ObjectiveTo investigate the effect of folic acid-modified crebanine polyethylene glycol-polylactic acid hydroxyacetic acid copolymer（PEG-PLGA） nanoparticles（FA-Cre@PEG-PLGA NPs， hereinafter referred to as NPs） combined with ultrasonic irradiation on subcutaneous tumor of liver cancer in Kunming（KM） mice. MethodsEighty-four healthy male KM mice were utilized to establish a subcutaneous tumor model of mouse hepatocellular carcinoma with H22 cells， then mice were randomly divided into model group， placebo group， hydroxycamptothecin group（8 mg∙kg^-1）， low， medium and high dose crebanine raw material groups（2， 2.5， 3 mg∙kg^-1， hereinafter referred to as the low， medium and high dose crebanine groups， respectively）， low， medium and high dose NPs groups（2， 2.5， 3 mg∙kg^-1）， and low， medium and high dose NPs combined with ultrasonic irradiation groups（2， 2.5， 3 mg∙kg^-1， hereinafter referred to as the low， medium and high dose combination groups， respectively）. The corresponding doses of drugs were administered via tail vein injection， the model group received no treatment， while the placebo group was injected with an equivalent amount of normal saline. Dosing was conducted for a total of 10 times on alternate days. The body mass of the mice was monitored， and parameters such as body mass change rate， thymus index， spleen index， tumor volume， tumor weight， relative tumor growth rate（T/C）， and tumor inhibition rate（TGI） were calculated. Pathological changes in liver and kidney tissues as well as the tumor were observed by hematoxylin-eosin（HE） staining. Additionally， the levels of aspartate aminotransferase（AST）， alanine aminotransferase（ALT）， blood urea nitrogen（BUN） and creatinine（CREA） in serum of mice were detected by biochemical method. Furthermore， the effect of ultrasound on the distribution of NPs in subcutaneous tumors of mouse hepatocellular carcinoma was observed by in vivo imaging technique. ResultsAmong different treatment methods， the combination of NPs and ultrasound irradiation had the best therapeutic effect. Compared with the model group， the body mass growth rates of mice in the medium and high combination groups decreased， while the thymus index and spleen index increased， but there was no statistically significant difference in serum AST， ALT， BUN and CREA levels， indicating that NPs combined with ultrasound irradiation had little effect on the normal physiological state of the body， oth groups had TGI>40% and T/C<60%， indicating a clear anti-tumor effect. Pathological analysis showed that compared with the NPs groups， the combination groups exhibited varying degrees of necrosis in tumor cells， accompanied by less damage to the liver and kidneys. In vivo imaging of small animals showed that compared with the high dose NPs group， the high dose combination group had stronger tumor targeting ability（P<0.01）. ConclusionNPs combined with ultrasonic irradiation can not only effectively targeted the drug to the tumor site， inhibit the subcutaneous tumor growth of mouse liver cancer， but also decrease damage to liver and kidney tissues.

Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P＜0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P＜0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P＜0.05 or P＜0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.

