Objective To compare target dosimetric distribution and normal tissue radiation between different static intensity?modulated radiation therapy ( IMRT) plans and volumetric modulated arc therapy ( VMAT) and to identify the best IMRT plan for patients with primary mediastinal B?cell lymphoma ( PMBCL) . Methods A total of 16 patients ( 8 males and 8 females) with early?stage ( Ann?Arbor stageⅠ) PMBCL were enrolled in this study,with doses of 45 Gy for primary gross tumor volume ( PGTV) and 40 Gy for planning target volume (PTV).Four plans were designed for each patient,consisting of static IMRT (5F?IMRT,7F?IMRT,9F?IMRT) and VMAT,and the target dosimetric distribution,normal tissue radiation dose,and efficiency of each plan were evaluated. The difference of dose was analyzed by analysis of variance. Results The mean conformity index ( CI) and homogeneity index ( HI) for PGTV in 5F?,7F?,9F?IMRT and VMAT were 1. 01 and 1. 10, 1. 01 and 1. 10, 1. 01 and 1. 10, and 1. 01 and 1. 11 ( P= 0. 963 and 0. 843) ,respectively,while these two indices for PTV were 1. 04 and 1. 22,1. 03 and 1. 19,1. 03 and 1. 17, and 1. 08 and 1. 14( P=0. 964 and 0. 969) ,respectively. The parameters of volume and dose were similar on normal tissue ( P= 0. 192?1. 000 ) . The treatment time and number of monitor units in 9F?IMRT were significantly higher than those in other static IMRT plans and VMAT ( P=0. 000,0. 000) ,and among these plans,VMAT had the lowest number of monitor units ( 13 345. 0 MU) and the shortest treatment time ( 5. 9 min) . Conclusions The target volume coverage of 7F?and 9F?IMRT is better than that of 5F?IMRT and VMAT.For early?stage PMBCL,VMAT is not superior to IMRT in terms of dosimetry,especially with a larger area of low?dose radiation to the breast,but it is highly efficient in practice.

OBJECTIVE: To study the effect of silencing LncRNA SNHG7 on hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury and its targeted regulation on miR-181b-5p. METHODS: Rat cardiomyocytes H9c2 were cultured in vitro and randomly divided into control group, H/R group, H/R + si-NC group, H/R + si-SNHG7 group, H/R + si-SNHG7 + anti-miR-NC group and H/R + si-SNHG7 + anti-miR-181b-5p group. The content of lactate dehydrogenase (LDH), malondialedhyde (MDA) and the activity of superoxide dismutase (SOD) were detected. Flow cytometry was carried out to detect the rate of apoptosis. qRT-PCR was used to detect the expression of SNHG7 and miR-181b-5p. Dual luciferase report experiment was used to verify the targeting relationship between SNHG7 and miR-181b-5p. Western blotting was used to detect the expression of Bax and Bcl-2. RESULTS: Compared with the control group, the H/R group showed significantly increased SNHG7 expression in cardiomyocytes, reduced miR-181b-5p expression, higher levels of LDH and MDA, reduced activity of SOD, increased cell apoptosis rate, higher level of Bax protein, and reduced level of Bcl-2 protein (all P< 0.05). Compared with the H/R and H/R + si-NC groups, the H/R + si-SNHG7 group had significantly reduced level of LDH and MDA, increased activity of SOD, reduced apoptosis rate, reduced level of Bax protein, increased level of Bcl-2 protein (all P< 0.05). The dual luciferase report experiment confirmed that SNHG7 could target miR-181b-5p. Interference with the expression of miR-181b-5p could reduce the effect of silencing SNHG7 on H/R-induced cardiomyocyte oxidative stress and apoptosis. CONCLUSION Silencing SNHG7 may inhibit H/R-induced cardiomyocyte oxidative stress and apoptosis by up-regulating the expression of miR-181b-5p, thereby exerting a protective effect on cardiomyocytes.
Animals ; Apoptosis ; Hypoxia ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac ; RNA, Long Noncoding/genetics* ; Rats

Objective To identify the main compositions of urinary calculi found in pediatric patients who had the history of exposing to infant formula milk powder contaminated with melamine and try to find out the urinary calculus formation mechanism in these patients.Methods Sixteen patients were studied.These infant patients with urinary calculi due to consumption of melamine tainted milk powder had been admitted to hospital from June,2008 to August,2008.The components of the urinary calculi were separated by liquid chromatograph,and identified by electrospray ionization mass spectrometry,electron bombard ionization mass spectrometry,Fourier transform infrared spectroscopy,and quantitatively determined by liquid chromatograph.Results The main chemical components of the urinary ealculi were melamine and uric acid.The molar ratio of uric acid tO melamine was 2:1.Conclusion The main urinary calculus formation mechanism in infant patients who exposed to the inrant formula milk powder contaminated with melamine is melamine and uric acid formed indissoluble complex.

