Objective To investigate the radiosensitizating effect of quercetin(QU)loaded manganese dioxide nanoparticles[Mn(QU)]on breast cancer cell line 4T1 and tumour-bearing mice.Methods Mang anese dioxide(MnO2)nanoparticles were synthesized by oleic acid template method.The morphology and chemical composition of MnO2 nanoparticles were characterized by transmission electron microscopy(TEM),scanning electron microscopy(SEM)and X-ray photoelectron spectroscopy.Then QU nanomaterials were encapsulated by using physical adsorption.The composition was characterized by ultraviolet spectrophotometer,and the ability of Mn(QU)nanoparticles reacting with different doses of hydrogen peroxide to produce oxygen at different pH values was detected by dissolved oxygen analyzer.CCK-8 assay was employed to detect the effects of different concentrations of Mn(QU)nanoparticles on the viability of 4T1 cells.Colony formation,γ-H2AX fluorescence staining,ROS fluorescence staining,LIVE/DEAD cell viability assay and flow cytometry were used to evaluate the radiosensitizing and pro-apoptotic effects of Mn(QU)nanoparticles on 4T1 cells.Finally,the effect of Mn(QU)nanoparticles combined with radiotherapy on tumor growth inhibition was evaluated in mouse model of 4T1 cell transplanted tumor.Results MnO2 nanoparticles with particle size of about 120 nm were successfully synthesized and encapsulated with QU.The oxygen generation capacity of the prepared Mn(QU)nanoparticles reacting with hydrogen peroxide was negatively correlated with pH value and positively with hydrogen peroxide concentration.The results of cell experiments showed that Mn(QU)nanoparticles at a concentration of 50 μg/mL had no obvious toxicity to 4T1 cells,but could significantly enhance the X-ray-induced killing effect on 4T1 cells,at a radiotherapy sensitization ratio of 1.61,improve DNA double-strand breaks and ROS production,and induce apoptosis of 4T1 cells.The results of tumor xenograft model experiment indicated that the inhibition of tumor volume was Mn(QU)nanoparticles combined with radiotherapy＞MnO2 nanoparticles combined radiotherapy＞QU combined radiotherapy＞Radiotherapy＞Control.Conclusion Mn(QU)nanoparticles combined with radiotherapy can significantly inhibit the proliferation and show radiosensitization of breast cancer 4T1 cells,and also exert a significant inhibitory effect on the growth of the transplanted tumor.

Objective To investigate the relationship among circulating soluble major histocompatibility complex class Ⅰ-related chain A(sMICA),soluble major histocompatibility complex class Ⅰ-related chain B(sMICB),the activity of systemic lupus erythematosus(SLE)and autoantibodies.Methods A total of 156 SLE patients(SLE group)and 103 healthy volunteers(control group)who underwent physical examination in outpatient physical examination center were selected from the Qianjiang Hospital Affiliated to Chongqing University from January 2020 to January 2023.According to SLE disease activity score(SLEDAI),these SLE patients were divided into mild activity group(n=43),moderate activity group(n=69),and severe activity group(n=44).Serum levels of sMICA and sMICB,and the proportion of autoantibodies and peripheral blood NK cells were detected.Spearman or Pearson method was used to analyze the correlation among sMICA,sMICB,score,autoantibodies and peripheral blood NK cells proportion.Receiver operating characteristics(ROC)curve was used to evaluate the value of sMICA and sMICB in the diagnosis of SLE activity.Results Serum sMICA(173.65±23.92 pg/ml)and sMICB(96.35±15.74 pg/ml)levels in SLE group were higher than those in control group(32.51±6.27 pg/ml,12.03±2.47 pg/ml),while the proportion of CD3-CD56+NK cells(12.02％±2.65％)in peripheral blood was lower than that in control group(18.35％±3.71％),and the differences were statistically significant(t=58.498,53.897,-16.010,all P＜0.05).Serum sMICA and sMICB levels in severe active group were higher than those in moderately active group and mildly active group(t=8.192,12.352;19.652,23.742,all P＜0.05),and the proportion of CD3-CD56+NK cells in peripheral blood was lower than that in moderate and mild active groups(t=8.154,10.658,P＜0.05).The differences in positive rates of anti-dsDNA antibody,anti-nuclear antibody,anti-nucleosome antibody and anti-histone antibody in SLE patients with different disease activities were significant(x2=8.795,7.216,7.539,8.946,all P＜0.05).Serum sMICA and sMICB levels in SLE patients were positively correlated with SLED AI score,anti-dsDNA antibody,anti-nuclear antibody,anti-nucleosome antibody and anti-histone antibody(r=0.206～0.402,all P＜0.05),and negatively correlated with the proportion of CD3-CD56+NK cells in peripheral blood(r=-0.563,-0.427,all P＜0.05).The areas under the curve of SLE in severe active group diagnosed by sMICA and sMICB alone were 0.652 and 0.704,respectively.The area under the curve of SLE in severe active group diagnosed by sMICA and sMICB combined with SLE was 0.812,which was higher than that by the single diagnosis(Z=3.050,2.346,all P＜0.05).Conclusion The increased serum sMICA and sMICB levels in SLE patients were associated with the increased positive rate of SLE autoantibodies,the decreased proportion of NK cells in peripheral blood and the enhanced disease activity,which could be used as potential markers of SLE.