Objective To investigate whether successful percutaneous coronary intervention(PCI)could improve symptoms and quality of life(QOL)in left main disease and/or 3-vessel disease patients with diabetes.Methods Patients with left main disease and/or 3-vessel disease who underwent PCI in the First Affiliated Hospital of Air Force Medical University from April 2018 to May 2021 were consecutively enrolled and subdivided into 2 groups:diabetes and no diabetes.Detailed baseline characteristics,symptoms,including dyspnea and angina,assessed with the Rose dyspnea scale(RDS),Seattle angina questionnaire(SAQ),the European quality of life-5 dimensions(EQ-5D)and 12-item short-form health survey(SF-12)questionnaire respectively,procedural details,and 1 month and 1 year follow-up data were collected.Results Among 440 left main disease and/or 3-vessel disease patients,disease was present in 176(40.00％),who had more hypertension,peripheral artery disease,and LCX lesion(all P＜0.05).The incidence of major adverse cardiovascular events(MACE)and all-cause mortality were similar between the two groups(both P＞0.05)at 1 month follow-up,while all-cause mortality in diabetes patients was significantly higher than those without diabetes at 1 year follow-up(P=0.013).Low left ventricular ejection fraction was an independent risk factor for MACE and all-cause mortality at 1 month and 1 year follow-up after successful revascularization(all P＜0.05).Most importantly,symptoms,including dyspnea and angina,and QOL were markedly improved regardless of diabetes both at 1 month and 1 year follow-up(all P＜0.05).Diabetes patients showed improved dyspnea and QOL at similar degree to the non-diabetes patients(all P＞0.05)and a more significantly relieved angina(P=0.013).Additionally,the number of chronic total occlusion(CTO)per patient was identified as an independent risk factor of dyspnea(OR 0.723,95％CI 0.525～0.997,P=0.048)and angina relief(OR 0.686,95％CI 0.473～0.995,P=0.047),and the contrast volume(OR 0.995,95％CI 0.992～0.999,P=0.008)as an independent risk factor of QOL improvement in diabetic patients.Conclusions Successful PCI is beneficial for relieving symptoms and improving quality of life in patients with diabetes who have left main disease and/or 3-vessel disease.

Objective To investigate the value of afterload-related cardiac performance(ACP)in evaluating cardiac dysfunction and prognosis in patients with septic shock.Methods This prospective observational study included 45 patients with septic shock.The patients were divided into the death(n=21)or survival(n=24)group according to whether they died within 28 days.Baseline and labora-tory data were collected within 24 h.Cardiac function indices were collected and monitored at 0,6,12,18,and 24 h using the pulse index continuous cardiac output.Variables affecting the prognosis were included in the multivariate Cox proportional hazard model.Prognosis was predicted using a receiver operating characteristic(ROC)curve.Results The ACP in the death group was significantly lower than that in the survival group at 0,6,12,18,and 24 h(all P＜0.05).Logistic regression analysis showed that decreased ACP,increased acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,increased sequential organ failure assessment(SOFA)score,increased fluid balance at 24 h,increased vasoactive-inotropic score,increased central venous pressure,and decreased mean arterial pressure were risk factors for poor prognosis.The Cox proportional hazard model showed that ACP,APACHE Ⅱ score,and SOFA score were independent risk factors influencing prognosis.ROC analysis showed that the area under the curve of ACP was the largest at 24 h,which was the best time point for predicting 28-day mortality.The corresponding sensitivity,specificity,and best cutoff values were 76.20％,91.70％,and 75.16％,respectively.Conclusion ACP could be used as a valuable index to evaluate cardiac dysfunction and as an independent risk factor for poor prognosis in patients with septic shock.

Objective To observe the clinical effect of abdominal full-thickness skin graft combined with adipose stem cells in repairing soft tissue defects after resection of facial benign tumors.Methods A total of 180 patients with soft tissue defects after resection of facial benign tumor in our hospital from January 2019 to June 2022 were selected,the study was designed by a double-blind method,and patients were divided into the observation group and the control group by a random number table method,with 90 cases in each group.Patients in the control group were repaired by abdominal full-thickness skin graft treatment,while these in the observation group were repaired by a combination of abdominal full-thickness skin graft and adipose stem cells.The scar status scores in the surgical area,clinical efficacy,incidence of complications and satisfaction of patients in the two groups were compared.Results Compared with preoperative results,the scores of color and thickness of scars,vascular distribution,and softness in face 6 months after surgery in both groups decreased,with statistically significant differences(P<0.05).Six months after surgery,the observation group had significantly lower scores on scar color and thickness,vascular distribution,and softness compared to the control group(P<0.05);there was no difference in the effective rate of the forehead,nose,eyelids,lips,or cheeks between the observation group and the control group(P>0.05);while the observation group had higher overall effective rate than the control group(P<0.05).There was no statistically significant difference in the incidence of complica-tions between the two groups(P>0.05).There was statistically significant difference in the distribution of the satisfaction of patients between the two groups(P<0.05),and the observation group showed significantly higher satisfaction of patients than the control group(P<0.05).Conclusion Abdominal full-thickness skin graft combined with adipose stem cells can improve facial scars in repairing soft tissue defects after resection of facial benign tumors,and enhance the repair effects and satisfaction of patients,with high safety.

