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 improve the resazurin reduction method for rapid clinical detection of eravacycline susceptibility of Acinetobacter baumannii. Methods:The susceptibility of 103 Acinetobacter baumannii strains to eravacycline was tested using the modified resazurin method and compared with the results from the broth microdilution method to evaluate the effectiveness of the improved method. Results:All results were obtained after about 5.5 h of incubation. The testing procedure was simple and saved 10-14 h compared with the broth microdilution method. The consistency in susceptibility result with the broth microdilution method was 99.03%. The very major error rate was 0.97%(1/103), with one resistant strain misclassified as sensitive (minimum inhibitory concentration of 2 μg/ml), and the major error rate was 0. This method could rapidly and accurately screen for eravacycline-resistant Acinetobacter baumannii strains in clinical settings. Conclusions:The modified resazurin method, due to its simplicity, rapidity, and ease of execution, has the potential to become a convenient method for the rapid clinical screening of eravacycline-resistant strains, providing a reference for early clinical treatment.

Objective:To evaluate the impact of implementing a regional hierarchical medical management model based on the medical internet of things (medical IoT) on the frequency of emergency department visits and hospitalizations, as well as related medical expenses, in patients with chronic obstructive pulmonary disease (COPD).Methods:This retrospective study included COPD patients enrolled in the regional hierarchical medical management system based on Medical IoT across 21 community health service centers in Songjiang District, Shanghai, between July 2017 and May 2018. Utilizing patient data from the year prior to enrollment as the baseline, changes in the number of emergency visits, hospitalizations, and associated medical costs during the first and second years of management were compared. Changes for patients receiving drug treatment were also analyzed.Results:A total of 973 COPD patients were enrolled. The mean age was 75.2±17.0 years, and 64.34% (626/973) were male. Compared to baseline, all COPD patients in the first year of management showed significant reductions: emergency visits decreased by 33.67%, total emergency costs by 45.60%, hospitalizations by 27.15%, and total hospitalization costs by 25.42%. In the second year, reductions were: emergency visits by 28.08%, total emergency costs by 36.10%, hospitalizations by 35.26%, and total hospitalization costs by 18.13% (all P<0.05). Among patients receiving drug therapy, reductions in the first year were: emergency visits by 39.66%, total emergency costs by 47.54%, hospitalizations by 25.19%, and total hospitalization costs by 28.40%. In the second year, reductions were: emergency visits by 46.98%, total emergency costs by 45.99%, hospitalizations by 41.98%, and total hospitalization costs by 24.94% (all P<0.05). No significant differences were observed before and after management for patients without drug treatment. Conclusion:The implementation of the regional hierarchical medical management model based on Medical IoT significantly reduced the frequency of emergency visits and hospitalizations, as well as related costs, for COPD patients.

Purpose To explore the pathological characteristics,diagnosis,and differential diagnosis of pure ery-throid leukemia(PEL).Methods A retrospective analysis was conducted on the clinicopathological data of 12 cases of PEL.Immunohistochemical EnVision method and flow cytometry were used to detect PEL-related immune markers,and heat-treated Giemsa R-banding technique was applied to analyze the chromosomal karyotype.Results Peripheral blood and bone marrow smears revealed that 2 out of 7 cases showed presence of proerythroblast in peripheral blood,and 7 out of 12 cases showed atypical proerythroblast in bone marrow samples.After recounting,the average percentage of proerythroblast in the 12 PEL cases was 36.8％(ranging from 2％to 69.5％),with an average of 53.2％of all er-ythroid cells(ranging from 5％to 88％).Among them,9 cases did not meet the diagnostic criteria for PEL.Bone marrow biopsy:11 cases showed hypercellularity,with tumor cells showing diffuse proliferation in 9 cases,accompa-nied by dysplasia of megakaryocytes in 7 cases,and there was increased proliferation of fibrous tissue in 9 cases.Im-munohistochemistry:12 cases exhibited strong staining intensity for CD71 and E-cadherin.11 cases expressed CD117,while 4 cases expressed CD34,3 cases exhibited slight expression of GPA,and 1 case weakly expressed CD61.Flow cytometry:in 8 cases,there was an increased proportion of early-stage erythroid cells,accounting for 3.1％to 80.31％of nucleated cells,with an average of 31.0％.All cases expressed CD117 and CD71 to varying degrees,with 7 out of 8 cases expressing CD36,5 out of 7 cases expressing CD105,and 3 out of 4 cases expressing GPA.A few ca-ses demonstrated aberrant expression of CD123 and CD7.Chromosomal Karyotyping:7 cases exhibited highly complex karyotypes(7/8),with frequent involvement of chromosomes 5,7,8,17,and 19.One case had a normal karyotype.Conclusion The diagnosis of PEL requires a comprehensive assessment combining various methods including bone marrow smears,bone marrow biopsy,immunohistochemistry,and flow cytometry.

