Objective To explore the construction of heart preservation model of empty beating donor based on extracorporeal membrane oxygenation (ECMO). Methods From January 2022 to August 2023, 20 Guangxi Bama miniature pigs weighing 25-30 kg were selected, half male and half female. Under general anesthesia and heparinization, a midline thoracotomy was performed. The pericardium was cut after freeing the anterior and posterior vena cavae, and a perfusion needle was inserted near the brachiocephalic artery in the ascending aorta, connected to a blood collection bag to collect 500-600 mL of blood. The anterior and posterior vena cavae were ligated, the aorta was blocked and perfused with HTK solution to stop the heart beating. The superior and inferior vena cavae were cut off, the right pulmonary vein was decompressed, the aorta and left and right pulmonary arteries and veins were cut off, and the whole heart was removed. An ECMO device was used to continuously perfuse a cardioprotective solution mainly composed of oxygenated warm blood, maintaining the isolated pig heart beating for 8 hours, monitoring (once/hour) ECMO perfusion parameters, blood gas indicators, perfusate electrolytes, inflammatory factors, myocardial enzymes, myoglobin, and troponin levels. Myocardial tissue was taken for hematoxylin-eosin (HE) staining to observe myocardial cell damage and evaluate the quality of heart preservation. Results Among the 20 isolated beating pig hearts, 17 successfully resumed beating, 3 experienced ventricular fibrillation, resuscitated after intracardiac electrical defibrillation, and all 20 pig hearts successfully beat for 8 hours. There was no statistical difference in ECMO perfusion parameters, blood gas indicators, perfusate electrolytes, and inflammatory factors at each time point (P>0.05). There were statistical increases in myocardial enzymes, myoglobin, and troponin levels (P<0.05). HE staining results suggested that there was no severe myocardial damage. Conclusion ECMO technology can be used for pig heart preservation with good results, and this study provides experimental evidence for improving heart preservation research in clinical heart transplantation.

Objective To evaluate the application value of the MR three-dimensional double inversion recovery(3D DIR)sequence in the diagnosis of optic neuritis(ON).Methods A retrospective analysis was conducted on MRI images from 40 patients with sus-pected ON.All patients underwent conventional T2 WI fat suppression(FS)and 3D DIR sequences.The lesion detection rate and diag-nostic accuracy of the intraorbital,intracanalicular,and intracranial segments of the optic nerve were compared between the two sequences,respectively.The receiver operating characteristic(ROC)curves were used to assess the diagnostic performance,and the intraclass correlation coefficient(ICC)were used to analyze interobserver consistency.Imaging assessments were independently performed by two senior and two junior radiologists.Results The sensitivity(SEN),specificity(SPE),and accuracy(ACC)in lesion detection of 3D DIR sequence were significantly better than those of conventional T2 WI FS sequence[odds ratio(OR)221 vs 104,P＜0.001].Notably,3D DIR sequence exhibited superior performance in detecting lesions in the intraorbital segment[area under the curve(AUC)0.915,OR=102]and intracanalicular segment(AUC 0.858,OR=51)compared with conventional T2WI FS sequence.Additionally,3D DIR sequence significantly improved diagnostic consistency among junior radiologists(ICC value increased from 0.469 to 0.655),bring-ing their diagnostic performance closer to that of senior radiologists(AUC improved to 0.883,ACC reached 90.1％).Conclusion The 3D DIR sequence has outstanding diagnostic efficacy in detecting ON lesions,significantly improving ACC and interobserver consistency,thereby offering strong support for the precise diagnosis of ON.

