proliferation activity on the plates.Cells differentiation was evaluated by RT-PCR,ALP activity and immunofluorescence of osteocalcin(OCN)protein.MAO and MAO+Sr implants were inserted in the diabetic rats' femurs to evaluate the influence on new bone formation and bone im-plant contact.A software was used to compare the differences of cells proliferation and osteogenic differentiation on different plates,as well as bone regeneration and bone implant contact between the implants with different surfaces.Results:After electrochemical treatment,Sr was detected on the MAO surface.The osteogeneic-related markers were upregulated on the MAO+Sr surface.In vivo study revealed the enhanced bone generation and implant bone contact of MAO+Sr surface in diabetic rats.Conclusion:Compared to the MAO surface,Sr doped micro-arc oxidation treated surface could further improve cells osteogenic differentiation and osseointe gration in diabetics type 2 diabetic rats.

Objective:To investigate the effects of intravenous lidocaine infusion (IVLI) on the quality of intraoperative neurophysiologic monitoring (IONM) in patients with thyroid tumor.Methods:A prospective randomized controlled study was conducted. A total of 60 patients with thyroid tumor undergoing thyroidectomy in the First Clinical Medical College of Shanxi Medical University between September 2022 and May 2023 were selected. According to the random number table method, all patients were divided into the lidocaine group and the control group, 30 cases in each group. The patients in the lidocaine group were continually given IVLI during the operation and the patients in the control group were continually given the equal 0.9% NaCl solution infusion during the operation. All patients in the 2 groups were induced by the same way of total intravenous anesthesia, and no muscle relaxants were added during anesthesia except the induction dose, and enhanced nerve monitoring tracheal catheter was inserted in the 2 groups. According to the standardized procedure of IONM, the electrode impedance values were measured at the time of eliciting the V1 and V2 signals from the vagus nerve, respectively, and the difference value was defined as the drop in the aggregate impedance level (DAIL). DAIL, perioperative hemodynamic parameters and postoperative recovery quality were compared between the 2 groups.Results:There were no statistically significant differences in the baseline data, operation time, intraoperative dosage of propofol and remifentanil between the 2 groups (all P > 0.05). Compared with the control group, the lidocaine group had a higher proportion of patients with DAIL<50% [80.0% (24/30) vs. 40.0% (12/30), χ2 = 10.00, P = 0.002], a lower hemodynamic fluctuation during extubation [mean arterial pressure: (95±6) mmHg (1 mmHg = 0.133 kPa) vs. (104±7) mmHg, t = 31.00, P < 0.001; heart rate: (73±5) times/min vs. (92±6) times/min, t = 172.58, P < 0.001], a lower visual analog score 24 h after surgery [(2.0±0.7) scores vs. (3.7±0.8) scores, t = -8.86, P < 0.001], a higher score of quality of recovery-15 scale [(127±11) points vs. (118±13) points, t = 2.92, P = 0.005]. Conclusions:IVIL can improve the quality of IONM in patients with thyroid tumor during surgery, reduce perioperative hemodynamic fluctuation and improve postoperative recovery quality of patients.