Objective:To investigate the effect of ultrasound-guided lower transverse abdominal muscle plane (TAP) block combined with esketamine intravenous controlled analgesia on postoperative patients with colorectal cancer (CRC) .Methods:A total of 120 CRC patients admitted to Linyi Central Hospital from Aug. 2022 to Aug. 2024 were selected and divided into control group and observation group according to random number table method, with 60 cases in each group. The control group received esketamine intravenous controlled analgesia, and the observation group was combined with TAP under ultrasound guidance on the basis of the control group. The postoperative recovery, pain numerical score (NRS), heart rate and mean arterial pressure of 1h, 8h and 48h were compared between the two groups. The levels of serum interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 β (IL-1 β) and adverse reactions were compared before anesthesia (T0), 24h (T1) and 48h (T2) after surgery. Results:The feeding time and the first exhaust time in the observation group were shorter than those in the control group ( P<0.05). The NRS scores of the observation group were lower than those of the control group at 1h, 8h and 48h after operation ( P<0.05). The heart rate and mean arterial pressure of both groups increased at 8h and 48h after surgery, and the observation group was lower than the control group ( P<0.05). Serum IL-6, IL-10 and IL-1 β in both groups were higher than those in T0 at T1 and T2, and IL-6 and IL-1 β in observation group were lower than those in control group, and IL-10 was higher than those in control group ( P<0.05). The incidence of adverse reactions in observation group was lower than that in control group ( P<0.05) . Conclusion:Ultrasound-guided TAP combined with esketamine intravenous controlled analgesia can effectively accelerate the postoperative recovery of CRC patients, reduce the level of pain, and alleviate the inflammatory response of the body, with high safety.

Objective:To investigate the effect of ultrasound-guided lower transverse abdominal muscle plane (TAP) block combined with esketamine intravenous controlled analgesia on postoperative patients with colorectal cancer (CRC) .Methods:A total of 120 CRC patients admitted to Linyi Central Hospital from Aug. 2022 to Aug. 2024 were selected and divided into control group and observation group according to random number table method, with 60 cases in each group. The control group received esketamine intravenous controlled analgesia, and the observation group was combined with TAP under ultrasound guidance on the basis of the control group. The postoperative recovery, pain numerical score (NRS), heart rate and mean arterial pressure of 1h, 8h and 48h were compared between the two groups. The levels of serum interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 β (IL-1 β) and adverse reactions were compared before anesthesia (T0), 24h (T1) and 48h (T2) after surgery. Results:The feeding time and the first exhaust time in the observation group were shorter than those in the control group ( P<0.05). The NRS scores of the observation group were lower than those of the control group at 1h, 8h and 48h after operation ( P<0.05). The heart rate and mean arterial pressure of both groups increased at 8h and 48h after surgery, and the observation group was lower than the control group ( P<0.05). Serum IL-6, IL-10 and IL-1 β in both groups were higher than those in T0 at T1 and T2, and IL-6 and IL-1 β in observation group were lower than those in control group, and IL-10 was higher than those in control group ( P<0.05). The incidence of adverse reactions in observation group was lower than that in control group ( P<0.05) . Conclusion:Ultrasound-guided TAP combined with esketamine intravenous controlled analgesia can effectively accelerate the postoperative recovery of CRC patients, reduce the level of pain, and alleviate the inflammatory response of the body, with high safety.

