Objective To analyze the relationship between the expression of ferroptosis markers in the tumor microenvironment(TME)and the prognosis of transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods This prospective observational study included 100 HCC patients who received TACE treatment at Langfang Hospital of Traditional Chinese Medicine from March 2019 to June 2021 as the study subjects.The levels of 8-isoprostaglandin F2α(8-iso-PGF2α),4-hydroxy-2-nonenal(4-HNE),8-hydroxy-2'deoxyguanosine(8-OH-dG)and hepcidin in plasma were evaluated by ELISA kit at baseline(1 day before TACE),1 day after TACE and 4～8 weeks.The changes of ferroptosis related markers during TACE treatment were compared.The difference between the level of 8-iso-PGF2α,4-HNE and the baseline 1 day after TACE treatment was recorded as △8-iso-PGF2α,△4-HNE.Results Compared with the baseline,the levels of 8-iso-PGF2α and 4-HNE increased significantly and the level of hepcidin decreased significantly one day after TACE treatment,and the differences were statistically significant(t=8.03,16.29,2.92,all P<0.05).Compared with 1 day after treatment,the levels of 8-iso-PGF2α,4-HNE decreased and the level of 8-OH-dG increased at 4～8 weeks after TACE treatment,and the differences were statistically significant(t=9.12,17.17,2.63,all P<0.05).Multivariate COX analysis showed that △8-iso-PGF2α,△4-HNE and 8-iso-PGF2α 1 day after TACE treatment were independent factors affecting the overall survival after TACE(Wald χ2=5.205,13.801,6.054,all P<0.05).The survival time of patients with △4-HNE>2.01 μg/ml was significantly longer than that of patients with △4-HNE≤2.01 μg/ml(Log-rank=5.718,P=0.017),and that of patients with△8-iso-PGF2α>1.75ng/ml was sig-nificantly longer than that of patients with△8-iso-PGF2≤1.75ng/ml(Log-rank=4.163,P=0.041).Conclusion The prognosis of HCC patients who are in a state of high ferroptosis(4-HNE and 8-iso-PGF2 increased)at 1 day after TACE treatment is better,which indicate that ferroptosis mediated HCC death induced by TACE treatment.

Objective Radial artery occlusion(RAO)is one of the common complications following coronary intervention via the traditional radial artery approach.This study aims to evaluate the clinical effectiveness of retrograde recanalization of occluded radial arteries through the distal transradial approach(dTRA)approach.Methods A total of 35 patients with RAO admitted to the cardiovascular department of the Anhui Chest hospital between December 2022 and April 2024,who were scheduled to undergo coronary intervention and had attempted recanalization of RAO via dTRA approach were selected.The primary result was the success rate of recanalizing RAO via dTRA.The secondary results included factors influencing the failure of recanalization via dTRA,postoperative puncture complications,and the patency rate at the 3-month follow-up.Results This study divided the patients into a successful group(29 cases,82.9％)and a failed group(6 cases,17.1％)based on whether the distal radial artery was successfully opened and occluded.The proportion of smoking(100.00％vs.17.24％,P=0.040),history of diabetes(100.00％vs.10.34％,P=0.025),and chronic total occlusion of coronary artery(83.33％vs.17.24％,P=0.030)in the failure group were higher than those in the success group,and the difference was statistically significant.The application rate of balloon tracking assisted technology in the failed group(16.67％vs.58.62％,P=0.045),and the diameter of the radial artery at 3 days after surgery[(1.63±0.13)mm vs.(2.13±0.32)mm,P=0.021]and the peak radial artery blood flow velocity at 3 days postoperatively[(0.10±0.78)m/s vs.(0.50±0.13)m/s,P＜0.001]were all lower in the successful group,and the differences were statistically significant.Logistic regression analysis 3 days after surgery showed that chronic complete occlusion of the coronary artery was an independent risk factor for surgical opening failure(OR 0.042,95％CI 0.004-0.438,P=0.008).After 3 months of follow-up,the patency rate of the successful group was 55.2％.Conclusions Retrograde recanalization of RAO via dTRA is safe and feasible,but its long-term patency rate is not high.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