Objectives:To compare the efficacy and imaging parameters of lateral lumbar interbody fusion(LLIF)combined with anterolateral screw fixation(AF)or bilateral pedicle screw fixation(BPSF)in the treatment of lumbar degenerative disease(LDD).Methods:A retrospective study was conducted on 100 patients with single-segment LDD who underwent LLIF-AF or LLIF-BPSF treatment at the First Affiliated Hospital of Kunming Medical University between December 2019 and December 2021.The patients were divided into the AF group(50 cases)and the BPSF group(50 cases).There was no statistical difference in the general informa-tion such as gender,age,and body mass index(BMI)between the two groups(P＞0.05).The perioperative data(length of hospital stay,operative time,intraoperative blood loss);Pre-operative,postoperative 7d,postoperative 6 months' visual analog scale(VAS)scores for low back and leg pain,Oswestry disablity index(ODI),imaging parameters such as disc height(DH),foraminal height(FH),cross-sectional area(CSA),as well as surgical complications were collected and analyzed,and the risk factors for intervertebral subsidence and non-fusion of fusion device were explored.Results:AF group was better than BPSF group in operative time,intraoperative blood loss,and hospital stay[125.0±26.6min vs 221.6±52.2min,25.0mL(20.0-50.0mL)vs 100.0mL(90.0-150.0mL),12.5±4.8d vs 14.9±4.6d],and the differences were statistically significant(P＜0.05).For the low back and leg pain VAS scores and ODI,as well as DH,FH,and CSA,the postoperative 7d and 6 months'values were signiticantly improved than before operation in both groups(P＜0.05),while no statistically significant differences were found between groups at the same time points(P＞0.05).Intervertebral subsidence occurred in 12 patients in each group,and there was no statistically significant difference between the two groups.There were statistically significant differences in BMI and QCT between the AF and BPSF groups of patients with subsidence of the intervertebral space and those without subsidence at 6 months after operation;There were statistically significant differences in QCT between the two groups of patients with non-fusion and fusion of the fusion device;BMI≥28kg/m2 and QCT＜80mg/cm3 were the independent risk factors for intervertebral subsidence in AF group,but not in the BPSF group;QCT＜80mg/cm3 was the independent risk facors for non-fusion of fusion device in both AF and BPSF groups.Conclusions:LLIF combined with AF or BPSF are both reliable methods for treating LDD.For patients with a high body weight of BMI≥28kg/m2 or decreased bone density of QCT＜80mg/cm3,BPSF internal fixation can provide stronger mechanical stability to the spine,reducing the incidence of postoperative disc space collapse or fusion device non-union;On the contrary,AF internal fixation has shorter operative time and hospital stay,less intraoperative blood loss,which can be considered as a priority.

Objective:The aim of the study was to evaluate the effect of Sr2+doped micro arc oxidation treated surface on osteogen-ic differentiation of BMSCs and osseointegration in the femurs of type 2 diabetes mellitus rats.Methods:TC4 surface was treated by micro arc oxidation to create TiO2 coating,then Sr was incorporated to the coating by electrochemical treated in a strontium dichlo-ride solution.The surface topography was characterized using scanning electronic microscope.Chemical compositions were deter-mined by X-ray photoelectron spectroscopy.Type 2 diabetic rat was induced by feeding with high-fat diet and following injection of streptozotocin.BMSCs were isolated after diabetic rat was euthanized.To study the cells attachment to different samples,cells actin filaments were observed to evaluate cells attachment to different plates.MTT assay was used to evaluate the cell proliferation activity on the plates.Cells differentiation was evaluated by RT-PCR,ALP activity and immunofluorescence of osteocalcin(OCN)protein.MAO and MAO+Sr implants were inserted in the diabetic rats' femurs to evaluate the influence on new bone formation and bone im-plant contact.A software was used to compare the differences of cells proliferation and osteogenic differentiation on different plates,as well as bone regeneration and bone implant contact between the implants with different surfaces.Results:After electrochemical treatment,Sr was detected on the MAO surface.The osteogeneic-related markers were upregulated on the MAO+Sr surface.In vivo study revealed the enhanced bone generation and implant bone contact of MAO+Sr surface in diabetic rats.Conclusion:Compared to the MAO surface,Sr doped micro-arc oxidation treated surface could further improve cells osteogenic differentiation and osseointe gration in diabetics type 2 diabetic rats.

