Objective To investigate the incidence of intraoperative hypothermia(IH)and rewarming efficacy in elderly patients with different traditional Chinese medicine(TCM)constitutions undergoing general anesthesia.Methods A total of 500 elderly patients undergoing general anesthesia at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2022 to November 2022 were enrolled.The patients were divided into IH group and non-IH group depending on the occurrence of IH.Baseline data of the patients were collected,and univariate and multivariate logistic regression analyses were performed to identify risk factors for IH.A risk prediction model was constructed after value-assignment of influencing factors and its diagnostic efficiency was assessed by receiver operating characteristic(ROC)curve.External validation of the model was conducted in 50 elderly patients undergoing general anesthesia at the same period.From December 2022 to February 2023,80 elderly patients undergoing general anesthesia and complicated with IH were randomized into a control group(routine measures for keeping warm)and an observation group(keeping warm with forced-air-warming blanket)to compare the rewarming efficacy.Results(1)Among 500 elderly patients undergoing general anesthesia,180 cases developed IH,with an incidence of 36.0%.(2)Except for age,sex,type of surgery,American Society of Anesthesiologists(ASA)classification,type of anesthesia,and total fluid output volume,statistically significant differences were presented in body mass index(BMI),TCM constitution type,surgical complexity grading,preoperative core body temperature,operating room temperature,rewarming strategy,surgical duration,anesthesia duration,total fluid intake volume,intraoperative irrigation volume,and intraoperative blood transfusion between the two groups(P＜0.05 or P＜0.01).(3)Multivariate logistic regression analysis identified BMI,TCM constitution type,surgical complexity grading,preoperative core body temperature,operating room temperature,rewarming strategy,anesthesia duration,total fluid intake volume,and intraoperative irrigation volume as independent influencing factors for the occurrence of IH in elderly patients undergoing general anesthesia.ROC curve analysis demonstrated that the area under the curve(AUC)of the constructed risk prediction model was 0.816,with a sensitivity of 74.40%and a specificity of 77.50%.(4)In an external validation cohort of 50 elderly patients undergoing general anesthesia(19 IH cases versus 31 non-IH cases),the constructed risk prediction model exhibited a sensitivity of 73.68%and a specificity of 77.42%.(5)The observation group exhibited lower tympanic temperature upon post-anesthesia care unit(PACU)admission,shorter rewarming time and PACU stay duration,faster rewarming rate,and lower incidence of shivering than the control group,the differences being statistically significant(P＜0.05 or P＜0.01).Conclusion IH is common in elderly patients undergoing general anesthesia,particularly in those under the conditions of low BMI,qi/yang/blood deficiency constitutions,major surgery,low preoperative core body temperature,low operating room temperature,passive rewarming,prolonged anesthesia,high fluid intake volume,and high and intraoperative irrigation volume.The constructed risk prediction model demonstrates favorable diagnostic performance.Proactive use of forced-air-warming blankets effectively improves rewarming outcomes in elderly patients undergoing general anesthesia and complicated with IH.

Mitochondrial DNA (mtDNA) acts as a damage-associated molecular pattern to activate the stimulator of interferon genes (STING) signaling in macrophages, promoting tissue inflammation. However, its role in acute myocardial infarction (AMI) remains unclear. Macrophage-specific Sting1 knockout mice were used to validate STING's pathological role in AMI. Cardiac and liver mtDNA were used to activate macrophages in co-culture systems with cardiomyocytes to assess fibrosis and hypertrophy. Panaxatriol saponin (PTS) was tested for its ability to block mtDNA-driven macrophage activation and subsequent cardiomyocyte damage. STING-PTS binding ability was analyzed. AMI rats received PTS to evaluate its effects on myocardial inflammation and ventricular remodeling. In vivo, macrophage-specific Sting1 knockout reduced myocardial inflammation and injury after AMI. In vitro, mtDNA-activated macrophages induced cardiomyocyte fibrosis and hypertrophy through STING signaling. PTS suppressed mtDNA-driven macrophage activation by directly binding STING, thereby blocking inflammatory cascades. In AMI rats, PTS treatment attenuated acute inflammation and reversed ventricular remodeling. These findings establish the mtDNA-STING axis in macrophages as a critical driver of post-AMI inflammation and identify pharmacological STING inhibition with PTS as a promising therapeutic strategy. The study bridges genetic validation with translational applications, highlighting macrophage STING as a novel target for ischemic heart disease management.