Objective:To investigate the surgical techniques and advantages of Ti-Robot-assisted surgery for pelvic fragility fractures in the elderly.Methods:A retrospective review was performed on geriatric patients presenting with pelvic fractures at the Orthopedics Department of Trauma, China-Japan Union Hospital of Jilin University from September 2019 to December 2022. Minimally invasive procedures were executed with the assistance of the Ti-Robot, and the therapeutic outcomes were appraised. The cohort comprised 24 patients aged ≥60 years, consisting of 6 men and 18 women, with a mean age of 66.1±4.9 years (range, 60-77 years). Fourteen patients sustained high-energy trauma, while 10 encountered low-energy trauma. Fracture classification utilized the FFP system proposed by Rommens and Hofmann. The cohort included 20 patients with FFP II fractures (5 males, 15 females; 4 of type IIa, 12 of type IIb, and 4 of type IIc) and 4 patients with FFP III fractures (1 male, 3 females; all type IIIa). The Matta standard assessment scale gauged fracture reduction, while the Gras classification, with Ti-Robot assistance, assessed screw positioning. Postoperative functionality was holistically assessed based on the Majeed quantitative evaluation system, focusing on pain intensity, sitting, standing, walking, and daily activities. The visual analogue scale (VAS) gauged pain levels in patients with type II fractures, pre and 72 hours post-surgery.Results:According to the Matta standard assessment scale, postoperative fracture reduction quality in 24 elderly patients showed 18 as excellent, 4 as good, and 2 as fair, yielding a 92% (22/24) combined excellent and good rate. Based on the Gras classification, 52 screws were rated as excellent and 7 as good, achieving a 100% positive rate. Utilizing Majeed's modified pelvic fracture evaluation system, postoperative functional recuperation revealed 19 patients as excellent and 5 as good. There were no reports of severe internal disease exacerbations, neurological manifestations, infections, or intraoperative extensive hemorrhaging, with all patients remaining stable. Fractures exhibited robust healing during follow-ups, averaging a recovery time of 3.5±0.7 months (range, 3-5 months). The VAS for 20 patients with FFP type II fractures decreased from 6.3±2.0 pre-surgery to 4.1±1.4 post-surgery ( t=6.14, P=0.003), signifying substantial pain mitigation. Conclusion:In the elderly with pelvic fragility fractures, particularly type II, securing with channel screws is viable. The Ti-Robot-assisted minimally invasive approach is advocated due to its potential to diminish surgical risks and expedite postoperative recuperation.

Objective:To propose and verify a surgical classification system for the axial primary malignant and aggressive benign tumor.Methods:The CZH surgical classification system was originally developed for the axial primary malignant and aggressive benign tumor. The CZH surgical classification system includes seven types, according to the anatomic features and the extension of tumor violation. A total of 136 patients (79 males and 57 females) with axial primary malignant and aggressive benign tumor from multiple tertiary centers who received surgery from July 2006 to July 2019 were included. The average age was 44.40±17.55 years (8-83 years) old. There were 99 malignant tumors and 37 aggressive benign tumors included. The number of patients with each classification was presented as followed, Type I 13, Type II 15, Type IIIa 3, Type IIIb 20, Type IVa 43, Type IVb 12, Type Va 21, Type Vb 3, Type VI 2, Type VIIa 3 and Type VIIb 1. Surgical procedures were selected according to different types in classification. The inter- and intra-observer consistencies were evaluated by the Kendall's W test. The VAS, Frankel score, overall survival and recurrence free survival were recorded during the follow-up. Results:The inter- and intra-observer consistent coefficient was 0.973 and 0.996, respectively ( P<0.05). The single posterior approach was adopted for the Type II tumors. Other patients underwent surgery by the combined antero-posterior approach. The majority in anterior approach (113 cases) was the modified submandibular approach. The reconstruction modes included anterior "T" shape titanium mesh (112 cases) or the 3D printed prothesis (7 cases) combined with the posterior occipto-cervical fusion (92 cases) or the pedicle screw system (44 cases). The average surgical duration and the volume of intraoperative bleeding was 348.40±136.14 min (60-760 min) and 1 225.69±859.40 ml (80-4 000 ml), respectively. The operation duration and volume of intraoperative bleeding among each type were with statistical difference. The patients with Type IV, V tumors had longer operation duration than those with Type II tumors. Those with Type V and VII tumors had longer operation duration than those with Type I tumors. The patients with Type V tumors had more intraoperative bleeding than those with Type I-IV tumors. The average preoperative VAS score was 4.15±2.25 and then was reduced significantly to 0.62±0.71 and 0.38±0.59 at one and three months after operation, respectively. The Frankel score was also significantly ameliorated at one and three months postoperatively. There were 22 postoperative complications (16.2%). The complications included cerebral spinal fluid leak (12.5%), dysphagia and/or dysphonia (7.4%), dyspnea (5.1%), wound infection (3.7%), wound hemorrhage (2.2%) and pharyngeal dehiscence (1.5%). The incidence of postoperative complication was 25.9% in Type IV-VII tumors, while 11.8% in Type I-III tumors. Conclusion:CZH surgical classification system was verified with high observer consistency. This classification system could assist surgeons to select proper surgical approaches, resection modes and reconstruction modes, and thus ensure the safety of surgery and reduce the recurrence. The tumors in Type IV, V and VII may be with more challenging for surgeons. The incidence of postoperative complication in Type IV-VII tumors may be higher than that in Type I-III tumors.