Three throat swab samples from infants and young children in Hubei Province were identified as positive for enteroviruses. All subjects were one month old, and the onset of symptoms occurred in June; these cases were sporadic and exhibited no clear epidemiological associations. The results of VP1 gene amplification analysis indicated that all three infant cases were attributed to Echovirus 30 (ECHO30). The ECHO30 strain isolated from the three samples was classified as Cluster Ⅲ within the H gene subtype. Whole genome amplification analysis revealed that the ECHO30 strain from Hubei exhibited the highest homology with ECHO30/MW586892/Ashburton/17WQ2027G/USA/2007-08-20 from GenBank, demonstrating nucleotide and amino acid homologies of 97.6% and 99.3%, respectively. Recombination analysis indicated the presence of recombination events in the non-structural protein region of the ECHO30 Hubei strain, with recombinant fragments potentially originating from ECHO30/KY888274/14-397/Germany/2013 and ECHO18 strains Echo18/MN815811/BJ2018-S6363/Beijing/2018. This study provides a comprehensive analysis of the genetic evolution of the ECHO30 strain prevalent in Hubei Province, contributing essential data for the prevention of ECHO30 infections.

Aim To explore the therapeutic effect and mechanism of Qingjie Huagong decoction in modulating PI3K/AKT/NF-κB signaling pathway in inflammatory response of acute pancreatitis(AP)mice.Methods Twenty-four mice were randomly divided into Blank group,Model group,Ustekin group,and Qingjie Hua-gong decoction group,with six mice in each group.The AP model was prepared by using rain frogin.Serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α lev-els were detected by ELISA;the pancreatic pathology was detected by HE staining;the expressions of PI3K,AKT,and NF-κB-related proteins and mRNAs were de-tected by immunohistochemistry,Western blot,and RT-qPCR.Results Compared with the blank group,the model group showed obvious pathological damage to the pancreas,with significantly higher serum α-AMS,PN-LP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels(P＜0.01),and significantly higher levels of PI3K,AKT,and NF-κB-related proteins and mRNA expression(P＜0.01).Compared with the model group,both the Qingjie Huagong decoction group and the ustekin group improved the histopathological changes in the pancreas of AP mice,decreased the serum α-AMS,PNLP,IL-1β,IL-6,IL-8,IL-18,and TNF-α levels,and down-reg-ulated the expression levels of pancreatic PI3K,AKT,NF-κB-related proteins and mRNA(P＜0.05 or P＜0.01).Conclusion Qingjie Huagong decoction may inhibit the inflammatory response and protect pancreat-ic tissues by regulating the expression of PI3K/AKT/NF-κB signaling pathway.