Objective:To explore the chain mediating role of psychological resilience and perceived social support between cancer-related fatigue and quality of life in patients undergoing chemotherapy for lung cancer, and to inform interventions to improve quality of life in patients undergoing chemotherapy for lung cancer.Methods:Convenience sampling was used to select 275 lung cancer patients with chemotherapy admitted to three ClassⅢ Grade A hospitals in Henan Province from June 2022 to November 2023 for the study. General Information Questionnaire, Cancer Fatigue Scale, Quality of Life Instruments for Cancer Patients-Lung (QLICP-LU), Connor-Davidson Resilience Scale, and Perceived Social Support Scale were used to survey the patients. Correlations between cancer-related fatigue, psychological resilience, perceived social support, and quality of life in lung cancer patients with chemotherapy were analyzed using Spearman correlation. Model 6 in the SPSS PROCESS program was used to test for chain mediating effects. A total of 275 questionnaires were distributed, 268 questionnaires were recovered, excluding the regular answer questionnaires, the valid questionnaires were 252, the effective recovery rate of questionnaires was 91.64% (252/275) .Results:Univariate analysis showed statistically significant differences in QLICP-LU scores among lung cancer patients with chemotherapy of different ages, educational levels, marital status, per capita monthly household income, and tumor stages ( P<0.01). Spearman correlation analysis showed that cancer-related fatigue was negatively correlated with psychological resilience, perceived social support and quality of life in patients undergoing chemotherapy for lung cancer ( P<0.01), and quality of life was positively correlated with psychological resilience and perceived social support ( P<0.01), and psychological resilience was positively correlated with perceived social support ( P<0.01). Mediating effect analysis showed that the direct effect of cancer-related fatigue on quality of life was -0.302, which accounted for 77.44% of the total effect. Psychological resilience and perceived social support realized mediating effects between cancer-related fatigue and quality of life through three mediating pathways, with a total indirect effect of -0.088, accounting for 22.56% of the total effect. Conclusions:Cancer-related fatigue can not only directly affect the quality of life of patients undergoing chemotherapy for lung cancer, but it can also have an indirect effect on them through the mediating role of psychological resilience and perceived social support. While focusing on patients' cancer-related fatigue, medical and nursing staff should focus on assessing patients' psychological status, providing psychological support, and increasing social support so as to improve patients' quality of life.

Objective:To explore the chain mediating role of psychological resilience and perceived social support between cancer-related fatigue and quality of life in patients undergoing chemotherapy for lung cancer, and to inform interventions to improve quality of life in patients undergoing chemotherapy for lung cancer.Methods:Convenience sampling was used to select 275 lung cancer patients with chemotherapy admitted to three ClassⅢ Grade A hospitals in Henan Province from June 2022 to November 2023 for the study. General Information Questionnaire, Cancer Fatigue Scale, Quality of Life Instruments for Cancer Patients-Lung (QLICP-LU), Connor-Davidson Resilience Scale, and Perceived Social Support Scale were used to survey the patients. Correlations between cancer-related fatigue, psychological resilience, perceived social support, and quality of life in lung cancer patients with chemotherapy were analyzed using Spearman correlation. Model 6 in the SPSS PROCESS program was used to test for chain mediating effects. A total of 275 questionnaires were distributed, 268 questionnaires were recovered, excluding the regular answer questionnaires, the valid questionnaires were 252, the effective recovery rate of questionnaires was 91.64% (252/275) .Results:Univariate analysis showed statistically significant differences in QLICP-LU scores among lung cancer patients with chemotherapy of different ages, educational levels, marital status, per capita monthly household income, and tumor stages ( P<0.01). Spearman correlation analysis showed that cancer-related fatigue was negatively correlated with psychological resilience, perceived social support and quality of life in patients undergoing chemotherapy for lung cancer ( P<0.01), and quality of life was positively correlated with psychological resilience and perceived social support ( P<0.01), and psychological resilience was positively correlated with perceived social support ( P<0.01). Mediating effect analysis showed that the direct effect of cancer-related fatigue on quality of life was -0.302, which accounted for 77.44% of the total effect. Psychological resilience and perceived social support realized mediating effects between cancer-related fatigue and quality of life through three mediating pathways, with a total indirect effect of -0.088, accounting for 22.56% of the total effect. Conclusions:Cancer-related fatigue can not only directly affect the quality of life of patients undergoing chemotherapy for lung cancer, but it can also have an indirect effect on them through the mediating role of psychological resilience and perceived social support. While focusing on patients' cancer-related fatigue, medical and nursing staff should focus on assessing patients' psychological status, providing psychological support, and increasing social support so as to improve patients' quality of life.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

