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.

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.

The imbalance of microbiota is related to various diseases in the human body,and the gut,as the largest microbial habitat in the human body,is closely related to the oral microbial environment.The oral microbiota can migrate to the intestinal mucosa with the digestive system.At the same time,microbial transmission from the gut to the mouth can also occur through interpersonal and com-munity transmission.Microbial transmission between the mouth and intestines can shape or reshape the microbial ecosystem in the two habitats,ultimately regulating the pathogenesis of the disease.The dysbiosis of the oral-gut microbiota axis can have a significant impact on related diseases such as respiratory diseases.This article reviews the research status of the relationship between oral-gut microbes and respiratory diseases.

OBJECTIVE To conduct rapid health technology assessment （HTA） of ulinastatin （UTI）， and to evaluate the efficacy， safety and cost-effectiveness of UTI in the treatment of acute pancreatitis （AP）. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang database， CBM and official websites of HTA institutions， the systematic review （SR）/meta-analysis， economic evaluation and HTA reports of UTI in the treatment of AP were collected from the inception to Apr. 2024. Two researchers independently conducted screening， quality evaluation and data extraction according to the admission and exclusion criteria， and descriptive analysis was adopted to analyze and summarize the data. RESULTS A total of 19 studies were included， involving 15 SR/meta-analysis and 4 economic studies， and no HTA report was retrieved. In the treatment of AP， UTI showed clear advantages over conventional treatment alone in terms of improving the overall effective rate， shortening the recovery time of amylase， reducing the time required to relieve abdominal pain and distension， lowering the mortality rate， and decreasing the average hospital stay. Compared to other positive drugs （carbendate mesylate， octreotide， somatostatin， etc.）， its efficacy is similar， with a favorable safety profile. As far as the current research was concerned， UTI had obvious economic advantages over other positive drugs. CONCLUSIONS UTI is safe and effective in the treatment of AP， and has economic advantages.

Objective To develop a nurse-patient interaction integrated APP"NET Home"to provide detailed care and follow-up management for patients with neuroendocrine tumors(NENs)trea-ted with long-acting octreotide.Methods"NET Home"APP included three ports:patient side,medical side and management side.After discharge,NENs patients timely and comprehensive fed back on adverse reactions and discomfort symptoms through APP,and medical staff timely guided patients to deal with them online.Results At 1 year after"NET Home"APP application,45 patients registered(injected with long-acting octreotide once every 28 days).A total of 145 copies of Micro-nutrition Evaluation Scales,147 Tumor Patients'Quality of Life Rating scales,102 Pain Digital Evaluation Scales,103 Adverse Reactions Questionnaire of Long-acting Octreotide Injection,102 Self-care Ability Scales,111 Self-rating Scales for depression and 102 Self-rating Scales for anxiety were collected.The medical staff treated 5 cases of adverse reactions by APP,and gave timely handling to 1 case of severe adverse reactions(the patient eventually stopped long-acting octreotide therapy).Compared with NENs patients who did not use APP,anxiety scores of NENs patients who used APP decreased(P＜0.05);their satisfaction scores and quality of life scores were improved,and the number of unplanned admissions decreased,but the differences showed no statistically significant(P＞0.05).Conclusion"NET Home"APP can realize refined and personalized nursing intervention through multiple module functions,which can realize continuous home care for NENs patients,relieve their anxiety and improve their self-management ability,quality of life and treatment compliance.

【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.

