Objective:To construct an ultrasound-responsive nano-oxygen carrier，and to enhance cell survival within myocardial patches and promote myocardial infarction（MI）repair.Methods:Ultrasound-responsive phase-change nanobubbles（ND）were first prepared and integrated into GelMA hydrogel to construct myocardial patches. Low-intensity pulsed ultrasound（LIPUS）irradiation was applied to explore whether the nanobubbles could optimize the hydrogel properties. Hemoglobin（Hb）was further encapsulated into the nanobubbles to construct an oxygen carrier（ND-Hb）. In vitro and in vivo experiments were conducted to evaluate whether the optimized myocardial patches could improve cell survival and facilitate MI repair. In vitro，cell-loaded patches were divided into 6 groups（control，ND，Hb，LIPUS，LIPUS+ND，and LIPUS+oxygen carrier groups）to assess the cell viability and protein expression. In vivo，an acute MI model was established in SD rats，which were randomly assigned to 4 groups（control，Hb，LIPUS+ND，and LIPUS+oxygen carrier groups）.Myocardial patches were implanted，and cardiac function（echocardiography），cell survival（BLI imaging），angiogenesis（CD31 and α-SMA immunofluorescence）and connexin protein expression（Cx43）were evaluated. Results:Following the incorporation of ND and LIPUS irradiation，scanning electron microscopy revealed numerous micropores（about 2 μm）within the hydrogel were observed by scanning electron microscopy. The nano-oxygen carrier was successfully constructed，with a particle size of（301.2 ± 92.4）nm，and released oxygen under LIPUS stimulation. In vitro，at days 3，7，and 14，the cell survival rates in the LIPUS+oxygen carrier group［（89.6 ± 2.1）%，（79.3 ± 1.8）%，（70.9 ± Conclusions:This study successfully employs LIPUS combined with ND-Hb to enhance hydrogel properties，facilitating nutrient exchange within myocardial patches. Additionally，ultrasound-mediated oxygen release improves seed cell survival and promotes myocardial infarction repair.

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 distribution of dense fine speckled(DFS)antinuclear antibody(ANA)in different ages,genders,and diseases,and to explore its clinical significance in the diagnosis of auto-immune disease(AID).Methods A retrospective summary was conducted on the clinical basic data of 53520 patients who visited the hospital from January 2022 to April 2024,as well as the results of indirect immunoflu-orescence(IIF)ANA fluorescence karyotype and titer,and immunoblotting ANA spectrum,and the relation-ship between DFS positivity and AID was analyzed.Results Of the 53 520 serum samples,the rate of ANA fluorescence positivity was 32.40％,with DFS-positive samples accounting for 1.18％of all ANA fluores-cence-positive samples.The male-to-female ratio of DFS positives was 1∶1.94,with the highest percentage of 51.9％in the 21-40 age group.Among DFS positive individuals,only 12.14％were clinically diagnosed with AID disease,significantly lower than other ANA fluorescent karyotype positive individuals(23.31％,P＜0.001).The overall positivity rate of ANA spectra using immunoblotting in DFS-positive individuals was 23.54％,which was significantly lower than that in other fluorescent karyotype positive ANA individuals(73.26％,P＜0.001).Moreover,DFS positive individuals were mainly accompanied by antibody positivity such as anti-Ro52 antibodies,which had no diagnostic specificity in AID diagnosis.When comparing DFS posi-tive individuals with similar fluorescence morphology to those with homogeneous nuclear granules and nuclei,at an ANA titer of 1∶100,the proportion of AID patients in homogeneous nuclear granules and nuclei was 20.04％,significantly higher than the proportion of AID patients in DFS positive individuals(9.44％,P=0.001).With the increase of ANA titer,the proportion of AID diseases significantly increased in both karyo-type samples.When the ANA titer of DFS positive samples was increased to ≥ 1∶320,the proportion of AID diseases significantly increased to 30.77％(P=0.002).Conclusion DFS is a rare ANA fluorescent karyo-type,and DFS positive individuals are mainly found in females aged 21-40,mostly non AID patients.Howev-er,high titers of DFS cannot rule out the possibility of AID.In clinical work,special attention should be paid to distinguishing it from the homogeneous nuclear granule type to avoid misdiagnosis.

