Objective The aim of this study was to explore the role and mechanism of ferroptosis in SiO2-induced cardiac injury using a mouse model. Methods Male C57BL/6 mice were intratracheally instilled with SiO2 to create a silicosis model.Ferrostatin-1(Fer-1)and deferoxamine(DFO)were used to suppress ferroptosis.Serum biomarkers,oxidative stress markers,histopathology,iron content,and the expression of ferroptosis-related proteins were assessed. Results SiO2 altered serum cardiac injury biomarkers,oxidative stress,iron accumulation,and ferroptosis markers in myocardial tissue.Fer-1 and DFO reduced lipid peroxidation and iron overload,and alleviated SiO2-induced mitochondrial damage and myocardial injury.SiO2 inhibited Nuclear factor erythroid 2-related factor 2(Nrf2)and its downstream antioxidant genes,while Fer-1 more potently reactivated Nrf2 compared to DFO. Conclusion Iron overload-induced ferroptosis contributes to SiO2-induced cardiac injury.Targeting ferroptosis by reducing iron accumulation or inhibiting lipid peroxidation protects against SiO2 cardiotoxicity,potentially via modulation of the Nrf2 pathway.

Objective:To develop a dose prediction-based quantitative evaluation method of the quality of radiotherapy plans, and to verify the clinical feasibility and clinical value of the method .Methods:The 3D U-Netwas trained using the radiotherapy plans of 45 rectal cancer cases that were formulated by physicists with more than five years of radiotherapy experience. After obtaining 3D dose distribution using 3D U-Net prediction, this study established the plan quality metrics of intensity modulated radiotherapy(IMRT) rectal cancer radiotherapy plans using dose-volume histogram(DVH) indexes of dose prediction. Then, the initial scores of rectal cancer radiotherapy plans were determined.Taking the predicted dose as the optimization goal, the radiotherapy plans were optimized and scored again. The clinical significance of this scoring method was verified by comparing the scores and dosimetric parameters of the 15 rectal cancer cases before and after optimization.Results:The radiotherapy plans before and after optimization all met the clinical dose requirements. The total scores were(77.21±9.74) before optimization, and (88.78±4.92) after optimization. Therefore, the optimized radiotherapy planswon increased scores with a statistically significant difference( t=-4.105, P<0.05). Compared to the plans before optimization, the optimized plans show decreased Dmax of all organs at risk to different extents. Moreover, the Dmax, V107%, and HI of PTV and the Dmax of the bladder decreased in the optimized plans, with statistically significant differences ( t=2.346-5.771, P<0.05). There was no statistically significant difference in other indexes before and after optimization ( P>0.05).The quality of the optimized plans were improved to a certain extent. Conclusions:This study proposed a dose prediction-based quantitative evaluation method of the quality of radiotherapy plans. It can be used for the effective personalized elevation of the quality of radiotherapy plans, which is beneficial to effectively compare and review the quality of clinical plans determined by different physicists and provide personalized dose indicators. Moreover, it can provide great guidance for the formulation of clinical therapy plans.

Objective:To develope a self-adjustable automatic planning method of intensity modulated radiotherapy based on predicted dose, in order to enhance the robustness of automatic planning.Methods:After the patients′ dose by 3D U-Res-Net_B network was predicted, the current dose was calculated based on the last iteration result, then the predicted dose was combined to calculate the target dose and optimized. With all iterations completed or exit conditions satisfied, final treatment plannings would be acquired. A total of 30 cases of rectal cancer were tested to verify the effectiveness of the algorithm.Results:The mean value of planning target volumes′ V100% was (95.03±0.91)% for clinical plans, close to (94.67±1.96)% for automatical plans( P>0.05), and better than (92.90±2.13)% for predicted dose with the statisically significant difference ( t=29.0, P<0.05). Automatic planning′s indexes such as V35 of small intestines, V40 of bladders and V20 - V40 of femoral heads were lower than predicted and clinical ones, with the statisically significant difference( t=4.5-118.0, P<0.05). Discrepancy in other indexes of organs at risk was not statistically significantly different( P>0.05). Conclusions:This method made automatic planning processes more robust and more adaptive to difficult clinical situations.

Objective:To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg.Methods:Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures.Results:All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair.Conclusion:Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site.

