BACKGROUND:The elastic modulus of traditional solid titanium alloy implants is higher than that of human bone,and the resulting"stress shielding"phenomenon may affect the osseointegration of implants.Simultaneously,the wettability of 3D printed titanium alloy surface needs to be improved.OBJECTIVE:To prepare hydrophilic Gyroid implants with excellent biomechanical properties.METHODS:The 3D models of Gyroid implant,solid implant,mandibular bone and crown were established,and the mechanical properties of different implants were analyzed by finite element analysis.The Gyroid structure implant model was imported into the 3D printer to make the Gyroid structure implant materialized,and then the hydrophilic Gyroid structure implant with excellent mechanical properties and surface activity was prepared by sandblasting acid etching and ultraviolet functionalization.The morphology and hydrophilicity of 3D printed Ti6Al4V specimens before and after surface modification were analyzed by scanning electron microscopy and contact angle test.RESULTS AND CONCLUSION:(1)The finite element analysis results showed that under the vertical average bite force,the Gyroid structure could uniformly disperse the load acting on the implant into the entire structure.The load on the solid structure implant could only be dispersed on its outer surface and concentrated in the neck.The maximum equivalent stress of the Gyroid structure implant was 200.67 MPa,which did not exceed 50%of the yield strength of Ti6Al4V material.The maximum equivalent stress of the Gyroid structure implant on the surrounding bone tissue was 24.27 MPa,which was slightly higher than the maximum equivalent stress of the solid structure implant 17.32 MPa,and in the range of 20-60 MPa.The stimulation effect of the Gyroid structure implant on new bone formation was better than that of the solid structure implant.(2)The 3D printing technology could materialize the Gyroid structure implant model.Scanning electron microscopy showed that there were many unmelted spherical metal particles on the surface of the 3D printed Ti6Al4V specimens.After sandblasting and acid etching,a micron-scale mesh pore structure was formed on the surface,and no protruding metal particles were seen.The surface morphology of the superimposed UV functional treatment group was basically consistent with that after sandblasting and acid etching.The contact angle test results showed that the surface hydrophilicity of the specimens treated with ultraviolet functionalization plus sandblasting and acid etching was better than that of the sandblasting and acid etching and non-surface treatment groups.(3)The sandblasting and acid etching technology can remove the weakly connected metal particles on the 3D printed specimen and improve the similarity between the solid model and the design model.On this basis,the ultraviolet functionalization treatment can significantly improve the hydrophilicity of the 3D printed Gyroid structure implant surface without affecting its structure.

Xiaoyao Powder has pharmacological action such as neuroprotection, anti-tumor, anti-depression, liver protection, regulation of intestinal flora, anti-fatigue and so on. Based on the five aspects of quality transfer and traceability, component measurability, component effectiveness, component specificity and compound compatibility environment, the quality marker (Q-marker) of Xiaoyao Powder was predicted and analyzed. It was considered that paeoniflorin, atractylenolide Ⅰ, atractylenolid Ⅱ, atractylenolide Ⅲ, liquiritin,glycyrrhizic acid, Saikosaponin A, Saikosaponin D, ferulic acid, Z-ligustilide, pachymic acid, Menthol,6-gingerol 8-gingerol and 10-gingerol have strong measurability and can be used as Q-marker of Xiaoyao Powder.

Human infection with Orf virus is a rare zoonotic disease in clinical practice,mainly caused by human contact with infected sheep or its pollutants.It is commonly seen in shepherds and slaughterhouse workers.The le-sion mainly involves the skin.Since it is rare in clinic and difficult to diagnose and treat,it is easy to be misdiag-nosed and underdiagnosed.This paper reports a case of human infection with Orf virus,with locally dense skin le-sions.The clinical diagnosis and treatment processes of this case are analyzed,and relevant literatures are reviewed retrospectively,so as to improve clinical understanding on this disease.

Human infection with Orf virus is a rare zoonotic disease in clinical practice,mainly caused by human contact with infected sheep or its pollutants.It is commonly seen in shepherds and slaughterhouse workers.The le-sion mainly involves the skin.Since it is rare in clinic and difficult to diagnose and treat,it is easy to be misdiag-nosed and underdiagnosed.This paper reports a case of human infection with Orf virus,with locally dense skin le-sions.The clinical diagnosis and treatment processes of this case are analyzed,and relevant literatures are reviewed retrospectively,so as to improve clinical understanding on this disease.