Objective This study analyzed the chemical structures of two unknown substances in e-liquid using methods such as nuclear magnetic resonance(NMR),infrared spectroscopy(IR),and mass spectrometry(MS).Methods After separating,purifying,and freeze-drying two suspicious substances from e-liquid,GC-MS analysis was used to obtain the mass spectrum characteristic ion fragments and fragmentation patterns of unknown compounds.The precise mass numbers were measured by high-resolution mass spectrometry,and proton numbers and their assignments,carbon types,and fluorine atom numbers and positions were obtained by combining 1HNMR,13CNMR,and 19FNMR.The functional groups were then analyzed by infrared spectroscopy.Results Through data analysis,the molecular formulas of the two suspicious substances are C13H13FN2O2 and C14H15FN2O2,respectively.Their structures were determined to be etomidate derivatives:1-(o-fluoromethylphenyl)imidazole-5-carboxylic acid methyl ester and 1-(o-fluoromethylphenyl)imidazole-5-carboxylic acid ethyl ester.Conclusion The structural data of two substances obtained in this study in terms of mass spectrometry,nuclear magnetic resonance,and infrared spectroscopy provide support for combating crimes involving the two substances,and provide reference for the regulation and detection of the two drugs.

Objective To analyze anesthetic and analgesic effect of perioperovtive administration of esketamine in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods The clinical data of 120 patients who underwent OPCABG under gene-ral anesthesia were retrospectively collected.Patients were divided into an esketamine group(n=60)and a non-esketamine group(n=60)according to whether esketamine was used perioperatively.The patients in the esketamine group received esketamine(1 mg/kg)during anesthesia induction and postoperative patient-controlled analgesia with sufentanil(3 μg/kg)plus esketamine(2 mg/kg).Those in the non-esketamine group received sufentanil(2 μg/kg)during anesthesia induction and postoperative patient-controlled analgesia with sufentanil(3 μg/kg).The mean arterial pressure(MAP)and heart rate(HR)were recorded at the time point of entering the room(T0),after anesthesia induction/before intubation(T1),1 min after intubation(T2),skin incision(T3),sternotomy(T4),after surgery and skin suture(T5),entering the ICU(T6),extubation(T7),24 hours after surgery(T8),and 48 hours after surgery(T9).The extubation time,Ramsay sedation scores,visual analog scale(VAS)scores,and adverse reactions were compared.Results There were no statistically significant differences in the baseline characteristics and MAP and HR at T0 and T1 between the two groups(P＞0.05).From T2 to T9,MAP and HR in the esketamine group were significantly lower than those in the non-esketamine group(P＜0.05).The postoperative extubation time,Ramsay sedation score,and VAS score were significantly lower in the esketamine group than in the non-esketamine group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The perio-perative administration of esketamine in OPCABG can stabilize the hemodynamics,shorten the extubation time,and promote the recovery of patients undergoing OPCABG without increasing postoperative adverse reactions.

Objective:To investigate the immune signatures of endometrial carcinoma(EC)patients with POLE mutation.Methods:A total of 104 paraffin-embedded tissue samples of EC were collected from December 2020 to October 2022,including 11 POLE mutants and 93 POLE wild type in Department of Pathology,Taihe Hospital.Immunohistochemistry was conducted to detect ex-pressions of CD4,CD8 and PD-L1 proteins in EC tissue.Combined with TCGA database,bioinformatics was used to analyze immune infiltration of POLE mutants,mainly including CD4,CD8,PD-L1 mRNA expressions and related prognosis analysis.Results:Based on TCGA database analysis,compared to POLE wild type EC,significantly different expression genes,including chemokine family,immune cell surface markers and lysozyme genes(all P<0.05),were revealed in POLE mutants.In POLE mutant samples,main enriched signaling pathways including immune regulation,mesenchymal-epithelial transformation,etc.(all P<0.01).Compared with POLE wild-type,abundance of CD4+T cells,CD8+T cells,M1 macrophages and dendritic cells in EC samples with POLE mutation was sig-nificantly up-regulated(P<0.05).TISIDB platform assay suggested that POLE mutants primarily drove biological behavior of immune cells,including recruitment and activation of dendritic cells,NK cells,T cells and other immune cells,and lymphocyte homing in EC.Additionally,various immunosuppressive genes(including PD-L1,CTLA-4,TIM-3,etc.)were significantly overexpressed in EC with POLE mutants.In clinical samples,it was also confirmed that POLE mutation was significantly correlated with hyper-expressions of CD8,CD4 and PD-L1(all P<0.001).Prognostic analysis of TCGA showed that survival time of CD8 or PD-L1 over-expression of the POLE mutant subgroup was significantly prolonged,while CD8 or PD-L1 down-regulation of POLE wild-type subgroup was the shortest(P<0.01);there was no significant difference in CD4 subgroup(P>0.05).Conclusion:In EC patients,infiltration abun-dance of CD8+T cells and expression of PD-L1 have crucial value for prognosis or treatment of EC patients with POLE mutation.

