As a novel form of cell death, ferroptosis is mainly regulated by the accumulation of soluble iron ions in the cytoplasm and the production of lipid peroxides and is closely associated with several diseases, including acute kidney injury, ischemic reperfusion injury, neurodegenerative diseases, and cancer. The term "immunosuppression" refers to various factors that can directly harm immune cells' structure and function and affect the synthesis, release, and biological activity of immune molecules, leading to the insufficient response of the immune system to antigen production, failure to successfully resist the invasion of foreign pathogens, and even organ damage and metabolic disorders. An immunosuppressive phase commonly occurs in the progression of many ferroptosis-related diseases, and ferroptosis can directly inhibit immune cell function. However, the relationship between ferroptosis and immunosuppression has not yet been published due to their complicated interactions in various diseases. Therefore, this review deeply discusses the contribution of ferroptosis to immunosuppression in specific cases. In addition to offering new therapeutic targets for ferroptosis-related diseases, the findings will help clarify the issues on how ferroptosis contributes to immunosuppression.
Ferroptosis/immunology* ; Humans ; Immune Tolerance/immunology* ; Animals ; Immunosuppression Therapy ; Iron/metabolism* ; Neoplasms/immunology*

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

Objective To compare the safety and efficacy of the da Vinci robot and thoracoscopic subxiphoid approach for the treatment of anterior mediastinal tumors. Methods The clinical data of patients who underwent anterior mediastinal tumor resection through the subxiphoid approach admitted to the same medical group in the Department of Thoracic Surgery of the First Hospital of Lanzhou University between June 2020 and April 2022 were retrospectively analyzed. According to the surgery approach, the patients were divided into a robot-assisted thoracoscopic surgery (RATS) group and a video-assisted thoracoscopic surgery (VATS) group. The perioperative data and the incidence of postoperative complications were compared between the two groups. Results A total of 79 patients were enrolled. There were 41 patients in the RATS group, including 13 males and 28 females, with an average age of 45.61±14.99 years. There were 38 patients in the VATS group, including 14 males and 24 females, with an average age of 47.84±15.05 years. All patients completed the surgery successfully. Hospitalization cost and operative time were higher or longer in the RATS group than those in the VATS group, and the difference was statistically significant (P<0.05). Intraoperative bleeding, postoperative hospital stay, postoperative water and food intake time, postoperative off-bed activity time, white blood cell count, neutrophil percentage and visual analogue scale (VAS) score on the first postoperative day, white blood cell count and neutrophil percentage on the third postoperative day, duration of analgesic pump use, the number of voluntary compressions of the analgesic pump, and mediastinal drainage volume were all superior to those in the VATS group (P<0.05). The differences in VAS scores on the third postoperative day, duration of drainage tube retention and postoperative complication rates were not statistically different between the two groups (P>0.05). Conclusion RATS subxiphoid anterior mediastinum tumor resection is a safe and feasible surgical method with less injury and higher safety, which is conducive to rapid postoperative recovery and has wide clinical application prospects.

