Surgical Research and New Technique

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Recent advances on diagnosis and treatment of massive rotator cuff tears

XU Hui, JIANG Xiping, HU Qingxiang, HE Yaohua

Surgical Research and New Technique 2024, 13 (1): 1-6. DOI: 10.3969/j.issn.2095-378X.2024.01.001

Abstract （372）

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Rotator cuff tear is a common shoulder disease, especially among athletes and middle-aged and elderly individuals. With the accelerating trend of aging population, the number of patients with rotator cuff tears is increasing. For massive rotator cuff tears, there is a high risk of re-tear after surgery and poor prognosis, which poses a significant clinical challenge. In recent years, surgical techniques for massive rotator cuff tears have continued to innovate, including superior capsule reconstruction, subacromial balloon spacer implantation, tendon transfer, and reverse shoulder arthroplasty. This article summarized the biomechanical effects of massive rotator cuff tears on the shoulder joint and focused on the latest treatment advancements, aiming to provide new reference for clinical treatment.

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Advances in systemic therapy of advanced renal cell carcinoma

HU Qingyue, ZHAI Wei, ZHENG Junhua

Surgical Research and New Technique 2023, 12 (4): 237-242. DOI: 10.3969/j.issn.2095-378X.2023.04.001

Abstract （488）

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Renal cell carcinoma is a common type of urinary cancer with insidious onset and rapid progression. Advanced renal cell carcinoma has poor prognosis and primarily depends on systemic therapy which mainly composed of targeted therapy and immunotherapy. Recently, new targeted drugs, immuno-targeted combination therapy, HIF-2α inhibitors, and probiotic combination therapy provide more possible options for the treatment. In this review, we gave an overview of the advances in systemic therapy of advanced renal cell carcinoma, aiming to help make clinical decisions.

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New mode of large-scale equipment management based on Internet of Things technology

YU Huiling, CHEN Wen, YU Jing

Surgical Research and New Technique 2024, 13 (1): 76-79. DOI: 10.3969/j.issn.2095-378X.2024.01.019

Abstract （113）

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Objective To make full use of large-scale medical equipment, improve the public welfare and medical efficiency of hospitals, and effectively supervise the use and efficiency of large-scale equipment. Methods By establishing a new large-scale equipment cloud management platform based on the Internet of Things technology to monitor equipment usage and efficiency in real time, where administrators directly conduct a comprehensive analysis of equipment efficiency on the cloud platform to maximize the equipment use efficiency. Results Through the management of the use of large-scale medical equipment through the Internet of Things cloud platform, the workload, efficiency, and patient experience of the equipment were intuitively analyzed, which significantly improved the hospital's supervision of large-scale equipment, elevated the efficiency of equipment use, and reduced the waiting time of patients. Conclusion The large-scale equipment cloud management platform supported by the Internet of Things technology has effectively improved hospital medical efficiency, reasonably triaged patients, reduced the waiting time for medical treatment, implemented social welfare, and laid a solid foundation for future informatization development of the hospital.

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Clinical value of diquafosol sodium combined with sodium hyaluronate for patients with dry eye after cataract surgery

LIU Yang

Surgical Research and New Technique 2023, 12 (3): 180-183. DOI: 10.3969/j.issn.2095-378X.2023.03.006

Abstract （188）

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Objective To investigate the clinical value of diquafosol sodium combined with sodium hyaluronate for patients with dry eye after cataract surgery. Methods In this study, 236 patients with dry eye after cataract surgery, who were treated with diquafosol sodium and sodium hyaluronate in our hospital from January 2022 to January 2023, were selected as the combined group, at the same time, 82 patients with dry eye after cataract surgery treated with sodium hyaluronate alone were selected as the single therapy group, and the therapeutic effects of the two groups were compared and analyzed. Results The total effective rate of the combined group was significantly higher than that of the single therapy group （P<0.05）. There was no significant difference in SPEED score, Fluorescent Test （FL）, Tear Breakup Time （BUT）, and Schirner Test （Slt） between the two groups before treatment （P>0.05）. After treatment, the SPEED score, FL, BUT, and Slt in both groups were significantly improved （P<0.05）, and the scores of SPEED, FL, BUT, and Slt in the combined group were significantly better than those in the single therapy group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion Compared with sodium hyaluronate alone, the combination of sodium hyaluronate and diquafosol sodium can significantly improve the therapeutic effect on dry eye after cataract surgery.