Objective To investigate the effects of metformin(Met)on the proliferation of pancreatic cancer cells under different glucose concentration culture conditions,and to find the potential role of miR-139-5p in the process.Methods PANC-1 cells were treated with different concentrations of metformin(0/5/10/20 mmol/L)in 25 mmol/L(high-glucose group,HG)or 5 mmol/L(normal-glucose group,NG)glucose culture,cell proliferation,apoptosis,migration and cell cycle were detected after 48 h.The expression of miR-139-5p was quantitatively detected by RT-qPCR,and the miR-139-5p mimics were transfected into PANC-1 cells to clarify the role of miR-139-5p.Results Metformin inhibited the proliferation,promoted apoptosis,and induced S phase and G2/M phase arrest of PANC-1 cells under in high glucose and normal glucose culture conditions,and its anti-proliferation and pro-apoptosis effects were more significant in the normal glucose groups.The expression of miR-139-5p was up-regu-lated by metformin treatment in normal but not in high glucose culture.Further studies showed that miR-139-5p mimics inhibited of PANC-1 cells proliferation without metformin pre-incubation and enhanced the anti-prolifera-tion effect of 5 mmol/L metformin.The pro-apoptotic effect of 10 mmol/L metformin in normal glucose culture conditions.Conclusions In normal-glucose culture conditions,metformin can inhibit proliferation,induce apop-tosis and cell cycle arrest of PANC-1 cells more significantly than in higher-glucose culture,which may be partly related to the up-regulation of miR-139-5p.

With the development of medical technology and the deepening of medical reform, hospital laboratory test continues to expand. Affected by factors such as technology and cost, the business of outsourcing laboratory test to independent clinical laboratories develops rapidly. However, this cooperation mode has not been carried out for a long time and lacks systematic management experience. Through the analysis of the motivation of hospital delivery, this study expounds the classification, judgment basis and requirements for suppliers of third-party clinical laboratory delivery, as well as the operation practice of laboratory test delivery, so as to provide reference for more standardized and effective testing delivery for hospitals.

【Objective】 To investigate the distribution of sleep and eating behavior problems in children with autism spectrum disorder (ASD), and to analyze their correlations with clinical characteristics, in order to provide basis for fwture mechanism research and clinical intervention. 【Methods】 A total of 211 ASD children aged 2 - 7 were enrolled into this study from outpatient department from January to June 2023, and 91 typically developed children matched with age and sex were enrolled into control group.Autism Behavior Checklist (ABC), Children′s Sleep Habits Questionnaire (CSHQ) and a self-made questionnaire were used to assess children′s autistic behavior, sleep problems and eating behaviors. Chi-square test, t test, non-parametric test and multinomial Logistic regression analysis were performed to analyze the relationship between sleep problems and eating behaviors in children with ASD. 【Results】 The prevalence rates of sleep problems and food selectivity were significantly higher in children with ASD than those in control group (χ²=6.876、17.299, P<0.05).The total score of CSHQ of ASD children (48.55±6.07) was significantly higher than that of control group (45.24±5.33)(t=4.494,P<0.05).ASD children were more likely to report bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnias and sleep disordered breathing than control group (P<0.05).The total score of CSHQ was significantly higher in ASD children with aberrant eating behaviors, and the difference was statistically significant in food selectivity (type selectivity, texture selectivity and pica) (Z=2.803, P<0.05).Multinomial Logistic regression indicated that the occurrence of sleep onset delay was positively affected by body and object use (OR=1.063), and negatively affected without food texture selectivity (OR=0.524) and pica (OR=0.343). 【Conclusions】 ASD children have a higher risk of sleep problems and aberrant eating behaviors than the typically developed children.Moreover,ASD children with aberrant eating behaviors have more severe sleep problems.The influencing factors of sleep onset delay include body and object use, food texture selectivity and pica.