Objective To analyze the long-term outcome of modified Morrow surgery (interventricular septal cardiomyectomy) in the treatment of hypertrophic obstructive cardiomyopathy (HOCM) in children. Methods The clinical data of the children with HOCM (aged≤14 years) who underwent modified Morrow surgery from January 2010 to August 2022 in Guangdong Provincial People's Hospital were retrospectively analyzed, including changes in hospitalization status, perioperative period, and long-term 15-lead electrocardiogram and echocardiography. Results A total of 29 patients were collected, including 22 males and 7 females, aged 10.00 (5.00, 12.00) years. Five (17.9%) patients had New York Heart Association (NYHA) heart function grade Ⅲ or Ⅳ. Ventricular septal cardiomyectomy was performed in all patients. All 29 patients survived and their cardiac function recovered after operation. Before discharge, right bundle branch block was observed in 2 patients and left bundle branch block in 6 patients. After surgery, in the left ventricular septal cardiomyectomy, the left atrial diameter decreased (P＜0.001), left ventricular end-systolic diameter increased (P=0.009), the peak pressure gradient of left ventricular outflow tract decreased (P＜0.001), and the thickness of ventricular septum decreased (P＜0.001). The systolic anterior motion of mitral valve disappeared and mitral regurgitent jet area decreased (P＜0.001). The flow velocity and peak pressure gradient of right ventricular outflow tract also decreased in the patients who underwent right ventricular septal cardiomyectomy. The average follow-up of the patients was 69.03±10.60 months. All the patients survived with their NYHA cardiac function grading Ⅰ or Ⅱ. No new-onset arrythmia event was found. Echocardiography indicated that the peak pressure gradient of the left ventricular outflow tract remained low (P<0.001). Moderate mitral regurgitation occurred in 2 patients, and left ventricular outflow tract obstruction with moderate mitral regurgitation occurred in 1 patient after simple right ventricular septal cardiomyectomy. Conclusion Right ventricular or biventricular obstruction is frequent in the children with HOCM and they usually have more symptoms before surgery. Modified Morrow surgery can effectively relieve outflow tract obstruction and improve their cardiac function. The long-term outcome is satisfactory. However, the posterior wall of the left ventricle remains hypertrophic. Also, there is an increased risk of a conduction block.

Objectives:To investigate the clinical feasibility of three-dimensional(3D)high-resolution late gadolinium enhancement(LGE)MRI in accessing left atrial myocardial fibrosis in patients with atrial fibrillation(AF). Methods:A total of 34 AF patients referred for hybrid surgical ablation were retrospectively enrolled in this study.3D-LGE-MRI images were acquired by Siemens 3.0 T machine and analyzed by ADAS post-processing software by two experienced radiologists to obtain parameters such as the area and the area percentage of LGE.Regional analysis was performed by one of the two radiologists at ten left atrial segments.The Kappa test was used to assess the agreement for scoring image quality,and the interclass correlation coefficient(ICC)was used to evaluate the interobserver agreement of LGE parameters.The parameters of left atrial morphology,area(and area percentage)of LGE,and location of LGE were compared between patients with persistent AF and paroxysmal AF. Results:Images of all 34 patients were considered to have diagnostic value.The scores of the overall image quality and the clarity of the left atrial wall evaluated by two radiologists were(2.88±0.64)points and(3.26±0.75)points(radiologist 1),(2.97±0.58)points and(3.24±0.70)points(radiologist 2),respectively.The corresponding Kappa values were 0.724 and 0.859.Both the area and the area percentage of LGE showed good consistency among observers,and the ICCs were 0.969 and 0.950,respectively.The difference in the area of LGE and the area percentage of LGE between patients with paroxysmal and persistent atrial fibrillation was similar(both P＞0.05).Compared with patients with paroxysmal AF,patients with persistent AF had a higher Utah stage and more severe myocardial fibrosis in the right inferior pulmonary vein antrum and the left atrial septum(all P＜0.05). Conclusions:3D high-resolution LGE-MRI provides a non-invasive way to visualize and quantify left atrial myocardial fibrosis.The extent of left atrial fibrosis in patients with persistent AF is more severe than that in patients with paroxysmal AF,with a preferential distribution in the right inferior pulmonary vein antrum and the left atrial septum.

