Objective To obtain the data of radiological diagnosis and treatment resource distribution at medical institutions of different levels and in various cities, understand the status of resource allocation, provide policy-making basis and suggestions for optimizing the allocation of radiological diagnosis and treatment resources within the province, and offer data and references for related research. Methods A basic situation questionnaire survey was conducted on radiological diagnosis and treatment institutions in Hunan Province. Data were reviewed, analyzed, and statistically processed using Excel software to understand the allocation situation of radiological diagnosis and treatment resources in Hunan Province. Results As of 2022, there were 3031 radiological diagnosis and treatment institutions, 19770 radiation workers, and 6617 pieces of radiological diagnostic and treatment equipment. There were 80 radiation treatment institutions, 49 nuclear medicine institutions, 178 interventional radiology institutions, and 3028 X-ray imaging diagnosis institutions. There were 1077 radiation workers in radiation treatment, 461 radiation workers in nuclear medicine, 3369 radiation workers in interventional radiology, and 14,863 radiation workers in X-ray imaging diagnosis. There were 135 pieces of radiation treatment equipment, 56 pieces of nuclear medicine equipment, 262 pieces of interventional radiology equipment, and 6164 pieces of X-ray imaging diagnosis equipment. Conclusion Primary and lower grade medical institutions in Hunan Province account for a relatively high proportion of the total number of medical institutions, whereas radiological diagnostic and treatment resources are predominantly concentrated in tertiary medical institutions, demonstrating a unbalanced allocation of radiological diagnosis and treatment resources in various cities. In terms of the overall allocation of radiological diagnosis and treatment resources, interventional radiology is superior to the national average, nuclear medicine and X-ray imaging diagnosis are comparable to the national averages, and radiation treatment is lower than the national average. The total GDP is not the decisive factor in determining the development of local medical levels. It is suggested that relevant authorities should improve the rationality of the planning for the allocation of radiological diagnosis and treatment resources, promote the allocation of radiological diagnosis and treatment resources to the grassroots and underdeveloped areas through various measures, and thus achieve the goal of balanced resource allocation.

Objective:To investigate the effects and molecular mechanism of non-coding RNA-activated DNA damage(NORAD)induced autophagy on oxaliplatin resistance in adenocarcinoma of esophagogastric junction (AEG).Methods:Four pairs of surgical samples of AEG and para-carcinoma normal tissues from patients with advance AEG treated in Anyang Tumor Hospital from January to June 2023 were collected. The expression of NORAD in AEG and para-carcinoma tissues was analyzed by long non-coding RNA microarray chip. The primary tumor cell line of AEG (PDC) was derived from fresh AEG tissues. Oxaliplatin-resistant cell lines of PDC and AEG cell line OE19 (PDC-R and OE19-R) were established. NORAD expression knockdown PDC-R and OE19 cell lines (shNORAD PDC-R and shNORAD OE19-R) were prepared by transfection. The target of NORAD, the correlation and interaction between microRNA-433-3p (miR-433-3p) and NORAD were predicted using Starbase v3.0 and DIANA-lncBase v3.0. PDC, PDC-R, OE19 and OE19-R cells were co-transfected with miR-144-3p and wild-type NORAD (NORAD-WT) or mutant NORAD (NORAD-Mut) plasmid, respectively. Dual-luciferase reporter assay was used to verify the correlation between NORAD and miR-433-3p. The expression levels of NORAD and miR-433-3p in normal gastric mucosal cell line GES-1 and AEG cell lines PDC, PDC-R, shNORAD PDC-R, OE19, OE19-R and shNORAD OE19-R were detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of p62 protein and microtubule-associated protein 1 light chain 3B-Ⅱ (LC3B-Ⅱ) was determined by Western blotting. The half inhibitory concentration (IC 50) of PDC, PDC-R, shNORAD PDC-R, OE19, OE19-R and shNORAD OE19-R cells was measured by cell counting kit-8 (CCK-8) assay. Independent sample t-test was used for statistical analysis. Results:The results of microarray analysis showed that NORAD was significantly up-regulated in AEG compared with that in para-carcinoma tissues (fold change≥2.0, P<0.05). Bioinformatics studies found that miR-433-3p was the potential target of NORAD. The results of dual-luciferase reporter assay indicated that the relative luciferase activity of the NORAD-WT group was lower than that of