Objectives:To compare the efficacy and imaging parameters of lateral lumbar interbody fusion(LLIF)combined with anterolateral screw fixation(AF)or bilateral pedicle screw fixation(BPSF)in the treatment of lumbar degenerative disease(LDD).Methods:A retrospective study was conducted on 100 patients with single-segment LDD who underwent LLIF-AF or LLIF-BPSF treatment at the First Affiliated Hospital of Kunming Medical University between December 2019 and December 2021.The patients were divided into the AF group(50 cases)and the BPSF group(50 cases).There was no statistical difference in the general informa-tion such as gender,age,and body mass index(BMI)between the two groups(P＞0.05).The perioperative data(length of hospital stay,operative time,intraoperative blood loss);Pre-operative,postoperative 7d,postoperative 6 months' visual analog scale(VAS)scores for low back and leg pain,Oswestry disablity index(ODI),imaging parameters such as disc height(DH),foraminal height(FH),cross-sectional area(CSA),as well as surgical complications were collected and analyzed,and the risk factors for intervertebral subsidence and non-fusion of fusion device were explored.Results:AF group was better than BPSF group in operative time,intraoperative blood loss,and hospital stay[125.0±26.6min vs 221.6±52.2min,25.0mL(20.0-50.0mL)vs 100.0mL(90.0-150.0mL),12.5±4.8d vs 14.9±4.6d],and the differences were statistically significant(P＜0.05).For the low back and leg pain VAS scores and ODI,as well as DH,FH,and CSA,the postoperative 7d and 6 months'values were signiticantly improved than before operation in both groups(P＜0.05),while no statistically significant differences were found between groups at the same time points(P＞0.05).Intervertebral subsidence occurred in 12 patients in each group,and there was no statistically significant difference between the two groups.There were statistically significant differences in BMI and QCT between the AF and BPSF groups of patients with subsidence of the intervertebral space and those without subsidence at 6 months after operation;There were statistically significant differences in QCT between the two groups of patients with non-fusion and fusion of the fusion device;BMI≥28kg/m2 and QCT＜80mg/cm3 were the independent risk factors for intervertebral subsidence in AF group,but not in the BPSF group;QCT＜80mg/cm3 was the independent risk facors for non-fusion of fusion device in both AF and BPSF groups.Conclusions:LLIF combined with AF or BPSF are both reliable methods for treating LDD.For patients with a high body weight of BMI≥28kg/m2 or decreased bone density of QCT＜80mg/cm3,BPSF internal fixation can provide stronger mechanical stability to the spine,reducing the incidence of postoperative disc space collapse or fusion device non-union;On the contrary,AF internal fixation has shorter operative time and hospital stay,less intraoperative blood loss,which can be considered as a priority.

Objective:To investigate the effects of intravenous lidocaine infusion (IVLI) on the quality of intraoperative neurophysiologic monitoring (IONM) in patients with thyroid tumor.Methods:A prospective randomized controlled study was conducted. A total of 60 patients with thyroid tumor undergoing thyroidectomy in the First Clinical Medical College of Shanxi Medical University between September 2022 and May 2023 were selected. According to the random number table method, all patients were divided into the lidocaine group and the control group, 30 cases in each group. The patients in the lidocaine group were continually given IVLI during the operation and the patients in the control group were continually given the equal 0.9% NaCl solution infusion during the operation. All patients in the 2 groups were induced by the same way of total intravenous anesthesia, and no muscle relaxants were added during anesthesia except the induction dose, and enhanced nerve monitoring tracheal catheter was inserted in the 2 groups. According to the standardized procedure of IONM, the electrode impedance values were measured at the time of eliciting the V1 and V2 signals from the vagus nerve, respectively, and the difference value was defined as the drop in the aggregate impedance level (DAIL). DAIL, perioperative hemodynamic parameters and postoperative recovery quality were compared between the 2 groups.Results:There were no statistically significant differences in the baseline data, operation time, intraoperative dosage of propofol and remifentanil between the 2 groups (all P > 0.05). Compared with the control group, the lidocaine group had a higher proportion of patients with DAIL<50% [80.0% (24/30) vs. 40.0% (12/30), χ2 = 10.00, P = 0.002], a lower hemodynamic fluctuation during extubation [mean arterial pressure: (95±6) mmHg (1 mmHg = 0.133 kPa) vs. (104±7) mmHg, t = 31.00, P < 0.001; heart rate: (73±5) times/min vs. (92±6) times/min, t = 172.58, P < 0.001], a lower visual analog score 24 h after surgery [(2.0±0.7) scores vs. (3.7±0.8) scores, t = -8.86, P < 0.001], a higher score of quality of recovery-15 scale [(127±11) points vs. (118±13) points, t = 2.92, P = 0.005]. Conclusions:IVIL can improve the quality of IONM in patients with thyroid tumor during surgery, reduce perioperative hemodynamic fluctuation and improve postoperative recovery quality of patients.

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.

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.