BACKGROUND:Tissue engineering has brought new hope to the clinical challenge of liver failure,and the preparation of plant-derived decellularized fiber scaffolds holds significant importance in liver tissue engineering. OBJECTIVE:To prepare apple tissue decellularized scaffold material by using fresh apple slices and a solution of sodium dodecyl sulfate,and assess its biocompatibility. METHODS:Fresh apples were subjected to decellularization using phosphate buffer saline and sodium dodecyl sulfate solution,separately.Afterwards,the decellularized apple tissues and apple decellularized scaffold materials were decontaminated with phosphate buffer saline.Subsequently,scanning electron microscopy was used to assess the effectiveness of decellularization of the apple materials.Adipose-derived mesenchymal stem cells were extracted from the inguinal fat BALB/C of mice,and their expression of stem cell-related markers(CD45,CD34,CD73,CD90,and CD105)was identified through flow cytometry.The cells were then divided into a scaffold-free control group and a scaffold group.Equal amounts of adipose-derived mesenchymal stem cells were seeded onto both groups.The biocompatibility of the decellularized scaffold with adipose-derived mesenchymal stem cells was evaluated using CCK-8 assay,hematoxylin-eosin staining,and phalloidine staining.Cell adhesion and growth on the scaffold were observed under light microscopy and scanning electron microscopy.Furthermore,the scaffold was subdivided into the non-induced group and the hepatogenic-induced group.Adipose-derived mesenchymal stem cells were cultured on the decellularized apple scaffold,and they were cultured for 14 days in regular culture medium or hepatogenic induction medium for comparison.Immunofluorescent staining using liver cell markers,including albumin,cytokeratin 18,and CYP1A1,was performed.Enzyme-linked immunosorbent assay was used to detect the secretion of alpha fetoprotein and albumin.Additionally,scanning electron microscopy was employed to observe the morphology of the induced cells on the scaffold,verifying the expression of liver cell-related genes on the decellularized scaffold material.Finally,the cobalt-60 irradiated and sterilized decellularized apple scaffolds were transplanted onto the surface of mouse liver and the degradation of the scaffold was observed by gross observation and hematoxylin-eosin staining after 28 days. RESULTS AND CONCLUSION:(1)The scanning electron microscopy results revealed that the decellularized apple scaffold material retained a porous structure of approximately 100 μm in size,with no residual cells observed.(2)Through flow cytometry analysis,the cultured cells were identified as adipose-derived mesenchymal stem cells.(3)CCK-8 assay results demonstrated that the prepared decellularized apple tissue scaffold material exhibited no cytotoxicity.Hematoxylin-eosin staining and phalloidine staining showed that adipose-derived mesenchymal stem cells were capable of adhering and proliferating on the decellularized apple tissue scaffold.(4)The results obtained from immunofluorescence staining and enzyme-linked immunosorbent assay revealed that adipose-derived mesenchymal stem cells cultured on the decellularized apple scaffolds exhibited elevated expression of liver-specific proteins,including albumin,alpha-fetoprotein,cytokeratin 18,and CYP1A1.These results suggested that they were induced differentiation into hepatocyte-like cells possessing functional characteristics of liver cells.(5)The decellularized apple scaffold implanted at 7 days has integrated with the liver,with partial degradation of the scaffold observed.By 28 days,the decellularized apple scaffold has completely degraded and has been replaced by newly-formed tissue.(6)The results indicate that the decellularized scaffold material derived from apple tissue demonstrates favorable biocompatibility,promoting the proliferation,adhesion,and hepatic differentiation of adipose-derived mesenchymal stem cells.

Objective:To explore the clinical effect of non-expansion whole framework ear reconstruction for microtia (referred to as the NEWF ear reconstruction).Methods:The clinical data of congenital microtia patients underwent NEWF ear reconstruction at Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. This advanced method used a tissue non-expansion approach, employing a double flap consisting of preauricular skin flap and fascia flaps, to fabricate and elevate the ear framework in the first stage concurrently. In the subsequent stage, residual ear tissues were utilized to reconstruct key elements such as the tragus, crus of the helix, cavum concha, and so on. At 6 months follow-up, the effectiveness of the reconstructed ear was assessed based on its aesthetic outcomes and complications. Aesthetic outcomes evaluation included 4 items: skin color (front of ear, back of ear and skin graft area were evaluated respectively), appearance of reconstructed ear substructure, scar of incision and hair condition. The individual score was 0-2 points, total scores from 0 to 10, with scores of 9-10 signifying excellent, 6-8 good, 3-5 moderate, and 0-2 poor. The data were analyzed by descriptive statistics.Results:Ear reconstruction was performed on 49 unilateral microtia cases, aged 6-33 years, including 37 males and 12 females, 34 right ears and 15 left ears. According to the Nagata classification: 30 cases were lobule-type, 5 cases were conchal-type, and 14 cases were small conchal-type. The follow-up period averaged 10.63 months, ranging from 6 to 13 months. One patient experienced exposure of the framework 1 month after the first stage surgery, then recovered well after surgery. The skin color of the front side of the reconstructed ear was close to normal, the substructure was clear, the skin graft area behind the ear recovered well, and the reconstructed ear was basically symmetrical with the healthy side. 9 cases (18.4%) had scar hyperplasia in the mastoid area behind the ear. 9 cases (18.4%) had hair growth on the front of the reconstructed ears. Aesthetic outcomes showed that excellent in 8 cases (16.3%), good in 36 cases (73.5%), moderate in 4 cases (8.2%), poor in 1 case (2.0%).Conclusion:The NEWF ear reconstruction enhances the stability of the ear framework, reduces the overall duration of treatment, making it a viable option for ear reconstruction for microtia.