Purpose To explore the pathological characteristics,diagnosis,and differential diagnosis of pure ery-throid leukemia(PEL).Methods A retrospective analysis was conducted on the clinicopathological data of 12 cases of PEL.Immunohistochemical EnVision method and flow cytometry were used to detect PEL-related immune markers,and heat-treated Giemsa R-banding technique was applied to analyze the chromosomal karyotype.Results Peripheral blood and bone marrow smears revealed that 2 out of 7 cases showed presence of proerythroblast in peripheral blood,and 7 out of 12 cases showed atypical proerythroblast in bone marrow samples.After recounting,the average percentage of proerythroblast in the 12 PEL cases was 36.8％(ranging from 2％to 69.5％),with an average of 53.2％of all er-ythroid cells(ranging from 5％to 88％).Among them,9 cases did not meet the diagnostic criteria for PEL.Bone marrow biopsy:11 cases showed hypercellularity,with tumor cells showing diffuse proliferation in 9 cases,accompa-nied by dysplasia of megakaryocytes in 7 cases,and there was increased proliferation of fibrous tissue in 9 cases.Im-munohistochemistry:12 cases exhibited strong staining intensity for CD71 and E-cadherin.11 cases expressed CD117,while 4 cases expressed CD34,3 cases exhibited slight expression of GPA,and 1 case weakly expressed CD61.Flow cytometry:in 8 cases,there was an increased proportion of early-stage erythroid cells,accounting for 3.1％to 80.31％of nucleated cells,with an average of 31.0％.All cases expressed CD117 and CD71 to varying degrees,with 7 out of 8 cases expressing CD36,5 out of 7 cases expressing CD105,and 3 out of 4 cases expressing GPA.A few ca-ses demonstrated aberrant expression of CD123 and CD7.Chromosomal Karyotyping:7 cases exhibited highly complex karyotypes(7/8),with frequent involvement of chromosomes 5,7,8,17,and 19.One case had a normal karyotype.Conclusion The diagnosis of PEL requires a comprehensive assessment combining various methods including bone marrow smears,bone marrow biopsy,immunohistochemistry,and flow cytometry.

Objective:To improve the resazurin reduction method for rapid clinical detection of eravacycline susceptibility of Acinetobacter baumannii. Methods:The susceptibility of 103 Acinetobacter baumannii strains to eravacycline was tested using the modified resazurin method and compared with the results from the broth microdilution method to evaluate the effectiveness of the improved method. Results:All results were obtained after about 5.5 h of incubation. The testing procedure was simple and saved 10-14 h compared with the broth microdilution method. The consistency in susceptibility result with the broth microdilution method was 99.03%. The very major error rate was 0.97%(1/103), with one resistant strain misclassified as sensitive (minimum inhibitory concentration of 2 μg/ml), and the major error rate was 0. This method could rapidly and accurately screen for eravacycline-resistant Acinetobacter baumannii strains in clinical settings. Conclusions:The modified resazurin method, due to its simplicity, rapidity, and ease of execution, has the potential to become a convenient method for the rapid clinical screening of eravacycline-resistant strains, providing a reference for early clinical treatment.

Objective:To evaluate the impact of implementing a regional hierarchical medical management model based on the medical internet of things (medical IoT) on the frequency of emergency department visits and hospitalizations, as well as related medical expenses, in patients with chronic obstructive pulmonary disease (COPD).Methods:This retrospective study included COPD patients enrolled in the regional hierarchical medical management system based on Medical IoT across 21 community health service centers in Songjiang District, Shanghai, between July 2017 and May 2018. Utilizing patient data from the year prior to enrollment as the baseline, changes in the number of emergency visits, hospitalizations, and associated medical costs during the first and second years of management were compared. Changes for patients receiving drug treatment were also analyzed.Results:A total of 973 COPD patients were enrolled. The mean age was 75.2±17.0 years, and 64.34% (626/973) were male. Compared to baseline, all COPD patients in the first year of management showed significant reductions: emergency visits decreased by 33.67%, total emergency costs by 45.60%, hospitalizations by 27.15%, and total hospitalization costs by 25.42%. In the second year, reductions were: emergency visits by 28.08%, total emergency costs by 36.10%, hospitalizations by 35.26%, and total hospitalization costs by 18.13% (all P<0.05). Among patients receiving drug therapy, reductions in the first year were: emergency visits by 39.66%, total emergency costs by 47.54%, hospitalizations by 25.19%, and total hospitalization costs by 28.40%. In the second year, reductions were: emergency visits by 46.98%, total emergency costs by 45.99%, hospitalizations by 41.98%, and total hospitalization costs by 24.94% (all P<0.05). No significant differences were observed before and after management for patients without drug treatment. Conclusion:The implementation of the regional hierarchical medical management model based on Medical IoT significantly reduced the frequency of emergency visits and hospitalizations, as well as related costs, for COPD patients.