Objective To investigate the therapeutic effect of Gypenoside L(Gyp-L)on diabetic retinopathy(DR)rats and its effect on the p38 mitogen-activated protein kinase(MAPK)signaling pathway.Methods Rats were divided into 6 groups(n=12):blank group,model group,low,medium,high dose group and combination group.The blank group was normal control rats,and the other groups were DR rat models.Rats in the blank group and model group were intragastrically administered with sodium carboxymethyl cellulose.Rats in the low,medium and high dose group were ga-vaged with 50,100,and 200 mg·kg-1·d-1 of Gypenoside L solution,respectively.Rats in the combination group were gavaged with 200 mg·kg-1·d-1 of Gypenoside L solution,and 2 mg·kg-1·d-1 of p38 MAPK agonist Anisomycin was in-jected into the tail vein.The rats in each group were gavaged with a volume of 2 mL per day for a total treatment period of 4 weeks.After the treatment,fundus photography was performed on the rats in each group,and retinal tissues were stained with hematoxylin and eosin(HE).Fasting blood glucose was measured using a Roche blood glucose meter,and se-rum insulin levels were measured using an ELISA kit.Retinal superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin(IL)-1 β,and IL-6 levels were measured according to the instructions of the kit.Western blot was used to detect the protein levels of p38 MAPK,p-p38 MAPK,p65 nuclear factor-κB(NF-κB),p-p65 NF-κB,inducible nitric oxide synthase(iNOS),and cyclooxygenase(COX-2)in the retina.Results Compared with the model group,the blood glucose level was decreased,the serum insu-lin level was increased,the fundus neovascularization was reduced,the retinal damage was alleviated,the retinal SOD,CAT and GSH-Px levels were increased,the MDA level was decreased,the TNF-α,IL-1β and IL-6 levels were decreased,and the p-p38 MAPK,p-p65 NF-κB,iNOS and COX-2 protein levels were decreased in the low,medium and high dose group(all P＜0.05).Compared with the high dose group,the blood glucose level in the combination group was increased,the serum insulin level was decreased,the fundus neovascularization increased,the retinal damage was aggravated,the ret-inal SOD,CAT and GSH-Px levels were decreased,the MDA level was increased,the TNF-α,IL-1[3 and IL-6 levels were in-creased,and the p-p38 MAPK,p-p65NF-κB,iNOS and COX-2 protein levels were increased(all P＜0.05).Conclusion This study shows that Gypenoside L can reduce inflammation and oxidative stress by blocking the p38 MAPK signaling path-way,thereby playing a role in the treatment of DR.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Objective:To develop and design a during-treatment records auto-review program to comply the quality assurance(QA)requirement of radiotherapy chart auditing,and thereby improve the review efficiency and accuracy.Methods:Based on the items the guideline required,the Aria Oncology Information System database backup files was analyzed by Java,Vue,and etc.languages and the corresponding review logic was formulated.A total of 530 treatment records generated at Shanghai Concord Cancer Center from January to March 2024(10 weeks)were auto-reviewed and compared with the manual results for evaluating the accuracy and efficiency of the program.Results:The auto-review program was running smoothly.Overall with the above data,the sensitivity,specificity,accuracy and the error-miss rate were 73.4%,14.3%,87.7%and 12.3%respectively.For sub-set items,the source-skin distance(SSD)error detecting rate was 100%,the wrong session reporting was 100%correlated with the plans switching and the wrong fraction reporting was 100%related to plan revision.For the other items,auto and manual reviews gave out the same accuracy.Conclusion:The none-error results from the program are all true,so the manual rechecking could limit to those auto-review error records,which can reduce the workload by 73.4%,therefore improve the effectiveness and accuracy of the radiotherapy data review.

Objective To evaluate the application value of the MR three-dimensional double inversion recovery(3D DIR)sequence in the diagnosis of optic neuritis(ON).Methods A retrospective analysis was conducted on MRI images from 40 patients with sus-pected ON.All patients underwent conventional T2 WI fat suppression(FS)and 3D DIR sequences.The lesion detection rate and diag-nostic accuracy of the intraorbital,intracanalicular,and intracranial segments of the optic nerve were compared between the two sequences,respectively.The receiver operating characteristic(ROC)curves were used to assess the diagnostic performance,and the intraclass correlation coefficient(ICC)were used to analyze interobserver consistency.Imaging assessments were independently performed by two senior and two junior radiologists.Results The sensitivity(SEN),specificity(SPE),and accuracy(ACC)in lesion detection of 3D DIR sequence were significantly better than those of conventional T2 WI FS sequence[odds ratio(OR)221 vs 104,P＜0.001].Notably,3D DIR sequence exhibited superior performance in detecting lesions in the intraorbital segment[area under the curve(AUC)0.915,OR=102]and intracanalicular segment(AUC 0.858,OR=51)compared with conventional T2WI FS sequence.Additionally,3D DIR sequence significantly improved diagnostic consistency among junior radiologists(ICC value increased from 0.469 to 0.655),bring-ing their diagnostic performance closer to that of senior radiologists(AUC improved to 0.883,ACC reached 90.1％).Conclusion The 3D DIR sequence has outstanding diagnostic efficacy in detecting ON lesions,significantly improving ACC and interobserver consistency,thereby offering strong support for the precise diagnosis of ON.