Objective:To investigate the expression of p21-activated kinase 2 (PAK2) in laryngeal squamous cell carcinoma and its relationship with the clinicopathological characteristics and chemosensitivity of patients.Methods:Transcriptome sequencing (RNA-seq) data for laryngeal squamous cell carcinoma were downloaded from the Cancer Genome Atlas (TCGA) database, and 123 patients were included in the study (12 cases had cancer tissues and normal tissues data, and the remaining 111 only had cancer tissues data). Differential expression of PAK2 in cancer and para-cancer tissues was analyzed by using R software, and the potential function of PAK2 in laryngeal squamous cell carcinoma was investigated by using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database signaling pathway enrichment. A total of 34 patients with primary laryngeal squamous cell carcinoma tissues and corresponding para-carcinoma 34 tissue specimens who underwent surgical resection were retrospectively selected from Chaoyang Central Hospital between April 2016 and June 2021, and 20 cases of normal laryngeal mucosa tissues were selected as the controls. Immunohistochemistry was used to detect the expression of PAK2 in various tissues, and its correlation with clinicopathological factors was analyzed. A total of 35 supraglottic primary laryngeal squamous cell carcinoma patients were retrospectively collected before induction chemotherapy during the same period, including 20 patients sensitive to chemotherapy and 15 patients resistant to chemotherapy. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of PAK2 mRNA in cancer tissues.Results:Analysis of TCGA database data showed that PAK2 expression was increased in cancer tissues compared with that in para-cancer tissues ( P = 0.012); KEGG database signaling pathways showed that the high expression of PAK2 in laryngeal squamous cell carcinoma was related to signal transduction pathways, cell cycle, and cancer. Immunohistochemistry showed that the proportion of PAK2 positive in 34 cases of laryngeal squamous cell carcinoma tissues was higher than that in adjacent tissues and normal tissues [58.82% (20/34) vs. 0.03% (1/34), 0 (0/20), all P < 0.001]. There were statistically significant differences in the proportion of PAK2 positive patients stratified with different degrees of differentiation [high differentiation vs. low or middle differentiation: 33.33% (6/18)vs. 87.50% (14/16)], lymph node metastasis [presence vs. absence: 90.91% (10/11) vs. 43.48% (10/23)], TNM staging [stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 82.35% (14/17) vs. 35.29% (6/17)] (all P < 0.05), and PAK2 positive patients were not associated with clinical type, tumor size, smoking history, drinking history, and age (all P > 0.05). qRT-PCR showed that the relative expression level of PAK2 mRNA in the chemotherapy-resistant group was higher than that in the chemotherapy-sensitive group (3.89±0.12 vs. 0.78±0.23, P < 0.001). Conclusions:The expression level of PAK2 in laryngeal squamous cell carcinoma tissues is increased, and the high expression of PAK2 is closely related to the malignant clinical characteristics of patients with laryngeal squamous cell carcinoma. The high expression of PAK2 may indicate the insensitivity to traditional chemotherapy regimens, and PAK2 may be a potential gene that targets and regulates the chemosensitivity of laryngeal squamous cell carcinoma.

Objective To develop a nurse-patient interaction integrated APP"NET Home"to provide detailed care and follow-up management for patients with neuroendocrine tumors(NENs)trea-ted with long-acting octreotide.Methods"NET Home"APP included three ports:patient side,medical side and management side.After discharge,NENs patients timely and comprehensive fed back on adverse reactions and discomfort symptoms through APP,and medical staff timely guided patients to deal with them online.Results At 1 year after"NET Home"APP application,45 patients registered(injected with long-acting octreotide once every 28 days).A total of 145 copies of Micro-nutrition Evaluation Scales,147 Tumor Patients'Quality of Life Rating scales,102 Pain Digital Evaluation Scales,103 Adverse Reactions Questionnaire of Long-acting Octreotide Injection,102 Self-care Ability Scales,111 Self-rating Scales for depression and 102 Self-rating Scales for anxiety were collected.The medical staff treated 5 cases of adverse reactions by APP,and gave timely handling to 1 case of severe adverse reactions(the patient eventually stopped long-acting octreotide therapy).Compared with NENs patients who did not use APP,anxiety scores of NENs patients who used APP decreased(P＜0.05);their satisfaction scores and quality of life scores were improved,and the number of unplanned admissions decreased,but the differences showed no statistically significant(P＞0.05).Conclusion"NET Home"APP can realize refined and personalized nursing intervention through multiple module functions,which can realize continuous home care for NENs patients,relieve their anxiety and improve their self-management ability,quality of life and treatment compliance.