Objective:To explore the formulation of the evaluation system of nuclear emergency medical rescue drills.Methods:By using the analytic hierarchy process, theoretical analysis and expert consultation, the evaluation system was established, and online questionnaires were used to investigate student satisfaction. Excel software was used for data entry, Matlab 6.5 software was used for weight calculation, and questionnaire data were authorized to SPSSAU online platform to analyze the correlation coefficient between trainees' attitude towards drills and satisfaction of the evaluation system.Results:An evaluation system of nuclear emergency medical rescue drills composed of multiple indicators was constructed, and the weights of each indicator of the system were obtained. The corresponding weights for group comprehensive proficiency, topic theoretical oral examination, personal practice and virtual system were 0.108, 0.557, 0.280 and 0.054, respectively. Simultaneously, the evaluation of the system by the trainees was investigated, and it was found that there was a significant correlation between the trainee's attitude towards the drills and satisfaction with the system.Conclusion:The nuclear emergency medical rescue evaluation system formed in this research is expected to provide theoretical methods for comprehensive evaluation of students' knowledge and capabilities, and at the same time it's helpful to improve the nuclear emergency rescue capabilities of students.

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,

In order to improve our military's medical support capabilities, the Army Military Medical University regularly organizes comprehensive military medical drills, of which nuclear emergency medical rescue is an important subject. Therefore, it is urgent to form a standardized teaching process of nuclear emergency medical rescue drills. Firstly, based on the two major tasks of nuclear emergency medical rescue, and "emergency treatment of nuclear wounded in killing area" and "early treatment of nuclear wounded in developing area," a nuclear emergency medical rescue drill teaching process has been formed, including "reconnaissance, detection, classification, decontamination and treatment". Then, it's applied to actual teaching, and the problems in teaching are found by analyzing the changes in the rescue ability of the students before and after learning. Finally, the corresponding improvement measures are put forward to open up new ideas for drill teaching.

Objective:To explore the application effect of problem-based learning (PBL) combined with situational teaching in medical rescue of nuclear emergency teaching.Methods:The 100 students from Batch 2017 of the Army Medical University were selected as the teaching objects, and the nuclear emergency medical lessons were divided into two parts: the control group (the first 20 lessons) and the experimental group (the last 20 lessons). The control group adopted traditional teaching method, the experimental group adopted PBL teaching mode for theoretical teaching, and situational teaching method for skill practices. The teaching effect of the two groups of students were examined by theoretical examination, skill practical assessment and questionnaire survey. SPSS 17.0 was used for chi-square test.Results:Theoretical examination results of experimental group (77.10±8.11) were higher than those of control group (73.97±7.93), with significant differences ( P<0.01). Practical assessment results of experimental group (78.40±6.35) was higher than those of control group (71.04±7.51), with significant differences ( P<0.01). Concerning the results of theoretical examination, practical assessment and student self-evaluation, the experimental group was superior to the control group in all aspects (all P<0.05). Conclusion:Compared with traditional teaching methods, the PBL combined with situational teaching could encourage the learning interest of students, enhance their ability of independent learning, promote them to master the knowledge and skills of medical rescue of nuclear emergency adroitly, cultivate their team spirit and elevate the practical ability of students.

