Objective To study the effects of hypoxia-inducible factor-1α (HIF-1α) on radiationinduced autophagic cell death in breast cancer cells.Methods MCF-7 cells were divided into four groups:control (normoxia,21％ Oxygen),irradiation (8 Gy X-rays),hypoxia (Cobalt chloride,CoCl2)and irradiation with hypoxia (CoCl2).150 μmol/L CoCl2 was utilized to induce hypoxic conditions.Western blot was applied to detect the expression of HIF-1α and MAPLC3.MDC and Hoechst staining were used to detect autophagy and apoptosis.Radiosensitivity was detected by cloning formation.The short hairpin interfering RNA (shRNA) retroviral transduction particles targeting HIF-1α was transfected into MCF-7 cells to establish HIF-1 α knockdown cells,then the radiosensibility,autophagy and apoptosis were detected.Results Compared with control group and irradiation group,the protein level of HIF-1 increased obviously in the normaxia,irradiation,hypoxia and irradiation with hypoxia groups,and the values were 0,0,1.00,1.89,respectively.The expression levels of MAPLC3 were markedly up-regulated in irradiation,hypoxia and irradiation with hypoxia groups as compared with control,and the ratios of LC3Ⅱ/LC3Ⅰ were 1.15,1.73,2.38 and 3.60,respectively.The radiosensitivity of MCF-7 cells decreased in the following order:normoxia with 3MA ＞ normoxia ＞ hypoxia with 3MA ＞ hypoxia.HIF-1α knockdown cell (pSUPER-HIF-1α Ri) and vector control were constructed.After treatment with CoCl2,survival fraction of MCF-7-pSUPER was significantly higher than that of control (t =3.080,6.946,6.658,6.380,P ＜0.05),and radiosensitivity was down-regulated after irradiation,but there was no significant difference between normoxia and hypoxia in survival fraction of MCF-7-pSUPER-HIF-1α Ri.After treatment of irradiation or hypoxia,the autophagic fractions in MCF-7-pSUPER-HIF-1α Ri significantly decreased,reduced by 21.1％,25.5％,15.5％,respectively(t =4.635,4.738,6.354,P ＜0.05) as compared with MCF-7-pSUPER,but there was no change in apoptosis.Conclusions HIF-1α may increase radiationinduced autophagy and decrease radiosensitivity,but have no influence on apoptosis.

Objective To explore the effect of prevention intraoperative hypothermia of different heat preservation measures during craniotomy cerebroma resection surgery in the department of neurosurgery. Methods According to the inclusion criteria, a total of 90 patients with craniocerebral surgery were recruited and randomly divided into A, B, C groups with random number table method, and 30 patients in each group. And the three groups were respectively given different heat preservation measures of regular cover, regular cover with infusion heating, regular cover with force-air warming. Meanwhile the rectal temperatures of just entered into the operating room, immediately after anesthesia induction and every 30 minutes after induction of anesthesia, as well as the HR, BP, the amount of infusion and flushing liquor, operation time, incidence of chills during operation, the condition of surgical site infection and hospitalization days were recorded and analyzed statistically by means of the software of SPSS 13.0. Results Rectal temperatures of the three groups were no statistically significant difference (P>0.05) ,when the patients just were moved into the operating room, immediately after anesthesia induction and 0.5 h、1 h after anesthesia induction. The rectal temperatures of the three groups had statistically significant difference (P<0.05) from the 1.5h after anesthesia induction to the end of the surgery.The incidence rates of introperative hypothermia and chill of group C were 26.7%(8/30)and10.0% (3/30),lower than group A and group B:60.0%(18/30), 33.3%(10/30)and 53.3%(16/30), 13.3%(4/30), meanwhile the statistically significant difference was found in these three groups (χ2=7.500, P=0.024;χ2=6.237, P=0.044).The volume of intraoperative blood loss and transfusion were 200(100, 300), 45(0, 60) ml, which lower than group A and group B:300(200, 525), 215(0, 400) ml and 250(150, 500), 120(0, 200) ml, and statistically significant difference was also found in these three groups(H=7.612, P=0.022;H=6.194, P=0.045). Conclusions Regular cover with force-air warming can effectively reduce the incidence of intraoperative hypothermia and chills of craniotomy cerebroma resection patients in the department of neurosurgery and reduce intraoperative bleeding and transfusion volume, as well as ensure the effect of surgical treatment. So it′s worth popularizing in clinic.

Objective: To conduct a systematic review and meta-analysis of studies evaluating the oncological and fertility outcomes of early-stage endometrial cancer (EC) treated with the levonorgestrel-releasing intrauterine system (LIUS)-based regimens. Methods: The Meta-analyses Of Observational Studies in Epidemiology statement for meta-analyses was followed. Searches were conducted on MEDLINE, Embase, PubMed, Preprints, and the Cochrane Central Register of Controlled Trials from January 1990 to August 4, 2022. The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment. The primary endpoint was the complete response (CR) rate and the secondary endpoints were relapse, pregnancy, and live birth rate. Results: A total of 25 studies (821 women) were included. The CR rate of LIUS-based regimens was 63.4% (95% confidence interval [CI]=52.3%–73.2%), with 29.6% (95% CI=23.3%–36.8%) of cases experiencing recurrence during follow-up. In sensitivity analyses, patients younger than 45 years of age with a body mass index <30 kg/m2 who were treated with LIUS-based regimens achieved a high CR rate of 84.6% (95% CI=80.3%–88.1%) over a median follow-up of more than 24 months. Overall pregnancy and live birth rates were 37.9% (95% CI=24.1%–53.9%) and 39.3% (95% CI=24.0%–57.0%), respectively. No statistical differences were apparent in CR or relapse rates among the LIUS+GnRH agonist, LIUS+oral progesterone, or hysteroscopic resection followed by LIUS subgroups. Conclusion LIUS-based therapies are viable for the conservative management of early-stage endometrioid EC on CR and fertility outcome.

Objective To explore the characteristics of contrast-enhanced ultrasonagraphy(CEUS) of sarcomatoid hepatocellular carcinoma ( SHC ) . Methods Fifteen lesions identified pathologically from 15 patients were included in this study . Among them ,9 lesions had completely sarcomatoid change and 6 lesions had partially sarcomatoid change . Totally 8 lesions were in the small size group with maximum diameter＜ 50 mm and 7 lesions in the big size group with maximum diameter ≥ 50 mm . The CEUS performance was observed and analyzed . Results In the arterial phase of CEUS ,9 lesions in the group with completely sarcomatoid change showed rim hyperenhancement and 6 lesions in the group with partially sarcomatoid change showed whole hyperenhancement , the difference between the two groups was statistically significant ( P ＜ 0 .001 ) . However ,the difference of CEUS performance between small size group and big size group was not statistically significant ( P ＝ 0 .608 ) , all the lesions showed hypoechogenecity in portal and(or) late phase of CEUS . Conclusions The difference of performance on CEUS is not related to the size of SHC ,but to the degree of sarcomatoid change within the tumor . SHC with completely sarcomatoid change shows rim hyperenhancement and SHC with partially sarcomatoid change shows entire hyperenhancement in arterial phase on CEUS .