BACKGROUND:It has also been confirmed that ferroptosis is closely related to a variety of musculoskeletal diseases,such as rheumatoid arthritis,osteosarcoma,and osteoporosis.The pathophysiological mechanisms of ferroptosis and osteoporosis need to be further studied and elucidated to broaden our understanding of iron metabolism and osteoporosis.It will provide research ideas for the future elucidation of new mechanisms of osteoporosis and the development of new technologies and drugs for the treatment of osteoporosis. OBJECTIVE:To provide an overview of the current status of research on ferroptosis in osteoporosis,to provide a new direction for future research on the specific molecular mechanisms of osteoporosis,and to provide more effective and better options for osteoporosis treatment strategies. METHODS:The first author used the computer to search the literature published from 2000 to 2024 in CNKI,WanFang,VIP,and PubMed databases with search terms"ferroptosis,iron metabolism,osteoporosis,osteoblast,osteoclast,bone metabolism,signal pathway,musculoskeletal,review"in Chinese and English.A total of 68 articles were finally included according to the selection criteria. RESULTS AND CONCLUSION:(1)Ferroptosis is a new type of cell death discovered in recent years,which is usually accompanied by a large amount of iron accumulation and lipid peroxidation during cell death,and its occurrence is iron-dependent.This is distinctly different from several types of cell death that are currently being hotly studied(e.g.,cellular pyroptosis,necrotic apoptosis,cuproptosis,and autophagy).(2)Intracellular iron homeostasis is manifested as a balance between iron uptake,export,utilization,and storage.The body's iron regulatory system includes systemic and intracellular regulation.The main factor of systemic regulation is hepcidin produced by hepatic secretion,and cellular regulation depends on the iron regulatory protein/iron response element system.Of course,intracellular iron homeostasis can be controlled by other factors,such as hypoxia,cytokines,and hormones.(3)Lipid peroxidation causes oxidative damage to biological membranes(plasma membrane and internal organelle membranes),lipoproteins,and other lipid-containing molecules.Polyunsaturated fatty acid-containing phospholipids are important targets of lipid peroxidation.Free polyunsaturated fatty acid is an important substrate for lipid oxidation and can bind to the phospholipid bilayer,leading to over-oxidation and thus triggering lipid apoptosis.(4)Several studies have shown that osteoblasts are overloaded with iron in different ways,resulting in the accumulation of unstable ferrous iron and the generation of reactive oxygen species and lipid peroxides,causing ferroptosis of osteoblasts and ultimately a decrease in bone formation,affecting bone homeostasis and the development of osteoporosis.(5)Osteoclasts are large multinucleated cells formed by the fusion of mononuclear macrophage cell lines or bone marrow mesenchymal stem cells induced by nuclear factor-κB ligand receptor activator,and they have the function of bone resorption.Iron ions can promote osteoclast differentiation and bone resorption through the production of intracellular lipid reactive oxygen species,while iron chelators can inhibit osteoclast formation in vitro and thus affect the occurrence and development of osteoporosis.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Background and Objectives: Chronic periodontitis can lead to alveolar bone resorption and eventually tooth loss. Stem cells from exfoliated deciduous teeth (SHED) are appropriate bone regeneration seed cells. To track the survival, migration, and differentiation of the transplanted SHED, we used super paramagnetic iron oxide particles (SPIO) Molday ION Rhodamine-B (MIRB) to label and monitor the transplanted cells while repairing periodontal bone defects. Methods: and Results: We determined an appropriate dose of MIRB for labeling SHED by examining the growth and osteogenic differentiation of labeled SHED. Finally, SHED was labeled with 25 μg Fe/ml MIRB before being transplanted into rats. Magnetic resonance imaging was used to track SHED survival and migration in vivo due to a low-intensity signal artifact caused by MIRB. HE and immunohistochemical analyses revealed that both MIRB-labeled and unlabeled SHED could promote periodontal bone regeneration. The colocalization of hNUC and MIRB demonstrated that SHED transplanted into rats could survive in vivo. Furthermore, some MIRB-positive cells expressed the osteoblast and osteocyte markers OCN and DMP1, respectively. Enzyme-linked immunosorbent assay revealed that SHED could secrete protein factors, such as IGF-1, OCN, ALP, IL-4, VEGF, and bFGF, which promote bone regeneration. Immunofluorescence staining revealed that the transplanted SHED was surrounded by a large number of host-derived Runx2- and Col II-positive cells that played important roles in the bone healing process. Conclusions SHED could promote periodontal bone regeneration in rats, and the survival of SHED could be tracked in vivo by labeling them with MIRB. SHED are likely to promote bone healing through both direct differentiation and paracrine mechanisms.