Objective:To estimate the radiation dose to caregivers and the public from 177Lu- peptide receptor radionuclide therapy (PRRT) for pediatric neuroblastoma patients and determine the duration of contact restrictions, in order to provide a reference for relevant radiation protection measures. Methods:A retrospective study was conducted by collecting data from 18 pediatric neuroblastoma patients, aged between 3 and 13 (6.72±2.72), who received 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) treatment at the Nuclear Medicine Department of Shandong Cancer Hospital from June 2023 to July 2023. Absorbed dose rate in air at 0, 0.1, 0.5, 1 and 2 m from the patients was measured using a radiation-survey at 1, 4, 24, 48 and 96 h after administration. The whole-body region of interest was delined using HERMES software. Subsequently, curve regression fitting was performed using a biexponential function model. By incorporating hypothesized social contact durations, the effective doses received by family members and the public in contact with patients were estimated. Additionally, MIM software was used to outline the whole-body VOI to obtain the total volume of lesions, and the Pearson or Spearman correlation coefficient was employed to analyze the relationship between the absorbed dose rate in air and clinical indicators as well as the total volume of lesions. Results:The 177Lu-DOTATATE administration dose was (4 353.42±1 451.51) MBq. All patients were discharged from hospital 24 h after 177Lu-DOTATATE administration. At the time of discharge, patients had excreted (76.70±3.99)% of the administered activity, and the absorbed dose rate in air at 0.1, 1 and 2 m from the patients were (32.74±6.98), 3.68(3.01, 4.70) and (1.22±0.51) μSv/h, respectively. After being discharged, the radiation doses to caregivers from children aged 2-5 years and 5-13 years were (2.47±1.80) mSv and (0.88±0.47) mSv, respectively. The contact restriction duration was 2 d for nighttime sleeping with family members and 1 d for contact with other children. On the day of discharge, patients should limit their time on public transportation within 4 h and do not need to restrict private transportation. Conclusions:To ensure the effective dose kept within the safety limits stipulated by current regulations, it is necessary to implement contact restrictions for patients’ family members and the public. After implementing preventive measures, 177Lu-DOTATATE treatment is a safe radionuclide therapeutic option.

Objective:To evaluate the safety and efficacy of the TiRobot assisted screw placement in patients with lumbar degenerative diseases.Methods:The clinical data of 165 patients with lumbar degenerative diseases from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyze, and all patients were treated with posterior lumbar decompression and instrumentation. Among them, 46 patients were used the TiRobot assisted screw placement during surgery (robotic-assisted group), and 119 patients underwent freehand screw placement by C-arm X-ray machine fluoroscopy (freehand group). The operation time, intraoperative blood loss, complication and skelalgia visual analogue scale (VAS), Oswestry disability index (ODI) before and after operation were recorded. The accuracy of screw placement and rate of proximal facet joint violation were compared between two groups.Results:There were no statistical difference in operation time, intraoperative blood loss and incidence of complication between two groups ( P>0.05). In the two groups, the 3 d VAS and ODI after operation were significantly lower than those before operation, robot-assisted group: (3.33 ± 1.40) scores vs. (6.54 ± 2.00) scores and (16.96 ± 8.03) scores vs. (43.09 ± 5.48) scores; freehand group: (3.56 ± 1.29) scores vs. (6.55 ± 1.65) scores and (18.89 ± 6.74) scores vs. (44.91 ± 4.96) scores, and there were statistical differences ( P<0.01); there were no statistical difference in VAS and ODI before operation and 3 d after operation between two groups ( P>0.05). A total of 234 screws were implanted in robot-assisted group, and 590 screws were implanted in freehand group. The accuracy of screw placement in robot-assisted group was significantly higher than that in freehand group: 80.77% (189/234) vs. 74.58% (440/590), the rate of proximal facet joint violation was significantly lower than that in freehand group: 2.56% (6/234) vs. 7.29% (43/590), and there were statistical differences ( χ2 = 3.56 and 6.68, P<0.05). Conclusions:The TiRobot assisted screw placement for lumbar degenerative diseases is safe and effective. Compared to freehand technique, the TiRobot assisted method demonstrates higher screw placement accuracy and a lower rate of proximal facet joint violation.