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Effect of transcutaneous electrical acupoint stimulation combined with thoracic paravertebral block on postoperative sleep quality, pain, and quality of recovery of patients after video-assisted thoracoscopic surgery

LI Na, HENG Lei

Surgical Research and New Technique 2023, 12 (3): 197-202. DOI: 10.3969/j.issn.2095-378X.2023.03.010

Abstract （120）

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Objective To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） and thoracic paravertebral block on sleep quality, pain, and quality of recovery after surgery in patients undergoing selective video-assisted thoracoscopic surgery. Methods A total of 60 patients undergoing video-assisted thoracoscopic surgery from June 2022 to March 2023 were selected and divided into the TEAS group or the control group by the random table method. Thirty minutes before anesthesia induction TEAS treatment was performed at Feishu, Neiguan, and Shenmen points bilaterally in the TEAS group until the end of surgery. The control group had the acupuncture electrodes on the same acupuncture point before anesthesia induction without electrical stimulus. The two groups of patients received a TPVB with ropivacaine （0.375%, 25 mL） before anesthesia induction. The visual analog scale （VAS） was used to evaluate pain scores after surgery and Pittsburgh Sleep Quality Index （PSQI） was used for evaluating subjective sleep quality. The PSQI scores were recorded at 24 h before operation （T0）, 24 h （T1）, 48 h （T2）, 7 d （T3）, and 14 d （T4） after operation. 15-item Quality of Recovery scores and VAS scores were also evaluated at 24 h after operation. Postoperative analgesic pump use and postoperative nausea and vomiting （PONV） were also recorded. Results Compared with the control group, the TEAS group showed significantly lower PSQI scores at T1, T2, and T3 （P<0.05）, a higher QoR-15 score at postoperative 24 h （P<0.05）, and lower VAS scores at T1, T2, and T3 （P<0.05）. The frequency of analgesic pump pressing of the TEAS group was lower than that of the control group. In addition, the PONV score of the TEAS group was lower than that of the control group （P<0.05）. There was no difference in other postoperative complications between the two groups （P>0.05）. Conclusion TEAS combined with TPVB can relieve postoperative pain and improve quality of recovery of patients after video-assisted thoracoscopic surgery.

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Research progress on graft selection in anterior cruciate ligament reconstruction

FENG Jianhao, WANG Jiaqi

Surgical Research and New Technique 2023, 12 (2): 125-130. DOI: 10.3969/j.issn.2095-378X.2023.02.013

Abstract （407）

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Anterior cruciate ligament （ACL） is one of the most vulnerable structures during sports and an essential anterior stabilizing structure in the knee joint. ACL injury can impair a patient’s ability to move, and if not properly treated in time, it often results in serious adverse complications like meniscal and articular cartilage damage, and even traumatic osteoarthritis. Currently, ACL reconstruction is the standard treatment for ACL injury, and the choice of grafts has a significant impact on patients’ postoperative functional recovery and surgical success. Autografts are the most commonly used grafts and have the most stable efficacy, but they have drawbacks like limited sources and donor-site morbidity. Although having greater adaptability, allografts carry a risk of immune rejection and the spread of diseases. Artificial ligaments are appropriate for those who must quickly resume their athletic activities, but they are technically challenging and have not been shown to be long-term effective. Due to the numerous issues with traditional grafts, recent rapid advancements in tissue engineering techniques are generating novel ideas for ACL reconstruction. In order to aid in the treatment of ACL injury, this article discussed the benefits, drawbacks, and clinical effectiveness of different grafts used in ACL reconstruction.

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Clinical observation of intraoperative infusion of Spravato on improving circulation in elderly patients undergoing general anesthesia

LIU Shuai

Surgical Research and New Technique 2023, 12 (2): 118-121. DOI: 10.3969/j.issn.2095-378X.2023.02.011