We strive to explore a student-centered evaluation system focused on improving students' learning efficiency and learning effect. Through classroom questioning, discussion of difficult cases, new progress report, question bank test, writing of clerkship notes, simulated inquiry between students with bedside inquiry, physical examination between students with bedside physical examination, operation training of basic clinical skills, direct observation and evaluation of clinical skills, mini-clinical exercise evaluation, graduation examination and other measures, an evaluation system for promoting learning by class evaluation, clerkship evaluation and practice evaluation has been established to cultivate the connotation construction of medical moral quality and clinical practice ability of medical students, and further promote the mastery of basic theoretical knowledge and clinical operation skills. By comparing the results of the phased examination for medical practitioners, the passing rate of 2018 is significantly higher than that of 2017, with 23.31% increased passing rate of theoretical results, and 0.79% increased passing rate of skills operation results. It can be seen that the evaluation system for promoting learning has played a guiding role in the teaching practice of clinical courses in our hospital.

Objective To investigate the protective effect and underlying mechanism of the superoxide dismutase mimic, manganese (Ⅲ) tetrakis (1-methyl-4-pyridyl) porphyrin pentachloride (MnTMPyP), on paraquat (PQ) -induced lung epithelial-like cell injury. Methods Alveolar epithelial-like cells (A549) were pretreated with 10 μmol/L of MnTMPyP for 1.5 h and then cultured with or without PQ (750 μmol/L) for 24 h. Cell survival was determined using the MTT assay. Reactive oxygen species (ROS) production and Ca2+ levels were measured using flow cytometry. Glutathione reductase (GR) activity was determined using spectrophotometry. Expressions of the endoplasmic reticulum (ER) stress proteins, glucose regulatory protein 78 (Grp78) and C/EBP homologous protein (CHOP), were measured using Western blotting. Results Cell viability and GR activity were decreased, but ROS production, cytoplasmic Ca2+ levels, and expressions of Grp78 and CHOP were all increased in the PQ group compared to those in the control group. There were no statistically significant changes in the MnTMPyP group. Cell viability and GR activity were increased, while ROS production, cytoplasmic Ca2+ levels, and expressions of Grp78 and CHOP were all significantly reduced in the MnTMPyP group compared to those in the PQ group. Conclusion MnTMPyP effectively reduced PQ-induced lung epithelial-like cell injury, and the underlying mechanism is related to antagonism of PQ-induced ER stress and oxidative stress.

Objective: To analyze the clinical epidemiological situation and trend of brucellosis in Shanxi Province in order to provide the basis for diagnosis. Methods: Brucellosis cases admitted to the First Hospital of Shanxi Medical University during January 2013 to December 2015 were included in the study. A retrospective investigation was undertaken and patient files were reviewed for general situation, clinical and laboratory findings, the process of diagnosis and treatments. Results: The data of 141 patients were collected, including 100 males and 41 females, the male to female ratio was 2.44 ∶ 1.00; the majority were 51-60 years old, 49 cases, accounting for 34.75%; the peak incidence was July and August each year, a total of 51 cases, accounting for 36.17%; of the 141 patients, 112 (79.43%) were professional, 29 (20.57%) were non-professional; and the clinical performance was diverse, 114 (80.85%) patients with irregular heat type, only 17 cases (12.06%) showed typical migratory joint pain; 31 cases (21.99%) were first diagnosed with only brucellosis, the shortest misdiagnosis time was 1 week, and the longest 18 month, the average misdiagnosis time was 3 months, and the total misdiagnosis rate was as high as 78.01% (110/141). Conclusions Significant changes have happened in the clinical epidemiological characteristics of brucellosis in Shanxi Province. Various forms of prevention knowledge propaganda and education should be continually carried out, so as to strengthen the awareness and attention of the clinical workers on the disease.

Objective To improve the diagnosis and treatment of infective endocardits(IE)by exploring the causes,pathogenic microorganism,clinical characteristics and therapeutic results of patients with IE.Methods From January 2006 to January 2016,89 cases with IE in Ganzhou People's Hospital were collected,and the clinical charac-teristics were analyzed retrospectively.Results Among the IE patients,40.5%had congenital heart diseases,33.7%had rheumatic heart diseases,18.0% were post－PCI or operative endocarditis,and patients without basic cardiac diseases accounted for 7.9%.The most common clinical manifestations were fever (86.5%),followed by anemia (85.4%).The blood culture positive rate was 63.4%.Streptococci viridians were the most common causative organ-isms(44.2%),followed by coagulase －negative staphylococci(21.2%).Eighty－six patients received echocardio-graphy examination,vegetation was observed in 61cases (68.5%).The hospital mortality rate was 10.1%,mostly due to refractory congestive heart failure and sepsis.Conclusion Congenital heart disease showed an upward trend, rheumatic heart disease decreased significantly.Intermittent fever,anemia are the main clinical manifestations.Blood culture positive rate is not high,Streptococcus viridians is the most common causative organism.Echocardiography is the main basis for the diagnosis.