BACKGROUND:Recent studies have shown that β-sitosterol has a good inhibitory effect on hypertrophic scar fibroblasts.However,its clinical application is limited by its poor water solubility and unstable physicochemical properties.OBJECTIVE:To prepare β-sitosterol-laden nanoparticles with sustained drug release function and to analyze the therapeutic effect of the drug-laden nanoparticles on hypertrophic scars in rats.METHODS:Mesoporous silica nanoparticles and mesoporous silica@β-sitosterol nanoparticles were prepared,and the physicochemical properties of the two nanoparticles were characterized.A self-made traction device was used to continuously apply traction force to the wound surface of the tail of 48 SD rats(deep to the periosteum)to establish a tail hypertrophic scar model.On day 21 of continuous traction,the 36 rats with successful modeling were randomly divided into 4 groups for intervention using a random number table method,with 9 rats in each group:the control group was injected with normal saline into the scar tissue,and the mesoporous silica group,β-sitosterol group,and mesoporous silica@β-sitosterol group were injected with mesoporous silica nanoparticle solution,β-sitosterol suspension,and mesoporous silica@β-sitosterol nanoparticle solution into the scar tissue,respectively,once a week for 6 consecutive weeks.Scar area and clinical scar score were recorded before injection and 14 and 42 days after injection.One week after the last injection,hematoxylin-eosin staining and Masson staining were used to evaluate dermal thickness and collagen fiber deposition and arrangement.Immunohistochemical staining was used to evaluate the expression of type Ⅰ collagen and α-smooth muscle actin in scars.Western blot assay was used to detect the protein expression of autophagy marker LC3-Ⅱ and apoptosis marker cleaved caspase-3 in scars.RESULTS AND CONCLUSION:(1)Under transmission electron microscopy,both nanoparticles were hollow spheres,and the mesoporous structure of mesoporous silica@β-sitosterol nanoparticles was fuzzy and the average particle size was slightly larger.Infrared spectroscopy showed that β-sitosterol was successfully encapsulated in mesoporous silica nanoparticles.The drug encapsulation rate and drug loading rate of mesoporous silica@β-sitosterol nanoparticles were 88.34％and 39.77％,respectively.The solubility of mesoporous silica@β-sitosterol nanoparticles was stronger than that of free β-sitosterol,and β-sitosterol could be slowly released in vitro for more than 6 days.(2)The results of animal experiments showed that the scar area of the mesoporous silica@β-sitosterol group was smaller than that of the other three groups 42 days after injection(P＜0.05).The clinical scar scores at 14 and 42 days after injection were lower than those of the control group and the mesoporous silica group(P＜0.05).The results of hematoxylin-eosin staining and Masson staining showed that the scar dermis thickness of the mesoporous silica@β-sitosterol group was reduced compared with the control group,the mesoporous silica group,and the β-sitosterol group(P＜0.05),and the collagen arrangement was relatively neat and regular in direction.The results of immunohistochemical staining showed that the expression of type Ⅰ collagen and α-smooth muscle actin in the mesoporous silica@β-sitosterol group was lower than that of the other three groups(P＜0.05).The results of western blot assay showed that the expression of LC3-Ⅱ protein in the mesoporous silica@β-sitosterol group was lower than that of the other three groups(P＜0.05),and the expression of cleaved Caspase-3 protein was higher than that of the other three groups(P＜0.05).(3)The results showed that mesoporous silica@β-sitosterol nanoparticles effectively improved the water solubility and water dispersibility of β-sitosterol,and had excellent drug controlled release properties.They could inhibit the autophagy of fibroblasts in the lesions and induce their apoptosis,thereby inhibiting collagen deposition,promoting the fading and remodeling of hypertrophic scars.

BACKGROUND:Recent studies have shown that β-sitosterol has a good inhibitory effect on hypertrophic scar fibroblasts.However,its clinical application is limited by its poor water solubility and unstable physicochemical properties.OBJECTIVE:To prepare β-sitosterol-laden nanoparticles with sustained drug release function and to analyze the therapeutic effect of the drug-laden nanoparticles on hypertrophic scars in rats.METHODS:Mesoporous silica nanoparticles and mesoporous silica@β-sitosterol nanoparticles were prepared,and the physicochemical properties of the two nanoparticles were characterized.A self-made traction device was used to continuously apply traction force to the wound surface of the tail of 48 SD rats(deep to the periosteum)to establish a tail hypertrophic scar model.On day 21 of continuous traction,the 36 rats with successful modeling were randomly divided into 4 groups for intervention using a random number table method,with 9 rats in each group:the control group was injected with normal saline into the scar tissue,and the mesoporous silica group,β-sitosterol group,and mesoporous silica@β-sitosterol group were injected with mesoporous silica nanoparticle solution,β-sitosterol suspension,and mesoporous silica@β-sitosterol nanoparticle solution into the scar tissue,respectively,once a week for 6 consecutive weeks.Scar area and clinical scar score were recorded before injection and 14 and 42 days after injection.One week after the last injection,hematoxylin-eosin staining and Masson staining were used to evaluate dermal thickness and collagen fiber deposition and arrangement.Immunohistochemical staining was used to evaluate the expression of type Ⅰ collagen and α-smooth muscle actin in scars.Western blot assay was used to detect the protein expression of autophagy marker LC3-Ⅱ and apoptosis marker cleaved caspase-3 in scars.RESULTS AND CONCLUSION:(1)Under transmission electron microscopy,both nanoparticles were hollow spheres,and the mesoporous structure of mesoporous silica@β-sitosterol nanoparticles was fuzzy and the average particle size was slightly larger.Infrared spectroscopy showed that β-sitosterol was successfully encapsulated in mesoporous silica nanoparticles.The drug encapsulation rate and drug loading rate of mesoporous silica@β-sitosterol nanoparticles were 88.34％and 39.77％,respectively.The solubility of mesoporous silica@β-sitosterol nanoparticles was stronger than that of free β-sitosterol,and β-sitosterol could be slowly released in vitro for more than 6 days.(2)The results of animal experiments showed that the scar area of the mesoporous silica@β-sitosterol group was smaller than that of the other three groups 42 days after injection(P＜0.05).The clinical scar scores at 14 and 42 days after injection were lower than those of the control group and the mesoporous silica group(P＜0.05).The results of hematoxylin-eosin staining and Masson staining showed that the scar dermis thickness of the mesoporous silica@β-sitosterol group was reduced compared with the control group,the mesoporous silica group,and the β-sitosterol group(P＜0.05),and the collagen arrangement was relatively neat and regular in direction.The results of immunohistochemical staining showed that the expression of type Ⅰ collagen and α-smooth muscle actin in the mesoporous silica@β-sitosterol group was lower than that of the other three groups(P＜0.05).The results of western blot assay showed that the expression of LC3-Ⅱ protein in the mesoporous silica@β-sitosterol group was lower than that of the other three groups(P＜0.05),and the expression of cleaved Caspase-3 protein was higher than that of the other three groups(P＜0.05).(3)The results showed that mesoporous silica@β-sitosterol nanoparticles effectively improved the water solubility and water dispersibility of β-sitosterol,and had excellent drug controlled release properties.They could inhibit the autophagy of fibroblasts in the lesions and induce their apoptosis,thereby inhibiting collagen deposition,promoting the fading and remodeling of hypertrophic scars.