Abstract （100）

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Objective To observe the influence of intraoperative infusion of Spravato on improving circulation stability in elderly patients under general anesthesia. Methods A total of 83 elderly patients who received general anesthesia surgery from May 2021 to October 2022 were selected, and were divided into an experimental group of 41 cases and a conventional group of 42 cases by random number table method. The conventional group received routine target-controlled intravenous general anesthesia and selected normal saline for goal-directed fluid therapy. The experimental group received general anesthesia treatment as the conventional group, and selected intraoperative infusion of Spravato for goal-directed fluid therapy. The mean arterial pressure （MAP） and heart rate （HR） before anesthesia induction （T1）, before endotracheal intubation （T2）, 1 min after intubation （T3）, and 10 min after intubation （T4）, as well as postoperative pain, sedation, and adverse reactions were compared between the two groups. Results The MAP and HR at T2, T3, and T4 of the experimental group compared with the conventional group were significantly lower （all P<0.05）. The VAS scores at 1 h, 2 h, and 6 h after operation in the experimental group were significantly lower than those in the conventional group （all P<0.05）. The Ramsay scores at 1 h and 2 h after operation in the experimental group were significantly higher than those in the conventional group （all P<0.05）. The total incidence of adverse reactions in the experimental group was significantly lower than that in the conventional group （all P<0.05）. Conclusion Intraoperative infusion of Spravato can effectively maintain the stability of circulation in elderly patients under general anesthesia, improve the effect of analgesia and sedation, and reduce the risk of adverse reactions.

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New progression in the treatment of hepatocellular carcinoma with portal vein tumor thrombosis

LOU Zhenbang, WANG Kang, CHENG Yuqiang, YU Hongming, CHENG Shuqun

Surgical Research and New Technique 2023, 12 (3): 157-162. DOI: 10.3969/j.issn.2095-378X.2023.03.001

Abstract （237）

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Portal vein tumor thrombus is a typical clinical manifestation of advanced hepatocellular carcinoma（HCC）, and it is also the main cause of death. In recent years, the idea and strategy of diagnosis and treatment of HCC complicated with portal vein tumor thrombosis have changed greatly with the successive use of targeted therapy and immunotherapy, such as the classification and staging of portal vein tumor thrombus, the process of multidisciplinary diagnosis and treatment, and the combination of comprehensive treatment.

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Effect of external counterpulsation combined with cardiac rehabilitation on patients with long COVID syndrome after PCI： A case report

LIU Jianfeng, WANG Peng, YANG Yun, FAN Zhenyu, HONG Yi

Surgical Research and New Technique 2024, 13 (1): 87-90. DOI: 10.3969/j.issn.2095-378X.2024.01.022

Abstract （139）

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“Long COVID" syndrome refers to the illness caused by novel coronavirus infection for more than 3 months, of which at least 2 months cannot be explained by other diseases. At present, there is no expert consensus or guidance on the treatment of "Long COVID" syndrome, and the treatment plan should integrate literature and real-world clinical practice. This paper reported a patient with "Long COVID" syndrome after percutaneous coronary intervention （PCI） who underwent cardiac rehabilitation combined with external counterpulsation, in order to provide reference for the rehabilitation treatment of such patients.

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Application of fluorescence imaging in urology

TANG Kairan, HAN Bangmin

Surgical Research and New Technique 2023, 12 (2): 81-85. DOI: 10.3969/j.issn.2095-378X.2023.02.001

Abstract （209）

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Fluorescence-guided surgery （FGS） is a technique that is applied in clinical practice progressively, especially in the field of urology, due to the advantages of high resolution, safety, and operability. The review is aimed at explaining the basic principles and development history of FGS, and discussing current status and prospects of fluorescent tracers in urology. The emerging technology of FGS can help effectively improve the accuracy of surgical resection of lesions while reduce postoperative adverse effects, contributing to achieving the goal of precision medicine.

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Clinical application of minimally invasive lumbar surgery under spinal endoscope via interlaminar approach

ZHONG Rongwei, CHEN Jiayu, LIU Zhanliang

Surgical Research and New Technique 2023, 12 (2): 86-88. DOI: 10.3969/j.issn.2095-378X.2023.02.002

Abstract （173）

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Objective To investigate the clinical effect of minimally invasive surgery of lumbar spine under endoscope through interlaminar approach. Methods A total of 180 patients with lumbar disc herniation admitted to the Department of Spinal Surgery of Meizhou People’s Hospital from May 2020 to May 2021 were selected as study subjects. According to the random number table method, they were divided into group A, group B, and group C. Group A （n=60） underwent traditional posterior lumbar open surgery. Group B （n=60） underwent transforaminal endoscopic minimally invasive lumbar surgery. Group C （n=60） underwent endoscopic minimally invasive lumbar surgery through interlaminar approach. The operation time and efficacy were compared among the three groups. Results The total effective rate of surgical treatment in group C was higher than that in group A and group B （P<0.05）. The total effective rate of surgical treatment in group B was higher than that in group A （P<0.05）. The operation time of group C was shorter than that of group A and group B （P<0.05）. The operation time of group B was shorter than that of group A （P<0.05）. Conclusion In the treatment of lumbar disc herniation by lumbar endoscopic minimally invasive surgery through interlaminar approach, the operation time is shorter and the clinical therapeutic effect is better than that by traditional lumbar posterior open surgery and lumbar endoscopic minimally invasive surgery through foraminal approach.