Objective: To explore the clinical application effects of portable visual retractor in superficial temporal fascia flap harvesting. Methods: From January 2010 to June 2019, 27 patients meeting the inclusion criteria and planning to perform operation of superficial temporal fascia flap harvesting were admitted to the Department of Plastic and Reconstructive Surgery of the First Clinical Medical Center of the People′s Liberation Army General Hospital. The patients were divided into traditional surgical method group [6 males and 3 females, aged (34±14) years], cold light source retractor group [6 males and 4 females, aged (35±16) years], and portable visual retractor group [7 males and 1 female, aged (30±14) years] according to way of superficial temporal fascia flap harvesting. The superficial temporal fascia flaps of patients in traditional surgical method group were resected by traditional way of resection, and the superficial temporal fascia flaps of patients in cold light source retractor group and portable visual retractor group were resected at assistance of cold light source retractor and portable visual retractor, respectively. Length of incision, operation time, intraoperative blood loss volume, postoperative drainage volume, and postoperative complication of patients in 3 groups were observed and recorded. Data were processed with Fisher′s exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, and Bonferroni correction. Results: The length of incision of patients in visual retractor group was (3.6±0.8) cm, significantly shorter than (12.6±1.6) cm in traditional surgical method group and (5.8±0.9) cm in cold light source retractor group (P<0.05). The incision length of patients in traditional surgical method group was significantly longer than that in cold light source retractor group (P<0.05). The operation time of patients in visual retractor group was 24.0 (23.3, 25.8) min, significantly shorter than 35.0 (30.5, 36.5) min in traditional surgical method group and 28.5 (26.8, 30.5) min in cold light source retractor group (H=16.5, 9.8, P<0.05). The operation time of patients in traditional surgical method group was significantly longer than that in cold light source retractor group (H=6.6, P<0.05). The intraoperative blood loss volume was (26±3) mL of patients in visual retractor group, significantly less than (34±4) mL in traditional surgical method group and (30±6) mL in cold light source retractor group (P<0.05). The intraoperative blood loss volume of patients in traditional surgical method group was significantly more than that in cold light source retractor group (P<0.05). The postoperative drainage volumes of patients in visual retractor group, cold light source retractor group, and traditional surgical method group were (33±4), (34±6), and (31±7) mL, respectively, and there were no significantly statistical differences in postoperative drainage volumes among patients in the three groups (F=0.3, P>0.05). There were no severe complications such as ischemia and necrosis of superficial temporal fascia flaps in patients of the three groups. One patient in cold light source retractor group had subcutaneous hematoma after operation, which was improved by removing stitches and hematoma. Conclusions Superficial temporal fascia flap harvesting at the assistance of portable visual retractor has the advantages of clear visual field, simple operation, short operation time, small incision, and less intraoperative blood loss.

Objective:To explore the methods of repairing large soft tissue defect with latissimus dorsi myocutaneous flap and the management of secondary wound in donor site.Methods:From June 2015 to June 2019, 30 patients with soft tissue defect caused by various reasons or hyperplastic scar were hospitalized in the First Medical Center of Chinese PLA General Hospital, including 10 males and 20 females, aged 25-64 years, with 18 cases of head soft tissue defects caused by the growth and rupture of tumor, 7 cases of hypertrophic scar in trunk and limbs, and 5 cases of facial and neck soft tissue defects caused by trauma. The area of primary wound after debridement or enlarged lesion resection was 14 cm×10 cm-18 cm×16 cm. Preoperative evaluation of 20 patients showed that the wound was relatively large, and the donor site could not be directly closed by suturing after resection of conventional single-lobe latissimus dorsi myocutaneous flap, so the bilobed latissimus dorsi myocutaneous flap with area of 14 cm×5 cm-18 cm×8 cm was cut to repair the wound, and the donor site was directly closed by suturing. Preoperative evaluation of 10 patients showed that the donor site could be directly closed by suturing after resection of conventional single-lobe latissimus dorsi myocutaneous flap, so that conventional single-lobe latissimus dorsi myocutaneous flap with area of 11 cm×9 cm-13 cm×10 cm was resected to repair the primary wound, resulting in big tension in donor site and secondary wound with area of 6 cm×4 cm-8 cm×6 cm that couldn′t be directly sutured, which was repaired with donor site local flap with area of 7 cm×4 cm-9 cm×6 cm, and the second donor site was directly closed by suturing. Intraoperative end-to-end anastomosis was performed between the thoracodorsal arteries and veins of the latissimus dorsi myocutaneous flap and the arteries and veins of the primary recipient wound. The survival of latissimus dorsi myocutaneous flaps and local flaps were observed after surgery, and the appearance and function of the donor and recipient areas were observed during follow-up.Results:All the latissimus dorsi myocutaneous flaps and local flaps survived in the patients after surgery. Follow-up of 6-12 months showed that the latissimus dorsi myocutaneous flap was similar in color to the surrounding normal skin, with soft texture and good elasticity. The donor site of 20 patients repaired with bilobed latissimus dorsi myocutaneous flaps were only left with linear scars, among which 2 patients had hypertrophic scars and none had functional impairment. The donor site of 10 patients repaired with single-lobe latissimus dorsi myocutaneous flaps and donor site local flaps had good appearance, left with linear scar, irregular shape, but no local traction or dysfunction.Conclusions:When repairing a large soft tissue defect, the bilobed latissimus dorsi myocutaneous flap or the single-lobe latissimus dorsi myocutaneous flap combined with the local flap transfer in the donor site can be used after preoperative evaluation so that the donor site wound can be closed at one time while repairing the primary wound. The donor site has less scar, and both the recipient and donor sites have good appearance and function after surgery.