Objective:To explore the surgical treatment strategies for Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures.Methods:A retrospective analysis was performed on the clinical data of 25 adult patients with Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures, admitted to the Upper Extremity Orthopaedics Department of Zhengzhou Orthopaedic Hospital from June 2013 to June 2023. There were 15 males and 10 females, with an average age of 43.5±14.7 years (range: 20-67 years). Among them, 5 cases were complicated with humeroulnar joint dislocation. The patients were divided into two groups: 17 cases were treated with open reduction and internal fixation (ORIF) of radial head fractures combined with ORIF of proximal ulnar fractures (open reduction group), and 8 cases were treated with radial head replacement combined with ORIF of proximal ulnar fractures (radial head replacement group). At the last follow-up, elbow joint range of motion was recorded, and pain, elbow function, and subjective upper limb function were evaluated using the Visual Analogue Scale (VAS), Mayo Elbow Performance Score (MEPS), and Disabilities of the Arm, Shoulder and Hand (DASH) scale. The incidence of complications was also recorded.Results:All 25 patients were followed up for an average of 25.6±9.0 months (range: 12-45 months). At the last follow-up, the affected elbows in the open reduction group had a flexion of 124.47°±12.59° (range, 90°-140°), extension of 21.12°±10.07° (range, 10°-50°), pronation of 48.59°±11.62° (range, 20°-61°), and supination of 48.53°±8.43° (range, 30°-60°). In the radial head replacement group, the affected elbows showed flexion of 128.75°±13.17° (range, 100°-140°), extension of 14.00°±7.71° (range, 0°-25°), pronation of 61.25°±10.26° (range, 60°-80°), and supination of 71.88°±10.33° (range, 60°-80°). The MEPS score in the open reduction group was 82(75, 85) points (range, 55-90 points), the VAS pain score was 1(1, 2) points (range, 0-3 points), and the DASH score was 9(8, 14) points. In the radial head replacement group, the MEPS score was 90(85, 90) points (range, 85-90 points), the VAS pain score was 1(0, 1) points (range, 0-1 points), and the DASH score was 5(5, 6) points. Complications included 5 cases of heterotopic ossification, 1 case of incision infection, 1 case of nonunion, 1 case of ulnar nerve injury combined with traumatic arthritis, and 1 case of proximal radioulnar bone bridge formation.Conclusions:Both radial head replacement and open reduction internal fixation combined with proximal ulnar fracture fixation can effectively treat Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures. There was no significant difference in postoperative flexion and extension, but the radial head replacement group demonstrated better forearm rotation and DASH scores postoperatively.

Objective To investigate the value of afterload-related cardiac performance(ACP)in evaluating cardiac dysfunction and prognosis in patients with septic shock.Methods This prospective observational study included 45 patients with septic shock.The patients were divided into the death(n=21)or survival(n=24)group according to whether they died within 28 days.Baseline and labora-tory data were collected within 24 h.Cardiac function indices were collected and monitored at 0,6,12,18,and 24 h using the pulse index continuous cardiac output.Variables affecting the prognosis were included in the multivariate Cox proportional hazard model.Prognosis was predicted using a receiver operating characteristic(ROC)curve.Results The ACP in the death group was significantly lower than that in the survival group at 0,6,12,18,and 24 h(all P＜0.05).Logistic regression analysis showed that decreased ACP,increased acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,increased sequential organ failure assessment(SOFA)score,increased fluid balance at 24 h,increased vasoactive-inotropic score,increased central venous pressure,and decreased mean arterial pressure were risk factors for poor prognosis.The Cox proportional hazard model showed that ACP,APACHE Ⅱ score,and SOFA score were independent risk factors influencing prognosis.ROC analysis showed that the area under the curve of ACP was the largest at 24 h,which was the best time point for predicting 28-day mortality.The corresponding sensitivity,specificity,and best cutoff values were 76.20％,91.70％,and 75.16％,respectively.Conclusion ACP could be used as a valuable index to evaluate cardiac dysfunction and as an independent risk factor for poor prognosis in patients with septic shock.

Coronary artery calcification often appears a variety of complex lesions,increasing coronary intervention of the difficulty of treatment,especially the severe calcification lesions,usually cannot be fully dilated,resulting in a reduced success rate of surgery,an increased rate of acute stent thrombosis and restenosis,and even a serious impact on the prognosis of patients.Intravascular lithotripsy(IVL)is increasingly used in calcified lesions.There is more and more evidence of using in stable angina pectoris and unstable angina pectoris,but its use in acute ST-segment elevation myocardial infarction is limited,and only a few cases have been reported abroad.Moreover,the consensus of Chinese experts in the diagnosis and treatment of coronary artery calcification in 2021 edition lists thrombotic lesions as contraindications of shock wave balloon.This case is the first time in China to report the use of shock wave balloon in patients with acute ST elevation myocardial infarction complicated with thrombus.In this case,the patient with acute ST elevation myocardial infarction complicated with thrombus was severely under expanded stent after stent implantation,and obtain good curative effect using shockwave balloon at selected time in hospital after intensive anticoagulant therapy.