Objective To investigate the therapeutic effect of Gypenoside L(Gyp-L)on diabetic retinopathy(DR)rats and its effect on the p38 mitogen-activated protein kinase(MAPK)signaling pathway.Methods Rats were divided into 6 groups(n=12):blank group,model group,low,medium,high dose group and combination group.The blank group was normal control rats,and the other groups were DR rat models.Rats in the blank group and model group were intragastrically administered with sodium carboxymethyl cellulose.Rats in the low,medium and high dose group were ga-vaged with 50,100,and 200 mg·kg-1·d-1 of Gypenoside L solution,respectively.Rats in the combination group were gavaged with 200 mg·kg-1·d-1 of Gypenoside L solution,and 2 mg·kg-1·d-1 of p38 MAPK agonist Anisomycin was in-jected into the tail vein.The rats in each group were gavaged with a volume of 2 mL per day for a total treatment period of 4 weeks.After the treatment,fundus photography was performed on the rats in each group,and retinal tissues were stained with hematoxylin and eosin(HE).Fasting blood glucose was measured using a Roche blood glucose meter,and se-rum insulin levels were measured using an ELISA kit.Retinal superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin(IL)-1 β,and IL-6 levels were measured according to the instructions of the kit.Western blot was used to detect the protein levels of p38 MAPK,p-p38 MAPK,p65 nuclear factor-κB(NF-κB),p-p65 NF-κB,inducible nitric oxide synthase(iNOS),and cyclooxygenase(COX-2)in the retina.Results Compared with the model group,the blood glucose level was decreased,the serum insu-lin level was increased,the fundus neovascularization was reduced,the retinal damage was alleviated,the retinal SOD,CAT and GSH-Px levels were increased,the MDA level was decreased,the TNF-α,IL-1β and IL-6 levels were decreased,and the p-p38 MAPK,p-p65 NF-κB,iNOS and COX-2 protein levels were decreased in the low,medium and high dose group(all P＜0.05).Compared with the high dose group,the blood glucose level in the combination group was increased,the serum insulin level was decreased,the fundus neovascularization increased,the retinal damage was aggravated,the ret-inal SOD,CAT and GSH-Px levels were decreased,the MDA level was increased,the TNF-α,IL-1[3 and IL-6 levels were in-creased,and the p-p38 MAPK,p-p65NF-κB,iNOS and COX-2 protein levels were increased(all P＜0.05).Conclusion This study shows that Gypenoside L can reduce inflammation and oxidative stress by blocking the p38 MAPK signaling path-way,thereby playing a role in the treatment of DR.

Objective: To study the effect of metformin sensitizing pancreatic cancer cells with radiotherapy, with a focus on elucidating the underlying mechanisms of radiotherapy resistance. In particular, the role of the PERK/P-eIF2/ATF4 signaling pathway in mediating these effects was preliminarily explored. Methods : Pancreatic cancer cell lines(PANC-1 and PANC-2) were categorized into control, radiotherapy, and drug treatment groups. Following the respective treatments, cell proliferation inhibition was assessed using the CCK-8 assay, colony formation assays, and cell death staining. Senescence was quantified by β-galactosidase(SA-β-Gal) staining. The expression of cell cycle regulators(P21, P16, γ-H2AX), apoptosis markers(Bax, Bcl-2, Cleaved caspase-3), and pathway-related proteins(PERK, P-eIF2, ATF4) was evaluated by Western blot and immunofluorescence. To further investigate the role of the PERK/P-eIF2/ATF4 axis in metformin-mediated modulation of pancreatic cancer cell senescence and radiosensitization, selective inhibitors(GSK2606414) and agonists(MK-28) of PERK were employed. Results : Radiotherapy markedly upregulated senescence-associated markers(P21, P16, γ-H2AX, and β-galactosidase activity) in pancreatic cancer cells. Senescent cells exhibited enhanced proliferative activity and increased tumor volume both in vitro and in vivo. Metformin mitigated radiotherapy-induced senescence by reducing the expression of senescence markers and significantly suppressing the clonogenic and proliferative capacity of treated cells. Mechanistically, radiotherapy activated the PERK signaling pathway, leading to increased expression of PERK, P-eIF2, and ATF4, thereby driving cellular senescence. Pharmacological inhibition of PERK reduced β-galactosidase activity, while PERK activation further promoted the expression of senescence-associated proteins—an effect that was reversed by metformin. Conclusion Metformin inhibits the activation of the PERK/P-eIF2/ATF4 signaling pathway in pancreatic cancer cells following radiotherapy, thereby delaying cellular senescence and reducing the associated radiotherapy resistance of senescent cells. This modulation contributes to the sensitization of pancreatic cancer cells to radiotherapy.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

The worksite survey of occupational disease diagnosis is a series of occupational health investigations in the workplace initiated by the occupational disease diagnosis institution or the public health administrative department in order to understand whether there is a causal relationship between the workers' diseases and the workplace in the process of occupational disease diagnosis and verification. The main purpose of the worksite survey is to find out whether there are occupational hazards that cause health damage to workers in the workplace, and to analyze whether there is a causal relationship between the exposure to occupational hazards at the corresponding concentration (intensity) and the diseases suffered by workers. In actual work, it is necessary to determine whether it is necessary to organize worksite survey according to the legal situation and actual work of occupational disease diagnosis. The mainly works of worksite survey includes three aspects: preliminary preparation, survey implementation and survey report writing. It is necessary to pay attention to the key and difficult tasks such as preparation before survey, survey plan and questionnaire, complexity and uncertainty of worksite survey and sampling and detection of occupational hazard factors in workplace. After the worksite survey,it is necessary to write a written occupational disease on-site investigation report to provide objective, reliable and scientific evidence for occupational disease diagnosis.