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Application of quality control circle activities in reducing defect rate of environmental management of multi-drug resistant organisms in EICU

JIN Yuhong, CHEN Xuemei

Surgical Research and New Technique 2023, 12 (3): 225-230. DOI: 10.3969/j.issn.2095-378X.2023.03.017

Abstract （90）

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Objective To explore the effect of quality control circle activities on reducing the defect rate of environmental management of multi-drug resistant organisms （MDRO） in EICU. Methods A quality control circle group was established to conduct activities themed on "reducing the defect rate of environmental management of multi-drug resistant organisms in EICU", formulate countermeasures, and organize implementation based on current situation investigation and cause analysis, aiming to achieve continuous quality improvement. Results The environmental management defect rate of MDRO in EICU decreased from 34.82% before the activity to 10.87% after the activity. The ability of group members to use the quality control circle to find and solve clinical problems was improved. Conclusion The activities of quality control circle can effectively reduce the defect rate of environmental management of MDRO in EICU and enhance the ability of team cooperation.

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Progress in modified gastric tube surgery and related techniques for esophageal cancer

TENG Jingyan, ZHANG Qiang, SHANG Pan, LI Guiya, YUAN Hao

Surgical Research and New Technique 2023, 12 (2): 131-136. DOI: 10.3969/j.issn.2095-378X.2023.02.014

Abstract （125）

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Esophageal cancer is a common malignancy of the digestive system, and its incidence rate and total mortality rate are both among the top cancers worldwide, posing a great threat to cancer patients. In recent years, despite the declining incidence, China is still a region with high incidence of esophageal cancer, and the diagnosis and treatment of esophageal cancer cannot be ignored. At present, the treatment of esophageal cancer is still a comprehensive treatment mode mainly based on surgery, and surgical resection is the main means to eradicate esophageal cancer. With the development of surgical techniques, tubular gastric esophagus has become the most commonly used method of esophageal reconstruction, and has obvious advantages over previous total gastric esophagus, but there will still be anastomotic fistula, anastomotic stenosis, gastroesophageal reflux, and other related complications. In order to reduce the incidence of postoperative complications, improve the quality of life in patients, a lot of research has been conducted on the innovation and development of tubular stomach, making tubular stomach technology more mature and practical, at the same time, fluorescence vascular imaging technology, robot-assisted surgery technology, and other related fields of improvement and popularization also provide a new idea for the development of tubular stomach. Comprehensive multidisciplinary development also provides support for the ERAS protocol for esophageal cancer. This paper reviewed the recent research of tubular gastroplasty and its modified techniques, as well as the development and application prospects of other related techniques.

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Influences of multidimensional support intervention based on ERAS on postoperative training compliance, pain, and joint function rehabilitation in patients with calcaneal fractures

ZHAO Haiyan, LI Xia

Surgical Research and New Technique 2024, 13 (1): 80-82. DOI: 10.3969/j.issn.2095-378X.2024.01.020

Abstract （152）

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Objective To observe the effects of multidimensional support intervention based on the concept of enhanced recovery after surgery （ERAS） on recovery of patients after calcaneal fracture surgery. Methods A total of 53 patients with calcaneal fractures who underwent surgical treatment from February 2022 to September 2023 were included in the study. They were randomly divided into a control group （n=26, conventional nursing intervention） and an observation group （n=27, multidimensional support intervention based on the concept of ERAS） by random number table method. The compliance with training, pain level （verbal rating scale, VRS）, and joint function [American Orthopaedic Foot & Ankle Society （AOFAS） ankle-posterior foot score] were compared between the two groups before and after intervention. Results After intervention, the compliance score and AOFAS ankle-posterior foot score in the observation group were higher than those in the control group, while the VRS score was lower （P<0.05）. Conclusion Multidimensional support intervention based on the REAS concept can improve the compliance of patients with calcaneal fractures in postoperative training, effectively alleviate postoperative pain, and have positive effects on promoting joint function rehabilitation.