ObjectiveTo investigate the effects of licoflavone A on the proliferation and glycolysis of gastric cancer cells in the hypoxic environment. MethodHuman gastric cancer AGS cells were classified into five groups： Normoxia， hypoxia， and low-， medium-， and high-dose （25， 50， 100 μmol·L^-1， respectively） licoflavone A. The cells in other groups except the normoxia group were cultured in the environment with 5% O₂ for 48 h. The cell counting kit-8 （CCK-8） and colony formation assay were employed to examine the proliferation of AGS cells. Cell migration was detected by the scratch assay. The protein and mRNA levels of hypoxia-inducible factor 1-alpha （HIF-1α）， glucose transporter 1 （GLUT1）， lactate dehydrogenase A （LDHA）， pyruvate kinase M2 （PKM2）， and hexokinase Ⅱ （HK2） in AGS cells were measured by Western blotting and real-time quantitative polymerase chain reaction （Real-time PCR）， respectively. The corresponding kits were used to determine glucose uptake and HK activity. ResultThe CCK-8 results showed that compared with the hypoxia group， the high- and medium-dose licoflavone A groups showed decreased proliferation rate of AGS cells at the time point of 24 h （P<0.01） and all the licoflavone A groups demonstrated decreased proliferation rate at the time point of 48 h （P<0.01）. Compared with the normoxia group， the hypoxia group showed increased number of clone formation of AGS cells （P<0.01）， which was decreased after the treatment with licoflavone A at high， medium， and low doses （P<0.01）. Compared with the normoxia group， the hypoxia group showed increased migration of AGS cells （P<0.01）， which was attenuated by the high， medium， and low doses of licoflavone A （P<0.01）. Compared with the normoxia group， the hypoxia group showed up-regulated mRNA levels of GLUT1， LDHA， PKM2， and HK2 （P<0.05， P<0.01）. Compared with those in the hypoxia group， the mRNA levels of GLUT1， LDHA， PKM2， and HK2 in the high-dose licoflavone A group， GLUT1， LDHA， and HK2 in the medium-dose licoflavone A group， and HK2 in the low-dose licoflavone A group were down-regulated （P<0.05， P<0.01）. The protein levels of HIF-1α， GLUT1， LDHA， PKM2， and HK2 in the hypoxia group were higher than those in the normoxia group （P<0.05， P<0.01）. Compared with those in the hypoxia group， the protein levels of HIF-1α， GLUT1， LDHA， PKM2， and HK2 in the high-dose licoflavone A group and HK2 in the medium- and low-dose licoflavone A groups were down-regulated （P<0.05， P<0.01）. The glucose uptake and HK activity were elevated in the hypoxia group compared with those in the normoxia group （P<0.01）. Compared with the hypoxia group， high-dose licoflavone A decreased the glucose uptake and HK activity， and medium-dose licoflavone A decreased the HK activity （P<0.01）. ConclusionLicoflavone A inhibits the proliferation of AGS cells under hypoxic conditions by regulating glycolysis in gastric cancer.

Objective To explore the clinical value of preoperative Glasgow-Blatchford score(GBS)and AIMS65 score in predicting the prognosis of patients with non-variceal upper gastrointestinal bleeding after receiving interventional treatment.Methods The clinical data of 59 patients with non-variceal upper gastrointestinal bleeding,who received transcatheter arterial embolization(TAE)at the Department of Interventional Vascular Surgery,Shanghai Tenth People's Hospital of China between 2018 and 2021,were collected.The clinical value of GBS and AIMS65 score in predicting patient's outcome was analyzed.Results With the preoperative GBS and AIMS65 scores increasing,the mortality also increased.Compared with AIMS65 score(AUC=0.630,0.95％CI:0.494-0.752),GBS(AUC=0.823,95％CI:0.702-0.910)had a higher predictive value for postoperative in-hospital death in patients with non-variceal upper gastrointestinal bleeding after receiving interventional treatment.With a GBS cutoff＞9 points,the Youden index for predicting in-hospital death was 0.54.Conclusion In predicting the postoperative in-hospital death for patients with non-variceal upper gastrointestinal bleeding after receiving TAE,the clinical value of the preoperative GBS score is higher than that of AIMS65 score.