Objective To investigate the apoptosis mechanism induced by paraquat (PQ) in human type Ⅱ alveolar epithelial-like A549 cells.Methods A549 cells were cultured in vitro.The cells in the experimental group were exposed to various concentrations of PQ (50,100,150,and 200 μmol/L),while those in the control group were cultured in RPMI1640 medium.After treatment for 24 and 48 h,the cell survival rate was assessed by MTT assay.Morphological changes in the nuclei were observed by Hoechst 33258 fluorescence staining.Cellular apoptosis and mitochondrial transmembrane potential were assayed by flow cytometry.The activities of caspase-3 and caspase-9 were assayed by spectrophotometry.Western blotting was used to analyze the expression of proteins in the Bcl-2 family,such as Bcl-2,Bcl-xL,Bax,and Bak.Results PQ exhibited significant anti-proliferative activity in A549 cells.PQ-treated A549 cells were subjected to Hoechst 33258 staining.The hallmarks of apoptosis were detected,and the degree of apoptosis increased.Mitochondrial membrane potential was decreased,the levels of active caspase-3 and caspase-9 increased,the expression of Bcl-2 and Bcl-xL was decreased,and the expression of Bax and Bak was increased.These effects occurred in concentration-and time-dependent manners.Conclusion PQ efficiently induced intracellular apoptosis through the mitochondrial pathway in A549 cells.

Objective To investigate the clinical value of 6‐indicator of albumin ,alpha 1 globulin ,alpha 2 globulin ,beta 1 globu‐lin ,beta 2 globulin and gamma globulin detected by the automatic capillary serum protein electrophoresis in liver cancer disease . Methods Eighty‐three hospitalized patients(51 cases of primary liver cancer and 32 cases of secondary liver cancer) in our hospital from December 2014 to November 2015 were collected .The automatic biochemical analyzer and automatic capillary serum protein e‐lectrophoresis was adopted to detect the 8 indicators of serum albumin(g/L for quantitative indicator and % for qualitative indica‐tor) ,total protein ,alpha 1 globulin ,alpha 2 globulin ,beta 1 globulin ,beta 2 globulin ,gamma globulin .And 100 individuals undergo‐ing the healthy physical examination were randomly extracted as the control group .The levels of above 8 indicators were compared among various groups .Results The level of albumin(% ) and gamma globulin had statistical difference between the primary liver cancer group before treatment and the control group(P<0 .05);the levels of albumin(g/L) ,albumin(% ) ,beta 1 globulin and gam‐ma globulin had statistical difference between the primary liver cancer group after treatment and the control group(P<0 .05);the levels of albumin(g/L) and albumin(% ) after treatment in the primary liver cancer group were decreased compared with before treatment ,the difference was statistical difference(P<0 .05);the sensitivity and specificity of gamma globulin for indicating primary liver cancer were significantly higher than those of the other three indicators;at the same time in the comparison of the positive rate of serum gamma globulin ,the positive rate of serum gamma globulin in the primary liver cancer group was higher than that in the secondary liver cancer group and the control group(P<0 .05) .Conclusion The automatic capillary serum protein electrophoresis detection finds that gamma globulin has some clinical value in the diagnosis and treatment of liver cancer .

Objective To reduce the incidence of portable moxibustion related burns through the implementation of nursing project.Methods Burn cases from January to June 2015 were retrospectively analyzed,and the solving strategy in this project was determined,which included revising the operating process of portable moxibustion and treatment process of burns;operating training and testing of portable moxibustion;institutionalizing management of moxibustion box and related items;popularizing portable moxibustion in different forms,and standard indicators were setted according to the operating characteristics.Results After the implementation of improved project,the evaluation rate before operation,the inspection rate in operation,the evaluation rate after operation and patients' awareness rate were all ≥ 80％,the nursing defect rate decreased from 68.95％ to 9.94％ (x2=720.38,P＜0.01);the incidence rate of portable moxibustion related burns decreased from 0.68‰ to 0.18‰ (x2 =5.14,P＜0.05).Conclusions Through the project,it can regulate the operation of portable moxibustion,and reduce the event of moxibustion related burns.