Objective To evaluate the clinical efficacy and adverse reactions of S-1 chemotherapy plus high-low oxygen radiotherapy synchronously in treatment of patients with locally advanced pancreatic cancer. Methods Sixty-four patients with locally advanced pancreatic cancer in Rizhao People's Hospital and the Affiliated Hospital of Qingdao University from January 2013 to October 2015 were randomly divided into study group and control group by using envelope method, in which the study group was treated with oral administration of S-1 plus high-low oxygen radiation synchronously and the control group with intravenous gemcitabine chemotherapy. The efficiency, disease control rate, clinical benefit rate, distant metastasis rate, survival rate and adverse reactions of the two groups were compared. Results The effective rates of the study group and the control group were 70.4 %(19/27)and 32.1 %(9/28),the difference was statistically significant (χ2=8.04,P<0.01), and the disease control rates were 88.9 % (24/27) and 67.9 % (19/28) (χ2= 3.56, P >0.05). The clinical benefit rates of the study group and the control group were 77.8 % (21/27) and 57.1 % (16/28) (χ2=2.66,P >0.05), and the distant metastasis rates were 63.0 %(17/27) and 71.4 %(20/28) (χ2=0.45, P > 0.05). The 1-year survival rates of the study group and the control group were 63.0 % (17/27) and 32.1 % (9/28), and the 2-year survival rates were 37.0 % (10/27) and 10.7 % (3/28), the differences were statistically significant (χ2= 5.24, P < 0.05; χ2= 5.28, P< 0.05). While there were no significant difference in the incidence of serious adverse reactions between the two groups (P> 0.05). Conclusion The treatment of locally advanced pancreatic cancer with S-1 plus high-low oxygen radiotherapy synchronously is better than that with intravenous gemcitabine chemotherapy in terms of effective rate, 1-year survival rate and 2-year survival rate,with no increase of adverse reactions.

Objective To study the local anatomic structure of subclavian vein and have a good command of operating methods and skills on subclavian vein catheterization (SVC) so as to improve the success rate of puncture. Methods Retrospectively analyze the clinical data of 600 cases of hospitalized patients who have had SVC (male 410, female 190) in our hospital from March 2010 to March 2014. Results There were 582 cases (97%) of successful puncture,including 546 cases (91%) of one-time puncture success,38 cases (6. 3%) of repeated puncture or other types of puncture,and 16 cases (2. 7%) of failed puncture. Postoperative complications occurred in 22 patients (3. 7%),including 8 cases (1. 3%) of strayed into the artery,3 cases (0. 5%) of pneumothorax,5 cases (0. 8%) of catheter tip into the internal jugular vein,2 cases (0. 3%) of catheter related infection,2 cases (0. 3%) of catheter blockage,and 2 cases (0. 3%) of arrhythmia. Conclusion SVC is easy,safe and reliable,and it is of high success rate and less complications. Catheter retention time of SVC is longer. From the above,SVC is a good central venous puncture method which is worth of popularizing in clinical use.

Objective To assess the effect of hybrid debranching technique in treatment of patients with traumatic aortic arch rupture combined with pseudoaneurysm.Methods Clinical data of 3 patients with traumatic aortic arch rupture combined with pseudoaneurysm repaired using debranching technique from June 2011 to June 2013 were analyzed to determine their clinical features and treatment options.Hypersound or computed tomography angiography (CTA) was performed to confirm the therapeutic effects at postoperative 1 week,3,6,and 12 months as well as annually thereafter.Results All patients underwent operation uneventfully.Operation time was 6.8-10.5 hours (mean,7.6 hours) and intraoperative blood loss was 250-450 ml (mean,310 ml).Length of stay was 26-45 days (mean,32 days).There were no deaths at the 0.5-2 years of follow-up.Hypersound or CTA revealed no leakage of contrast medium after operation.Conclusion Hybrid debranching technique greatly reduces surgical trauma and provides satisfactory outcome and good function recovery.

Objective To evaluate the efficacy of inspiring carbogen and low concentration oxygen combined with late coupe accelerated hyperfraction radiotherapy on esophageal carcinoma.Methods 74 patients with esophageal carcinoma were randomly divided into two groups:the trial group and the centrol group,which consisted of 37 patients respectively.6MV X-ray was employed in the two groups.The schedule of the trial group was as following:conventional radiotherapy of 1.8～2.0Gy per day was employed during the first phase to a total dose of 38～40Gy,followed by late course accelerated hyperfraetion radiotherapy(twice fractions per day,interval between two fractions more than 6 hours,1.3～1.4Gy per fraction,middle total dose of 64.2Gy).Carbogen and low concentraetion oxygen was inspired during the course of radiation.Results 71 patients were enrolled.At the end of radiation at a total dose of 38～40Gy,complete remission rate(CRR)in the trial group was 31%,whereas that in the control group was 19%(P＞0.05),when the whole radiotherapy was finished,the CRR was 57%and 31%(P＜0.05)respectively,and one month after radiotherapy.the CRR was 71%and 33%respectively(P＜0.01).Six months after radiotherapy,the CRR WaLa 74%and 36%respectively(P＜0.01).Thelocal controlrate of sixmonthswas 91% and 72% respectively in the two groups(P＜0.05).Conclusions Inspiring carbogen and low concentration oxygen combined with late course accelerated hyperfraction radiotherapy may sigllificantly improve short-term efficacy and local control rate in esophageal carcinoma patients in Ⅰ～Ⅲstage.Furthermore,its side effects can be tolerated,and its elongating life time of patients may be prognostic.

As an important medical instrument in percutaneous transluminal coronary angioplasty, endovascular stents must have excellent biocompatibility. In this paper, after a description of the performance and fabrication process of stents, we analyzed the technology to improve the biocompatibility of stents during the fabrication process which is the effective method for decreasing the rate of restenosis.
Angioplasty, Balloon, Coronary ; Animals ; Coronary Disease ; therapy ; Coronary Restenosis ; prevention & control ; Humans ; Stents