Objective:To retrospectively analyze the dual plasma molecular adsorption system (DPMAS) treatment technology and the laboratory data before and after treatment in patients with liver failure and refractory hyperbilirubinemia, so as to provide a clinical basis for the prediction and prevention of common related complications.Method:A retrospective study was conducted on 161 cases with liver failure and 68 cases with refractory hyperbilirubinemia who underwent DPMAS treatment in our department from October 2022 to July 2024. The general clinical data characteristics, DPMAS treatment status, DPMAS-related complications, and changes in important laboratory indicators before and after the initial DPMAS treatment in both patient groups were analyzed.Results:Among the 229 enrolled cases, 82.53% were male, and the median age was 50 years. The cause of liver failure was hepatitis B virus infection in 84.47%, while hepatitis B accounted for only 51.47% in the other group. There were significant differences in platelets, creatinine, coagulation function, and inflammatory factor-related indicators between the two groups at baseline. The total number of DPMAS treatments given was 471 times. The proportion of albumin used in the initial stage of treatment was significantly higher in patients with refractory hyperbilirubinemia than that in the liver failure group, while the proportion of plasma used in the liver failure group was significantly higher ( P<0.001). The most commonly used anticoagulation regimen was unfractionated heparin. A combined anticoagulation therapy regimen was used in 9.3% of the refractory hyperbilirubinemia group. The internal jugular vein was selected in nearly half of the treated cases. A peripheral vascular access pathway was the treatment option in 31.2%. The proportion of centrifugal separation was significantly higher than that of membrane separation (76.22% vs. 23.78%). The incidence rate of DPMAS-related complications was 16%. The most common complication was bleeding, including bleeding at the puncture site (accounting for 32% of the total complications) and bleeding at non-puncture sites (12%), followed by hypotension (22%), allergic reactions (13%) and infections (11%), respectively. The indexes of hemoglobin, platelets, total bilirubin, and C-reactive protein were significantly decreased within 24-48 hours after DPMAS treatment in both groups of patients. The prothrombin time and international normalized ratio were significantly increased in the liver failure group, while fibrinogen was significantly reduced. Conclusion:DPMAS clinical application is generally safe in patients with liver disease. The most common complications are bleeding, hypotension, allergic reactions, and infections, which need to be paid special attention and timely intervention to ensure the safety profile of treatment.

Objective:To retrospectively analyze the dual plasma molecular adsorption system (DPMAS) treatment technology and the laboratory data before and after treatment in patients with liver failure and refractory hyperbilirubinemia, so as to provide a clinical basis for the prediction and prevention of common related complications.Method:A retrospective study was conducted on 161 cases with liver failure and 68 cases with refractory hyperbilirubinemia who underwent DPMAS treatment in our department from October 2022 to July 2024. The general clinical data characteristics, DPMAS treatment status, DPMAS-related complications, and changes in important laboratory indicators before and after the initial DPMAS treatment in both patient groups were analyzed.Results:Among the 229 enrolled cases, 82.53% were male, and the median age was 50 years. The cause of liver failure was hepatitis B virus infection in 84.47%, while hepatitis B accounted for only 51.47% in the other group. There were significant differences in platelets, creatinine, coagulation function, and inflammatory factor-related indicators between the two groups at baseline. The total number of DPMAS treatments given was 471 times. The proportion of albumin used in the initial stage of treatment was significantly higher in patients with refractory hyperbilirubinemia than that in the liver failure group, while the proportion of plasma used in the liver failure group was significantly higher ( P<0.001). The most commonly used anticoagulation regimen was unfractionated heparin. A combined anticoagulation therapy regimen was used in 9.3% of the refractory hyperbilirubinemia group. The internal jugular vein was selected in nearly half of the treated cases. A peripheral vascular access pathway was the treatment option in 31.2%. The proportion of centrifugal separation was significantly higher than that of membrane separation (76.22% vs. 23.78%). The incidence rate of DPMAS-related complications was 16%. The most common complication was bleeding, including bleeding at the puncture site (accounting for 32% of the total complications) and bleeding at non-puncture sites (12%), followed by hypotension (22%), allergic reactions (13%) and infections (11%), respectively. The indexes of hemoglobin, platelets, total bilirubin, and C-reactive protein were significantly decreased within 24-48 hours after DPMAS treatment in both groups of patients. The prothrombin time and international normalized ratio were significantly increased in the liver failure group, while fibrinogen was significantly reduced. Conclusion:DPMAS clinical application is generally safe in patients with liver disease. The most common complications are bleeding, hypotension, allergic reactions, and infections, which need to be paid special attention and timely intervention to ensure the safety profile of treatment.