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Treatment strategies for eyelid disease associated with thyroid eye disease

WANG Huixue, YI Lan, JI Jiali, CHEN Qian, QIU Qinghua

Surgical Research and New Technique 2024, 13 (2): 91-95. DOI: 10.3969/j.issn.2095-378X.2024.02.001

Abstract （197）

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Thyroid eye disease （TED） is the most common orbital disease in adults, and it is an organ-specific autoimmune inflammation closely related to thyroid disease. The clinical manifestations of TED are complex, including abnormal eyelid position such as eyelid recession and ptosis in one or both eyes. Severe eyelid recession can lead to exposed corneal ulcers. For TED eyelid complications, drug or surgical treatment is performed according to disease progression to reconstruct the patient's ocular surface appearance and achieve anatomical and social function reduction.

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History and development of laparoscopic pancreaticoduodenectomy

LIU Jiangxi, WANG Yufeng, DING Yue, ZHU Ying, LI Kun

Surgical Research and New Technique 2024, 13 (1): 72-75. DOI: 10.3969/j.issn.2095-378X.2024.00.001

Abstract （316）

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Laparoscopic pancreaticoduodenectomy （LPD） is one of the most complex and risky operations in pancreatic surgery. LPD was once neglected due to high morbidity and mortality, but with the advancement of laparoscopic instruments and the improvement of surgical protocols, LPD has returned to the favor of surgeons. This paper focused on the history and development of LPD.

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Construction of visual collaborative management platform for life support equipment in smart hospitals

MI Rong, HUANG Yicheng, XU Weiping

Surgical Research and New Technique 2023, 12 (3): 216-220. DOI: 10.3969/j.issn.2095-378X.2023.03.015

Abstract （108）

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Objective To introduce the construction scheme of a visual collaborative management platform for smart hospital life support equipment, effectively achieving efficient allocation and collaborative management and promoting refined management of hospital life support equipment. Methods A cloud-based architecture was adopted to achieve visual collaborative functions such as equipment monitoring, allocation, and borrowing through data collection and analysis. The platform was also tested for practical applications. Results This platform was different from traditional hospital equipment management mode, effectively solving problems such as delayed equipment monitoring and uneven utilization. At the same time, it achieved comprehensive monitoring, collaboration, and visual functions of equipment, improved equipment fault handling efficiency and equipment utilization, and provided new ideas and methods for the development of smart hospitals and cross hospital campus. Conclusion The construction of a visual collaborative management platform for life support equipment in smart hospitals is an important task and has broad promotion and application value. The application of this platform will provide more convenient and efficient solutions for hospital equipment management, further promoting the high-quality development of hospitals.

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Study on the mechanism of NLRP3/Caspase-1 pathway on osteoblast pyroptosis based on Caspase-1

YU Tao, WANG Hai

Surgical Research and New Technique 2023, 12 (3): 163-167. DOI: 10.3969/j.issn.2095-378X.2023.03.002

Abstract （182）

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Objective To explore the mechanism of nucleotide binding oligomerization domain-like receptor protein 3 （NLRP3）/cysteine aspartate specific proteinase-1（Caspase-1） pathway on osteoblast pyroptosis by regulating the level of Caspase-1. Methods Mouse embryonic MC3T3-E1 osteoblasts were cultured and divided into group A with high sugar treatment, group B with high sugar + Caspase-1 inhibitor treatment, group C with high sugar + Caspase-1 siRNA treatment, and control group. The level of lactate dehydrogenase （LDH） released from osteoblasts was detected by light absorption method, the osteoblast pyroptosis was detected by Hoechst33342/PI staining, and the NLRP3, Caspase-1, interleukin-1β （IL-1β）, and IL-18 of osteoblasts were detected by RT-PCR and Western blot respectively. Results The pyroptosis ratio and LDH activity of MC3T3-E1 osteoblasts in group A, B, and C were significantly higher than those in the control group, while those in group B and C were significantly lower than those in group A （P<0.05）. The relative expression levels of NLRP3, Caspase-1, IL-1 β, and IL-18 mRNA and protein in group A, B, and C were higher than those in the control group, while the relative expression levels of Caspase-1, IL-1 β, and IL-18 mRNA and protein in group B and C were significantly lower than those in group A （P<0.05）. There was no significant difference in the relative expression levels of NLRP3 mRNA and protein among group A, B, and C （P>0.05）. Conclusion Inhibition of Caspase-1 inhibits the elevation of IL-1β and IL-18 caused by the elevation of NLRP3 in osteoblasts due to high glucose, thus inhibiting osteoblast pyroptosis.

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Surgical Research and New Technique 2024, 13 (1): 0-0.

Abstract （125）

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