Objective:To continuously track the publishing budget of provincial Center for Disease Control and Prevention (CDC)in China and comprehend the management changes in the provincial CDCs based on the financial input.Methods:Publishing budget data for the period 2021—2024 of 31 provincial CDCs and provincial health administrations in China were collected and analyzed from the perspectives of time change and proportion relationship.Results:Statistical analysis revealed that the overall budget income of provincial CDCs in 2024 exceeded that of 2021.Most provincial CDCs in many provinces exhibited high-level growth(some with slight fluctuations),stable growth,and rapid growth in budget income changes.The proportion of provincial CDCs'budget income relative to provincial health administrations steadily increased,and the synergistic relationship mainly manifested as increase in the same direction,but there is a situation of changing from"strong benign"to"weak benign".Conclusion:The development of the budget income for provincial CDCs in China aligns with the imperative to establish a stable public health investment mechanism,reflecting more support towards provincial CDCs in recent years.Future efforts should continue focusing on the synergistic relationship between provincial CDCs and provincial health administrations,so as to provide guidance for the local provincial CDC budget management and provide references for CDCs in other provinces.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

Stem cell treatment may enhance erectile dysfunction (ED) in individuals with cavernous nerve injury (CNI). Nevertheless, no investigations have directly ascertained the implications of varying amounts of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) on ED. We compare the efficacy of three various doses of HUC-MSCs as a therapeutic strategy for ED. Sprague-Dawley rats (total = 175) were randomly allocated into five groups. A total of 35 rats underwent sham surgery and 140 rats endured bilateral CNI and were treated with vehicles or doses of HUC-MSCs (1 × 10 6 cells, 5 × 10 6 cells, and 1 × 10 7 cells in 0.1 ml, respectively). Penile tissues were harvested for histological analysis on 1 day, 3 days, 7 days, 14 days, 28 days, 60 days, and 90 days postsurgery. It was found that varying dosages of HUC-MSCs enhanced the erectile function of rats with bilateral CNI and ED. Moreover, there was no significant disparity in the effectiveness of various dosages of HUC-MSCs. However, the expression of endothelial markers (rat endothelial cell antigen-1 [RECA-1] and endothelial nitric oxide synthase [eNOS]), smooth muscle markers (alpha smooth muscle actin [α-SMA] and desmin), and neural markers (neurofilament [RECA-1] and neurogenic nitric oxide synthase [nNOS]) increased significantly with prolonged treatment time. Masson's staining demonstrated an increased in the smooth muscle cell (SMC)/collagen ratio. Significant changes were detected in the microstructures of various types of cells. In vivo imaging system (IVIS) analysis showed that at the 1 st day, the HUC-MSCs implanted moved to the site of damage. Additionally, the oxidative stress levels were dramatically reduced in the penises of rats administered with HUC-MSCs.
Male ; Animals ; Erectile Dysfunction/metabolism* ; Rats, Sprague-Dawley ; Mesenchymal Stem Cell Transplantation/methods* ; Rats ; Penis/pathology* ; Humans ; Disease Models, Animal ; Umbilical Cord/cytology* ; Peripheral Nerve Injuries/complications* ; Mesenchymal Stem Cells ; Nitric Oxide Synthase Type III/metabolism* ; Actins/metabolism* ; Nitric Oxide Synthase Type I/metabolism*