Objective: To explore the feasibility of problem-based learning (PBL) teaching method in teaching nuclear protection medicine under E-learning environment. Methods: A total of 120 students from Class 1 (experimental group) and 141 students from Class 3 (control group) of 5-year clinical medicine in Grade 2014 were included. The control group adopted the traditional teaching method, that is, theoretical knowledge was taught by teachers in theory class and practice was made by students after teachers introducing methods and precautions, and making demonstrations in experimental class. The experimental group adopted PBL teaching method based on E-learning and the simulation software of nuclear accident medical emergency rescue. Results: Average theoretical scores in the experimental group (79.61±7.71) were higher than those in the control group (73.66±7.89), with statistically significant difference (P<0.05). According to the results, 74.2% (89/120) students in the experimental group had a relative good experience of PBL under E-learning environment; 72.5% (87/120) had better comprehension of nuclear protection medicine; 82.5% (99/120) students considered that the simulation software of nuclear accident medical emergency rescue was able to help them get familiar with and comprehend the operation procedures; 80.0% (96/120) students believed that it was able to stimulate interests for study and exploration; 77.5% (90/120) students considered that it was able to promote study initiatives; 84.2% (101/120) students believed that it was able to deepen understandings to nuclear protection medicine. Conclusion Application of PBL teaching methods in the teaching of nuclear protection medicine under E-learning environment can better enable students to comprehend what they have learned, achieving better teaching effectiveness.

PURPOSE: The transforming growth factor β1 (TGF-β1)/SMAD family member 3 (SMAD3) pathway, and hypoxia-inducible factor 1α (HIF-1α) are two key players in various types of malignancies including breast cancer. The TGF-β1/SMAD3 pathway can interact with HIF-1α in some diseases; however, their interaction in breast cancer is still unknown. Therefore, our study aimed to investigate the interactions between the TGF-β1/SMAD3 pathway and HIF-1α in breast cancer. METHODS: Expression of HIF-1α in serum of breast cancer patients and healthy controls was detected by quantitative reverse transcription polymerase chain reaction, and the diagnostic value of HIF-1α for breast cancer was evaluated by receiver operating characteristic curve analysis. Breast cancer cell lines overexpressing SMAD3 and HIF-1α were established. Cell apoptosis and proliferation following different treatments were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, and cell counting kit-8, respectively. Expression of related proteins was detected by western blot. RESULTS: Serum levels of HIF-1α were higher in breast cancer patients than in normal controls. Both SMAD3 and HIF-1α overexpression inhibited cell apoptosis and promoted cell proliferation. Treatment with inhibitors of HIF-1α and SMAD3 promoted apoptosis in breast cancer cells and inhibited their proliferation. Overexpression of HIF-1α promoted the expression of TGF-β1 and SMAD3, while SMAD3 overexpression did not significantly affect expression of HIF-1α or TGF-β1. CONCLUSION: HIF-1α serves as an upstream regulator of the TGF-β1/SMAD3 pathway and promotes the growth of breast cancer.
Apoptosis ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Count ; Cell Line ; Cell Proliferation ; Humans ; Hypoxia-Inducible Factor 1 ; Polymerase Chain Reaction ; Reverse Transcription ; ROC Curve ; Smad3 Protein ; Transforming Growth Factor beta1 ; Transforming Growth Factors*