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 This study analyzed the chemical structures of two unknown substances in e-liquid using methods such as nuclear magnetic resonance(NMR),infrared spectroscopy(IR),and mass spectrometry(MS).Methods After separating,purifying,and freeze-drying two suspicious substances from e-liquid,GC-MS analysis was used to obtain the mass spectrum characteristic ion fragments and fragmentation patterns of unknown compounds.The precise mass numbers were measured by high-resolution mass spectrometry,and proton numbers and their assignments,carbon types,and fluorine atom numbers and positions were obtained by combining 1HNMR,13CNMR,and 19FNMR.The functional groups were then analyzed by infrared spectroscopy.Results Through data analysis,the molecular formulas of the two suspicious substances are C13H13FN2O2 and C14H15FN2O2,respectively.Their structures were determined to be etomidate derivatives:1-(o-fluoromethylphenyl)imidazole-5-carboxylic acid methyl ester and 1-(o-fluoromethylphenyl)imidazole-5-carboxylic acid ethyl ester.Conclusion The structural data of two substances obtained in this study in terms of mass spectrometry,nuclear magnetic resonance,and infrared spectroscopy provide support for combating crimes involving the two substances,and provide reference for the regulation and detection of the two drugs.

Objective To analyze anesthetic and analgesic effect of perioperovtive administration of esketamine in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods The clinical data of 120 patients who underwent OPCABG under gene-ral anesthesia were retrospectively collected.Patients were divided into an esketamine group(n=60)and a non-esketamine group(n=60)according to whether esketamine was used perioperatively.The patients in the esketamine group received esketamine(1 mg/kg)during anesthesia induction and postoperative patient-controlled analgesia with sufentanil(3 μg/kg)plus esketamine(2 mg/kg).Those in the non-esketamine group received sufentanil(2 μg/kg)during anesthesia induction and postoperative patient-controlled analgesia with sufentanil(3 μg/kg).The mean arterial pressure(MAP)and heart rate(HR)were recorded at the time point of entering the room(T0),after anesthesia induction/before intubation(T1),1 min after intubation(T2),skin incision(T3),sternotomy(T4),after surgery and skin suture(T5),entering the ICU(T6),extubation(T7),24 hours after surgery(T8),and 48 hours after surgery(T9).The extubation time,Ramsay sedation scores,visual analog scale(VAS)scores,and adverse reactions were compared.Results There were no statistically significant differences in the baseline characteristics and MAP and HR at T0 and T1 between the two groups(P＞0.05).From T2 to T9,MAP and HR in the esketamine group were significantly lower than those in the non-esketamine group(P＜0.05).The postoperative extubation time,Ramsay sedation score,and VAS score were significantly lower in the esketamine group than in the non-esketamine group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The perio-perative administration of esketamine in OPCABG can stabilize the hemodynamics,shorten the extubation time,and promote the recovery of patients undergoing OPCABG without increasing postoperative adverse reactions.

Objective:To investigate the immune signatures of endometrial carcinoma(EC)patients with POLE mutation.Methods:A total of 104 paraffin-embedded tissue samples of EC were collected from December 2020 to October 2022,including 11 POLE mutants and 93 POLE wild type in Department of Pathology,Taihe Hospital.Immunohistochemistry was conducted to detect ex-pressions of CD4,CD8 and PD-L1 proteins in EC tissue.Combined with TCGA database,bioinformatics was used to analyze immune infiltration of POLE mutants,mainly including CD4,CD8,PD-L1 mRNA expressions and related prognosis analysis.Results:Based on TCGA database analysis,compared to POLE wild type EC,significantly different expression genes,including chemokine family,immune cell surface markers and lysozyme genes(all P<0.05),were revealed in POLE mutants.In POLE mutant samples,main enriched signaling pathways including immune regulation,mesenchymal-epithelial transformation,etc.(all P<0.01).Compared with POLE wild-type,abundance of CD4+T cells,CD8+T cells,M1 macrophages and dendritic cells in EC samples with POLE mutation was sig-nificantly up-regulated(P<0.05).TISIDB platform assay suggested that POLE mutants primarily drove biological behavior of immune cells,including recruitment and activation of dendritic cells,NK cells,T cells and other immune cells,and lymphocyte homing in EC.Additionally,various immunosuppressive genes(including PD-L1,CTLA-4,TIM-3,etc.)were significantly overexpressed in EC with POLE mutants.In clinical samples,it was also confirmed that POLE mutation was significantly correlated with hyper-expressions of CD8,CD4 and PD-L1(all P<0.001).Prognostic analysis of TCGA showed that survival time of CD8 or PD-L1 over-expression of the POLE mutant subgroup was significantly prolonged,while CD8 or PD-L1 down-regulation of POLE wild-type subgroup was the shortest(P<0.01);there was no significant difference in CD4 subgroup(P>0.05).Conclusion:In EC patients,infiltration abun-dance of CD8+T cells and expression of PD-L1 have crucial value for prognosis or treatment of EC patients with POLE mutation.