BACKGROUND:The elastic modulus of traditional solid titanium alloy implants is higher than that of human bone,and the resulting"stress shielding"phenomenon may affect the osseointegration of implants.Simultaneously,the wettability of 3D printed titanium alloy surface needs to be improved.OBJECTIVE:To prepare hydrophilic Gyroid implants with excellent biomechanical properties.METHODS:The 3D models of Gyroid implant,solid implant,mandibular bone and crown were established,and the mechanical properties of different implants were analyzed by finite element analysis.The Gyroid structure implant model was imported into the 3D printer to make the Gyroid structure implant materialized,and then the hydrophilic Gyroid structure implant with excellent mechanical properties and surface activity was prepared by sandblasting acid etching and ultraviolet functionalization.The morphology and hydrophilicity of 3D printed Ti6Al4V specimens before and after surface modification were analyzed by scanning electron microscopy and contact angle test.RESULTS AND CONCLUSION:(1)The finite element analysis results showed that under the vertical average bite force,the Gyroid structure could uniformly disperse the load acting on the implant into the entire structure.The load on the solid structure implant could only be dispersed on its outer surface and concentrated in the neck.The maximum equivalent stress of the Gyroid structure implant was 200.67 MPa,which did not exceed 50%of the yield strength of Ti6Al4V material.The maximum equivalent stress of the Gyroid structure implant on the surrounding bone tissue was 24.27 MPa,which was slightly higher than the maximum equivalent stress of the solid structure implant 17.32 MPa,and in the range of 20-60 MPa.The stimulation effect of the Gyroid structure implant on new bone formation was better than that of the solid structure implant.(2)The 3D printing technology could materialize the Gyroid structure implant model.Scanning electron microscopy showed that there were many unmelted spherical metal particles on the surface of the 3D printed Ti6Al4V specimens.After sandblasting and acid etching,a micron-scale mesh pore structure was formed on the surface,and no protruding metal particles were seen.The surface morphology of the superimposed UV functional treatment group was basically consistent with that after sandblasting and acid etching.The contact angle test results showed that the surface hydrophilicity of the specimens treated with ultraviolet functionalization plus sandblasting and acid etching was better than that of the sandblasting and acid etching and non-surface treatment groups.(3)The sandblasting and acid etching technology can remove the weakly connected metal particles on the 3D printed specimen and improve the similarity between the solid model and the design model.On this basis,the ultraviolet functionalization treatment can significantly improve the hydrophilicity of the 3D printed Gyroid structure implant surface without affecting its structure.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

G protein-coupled receptors (GPCRs) are a large family of membrane protein receptors, and Takeda G protein-coupled receptor 5 (TGR5) is a member of this family. As a membrane receptor, TGR5 is widely distributed in different parts of the human body and plays a vital role in regulating metabolism, including the processes of energy consumption, weight loss and blood glucose homeostasis. Recent studies have shown that TGR5 plays an important role in glucose and lipid metabolism disorders such as fatty liver, obesity and diabetes. With the global obesity situation becoming more and more serious, a comprehensive explanation of the mechanism of TGR5 and filling the gaps in knowledge concerning clinical ligand drugs are urgently needed. In this review, we mainly explain the anti-obesity mechanism of TGR5 to promote the further study of this target, and show the electron microscope structure of TGR5 and review recent studies on TGR5 ligands to illustrate the specific binding between TGR5 receptor binding sites and ligands, which can effectively provide new ideas for ligand research and promote drug research.

This study used the Appraisal of Guidelines Research & Evaluation-Health Systems （AGREE-HS） to demonstratively compare 34 global coronavirus disease-2019 （COVID-19） health systems guidance documents （HSGs） and 6 World Health Organization （WHO） standard HSGs. The comparison involved topic， participants， methods， recommendations， and implementability， with the aim of exploring the characteristics of emergency HSGs. The results showed that the emergency HSGs had an overall average score of 49%， with topic having the highest score， recommendations having the second highest score， and participants having the lowest score. The standard HSGs had an overall average score of 79%， with high scores in all items. The emergency HSGs had lower scores in participants， methods， recommendations， and implementability than the standard HSGs （P<0.001）， while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs （P<0.05）. Compared with those released by countries， the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores （P=0.000 2）. This indicates that emergency HSGs， represented by the COVID-19 emergency HSG， place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation， evidence support， and comprehensive consideration in the time- and resource-limited context. They have the characteristics of prominent topics， clear purposes， orientation to demand， keeping up with the latest evidence， flexible adjustment， and timeliness， emphasizing immediate implementation effects， weakening long-term effects， and focusing on comprehensive benefits. Additionally， developers， types， and report completeness are important influencing factors.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.