NORAD-Mut group in PDC and PDC-R cells (0.441±0.104 vs. 0.928±0.204, 0.449±0.112 vs. 0.947±0.201), and the differences were statistically significant ( t=-14.74 and -14.94, both P<0.001). The results of dual-luciferase reporter assay of OE19 and OE19-R cell lines were the same as those of PDC cell lines. The results of qRT-PCR showed that the expression of NORAD in GES-1 cells (1.016±0.213) was lower than that of PDC cells (2.194±0.322) and PDC-R cells (4.040±0.336), and the differences were statistically significant ( t=-14.94 and -37.21, both P<0.001). Furthermore, the expression level of NORAD in PDC was also found to be lower than that in PDC-R cells, and the difference was statistically significant ( t=-19.43, P<0.001). Additionally, shNORAD PDC-R cells exhibited lower expression level of NORAD (0.290±0.165) compared with PDC-R cells, and the difference was statistically significant ( t=-49.05, P<0.001). The expression level of miR-433-3p in GES-1 cells (1.017±0.248) was higher than that in PDC cells (0.470±0.156) and PDC-R cells (0.203±0.045), and the differences were statistically significant ( t=9.15 and 15.85, both P<0.001). Moreover, the expression level of miR-433-3p was found to be higher in PDC cells compared with PDC-R cells, and the difference was statistically significant ( t=8.11, P<0.001). Additionally, the expression level of miR-433-3p in shNORAD PDC-R cells (0.699±0.256) was also higher than that in PDC-R cells ( t=9.37, P<0.001). The results of Western blotting showed that the expression of LC3B-Ⅱ in PDC-R was higher than that in PDC cells (0.426±0.060 vs. 0.212±0.041), the expression of LC3B-Ⅱ in shNORAD PDC-R cells (0.155±0.029) was lower than that in PDC cells, and the differences were statistically significant ( t=8.70 and -79.45, both P<0.001). However the expression of p62 protein in each cell line showed an opposite trend, with a lower relative expression in PDC-R than PDC (0.205±0.031 vs. 0.311±0.400), and the expression in shNORAD PDC-R (0.504±0.084) was higher than that in PDC, and the differences were statistically significant ( t=-31.19 and 62.80, both P<0.001). The expression patterns of NORAD, miR-433-3p, LC3B-Ⅱ and p62 proteins in OE19, OE19-R and shNORAD OE19-R cells were similar to those in PDC. The results of CCK-8 assessment of target cell viability showed that the IC 50 values of PDC, PDC-R and shNORAD PDC-R cell lines were 14.28, 22.27 and 2.51 μg/mL, respectively; and the IC 50 values of OE19, OE19-R and shNORAD PDC-R cell lines were 3.95, 8.12 and 1.89 μg/mL, respectively. Conclusions:NORAD is highly expressed in AEG tissues and cells. NORAD is overexpressed in oxaliplatin-resistant cell lines and increase the autophagy activity of cells. After NORAD is knockdown, autophagy activity is inhibited and the sensitivity of AEG cells to oxaliplatin is significantly enhanced.

Objective:To reconstruct the dose of nasopharyngeal carcinoma and verify the results of the whole-process radiotherapy plan based on log files and cone beam CT (CBCT).Methods:A total of 15 patients with nasopharyngeal carcinoma who received volumetric modulated arc therapy (VMAT) with Halcyon accelerator in the Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February to September 2022 were retrospectively selected. Log files and CBCT for all fractionated radiotherapy were recorded. The errors of monitor unit (MU), gantry angle, and multi-leaf collimator (MLC) leaf position per control point were analyzed. The adaptive CT (aCT) were generated according to CBCT and planned CT (pCT) using a commercial software Velocity TM, and the similarities among aCT, pCT and CBCT were analyzed. The original plan was modified from the log files and imported into the treatment planning system to calculate the delivered dose on the corresponding fractionated aCT to reconstruct the fractionated dose. And all the reconstructed doses were mapped back to pCT to obtain the cumulative dose. Theγpass ratios with criteria of 2 mm/2% and 2 mm/3% and the dose differences between the planned dose and the cumulative dose in the planning target volume (PTV) and organs at risk (OAR) were compared. Results:The root mean square (RMS) and the 95th percentile of the errors of MU, gantry angle and MLC leaf position errors were within an acceptable range. The aCT generated by Velocity TM had the anatomical structure of CBCT and the resolution, contrast, noise characteristics of pCT, which could be directly used for dose calculation. Compared with the planned dose, the changes of V 70 Gy of nasopharyngeal primary tumor (PTV nx), V 68 Gy of cervical glands (PTV nd) and V 60 Gy of planning target volume (PTV1) were -0.88%±1.91%, -2.99%±2.99% and -0.63%±0.93%, respectively, and V 40 Gy of parotid gland was increased to 2.65%±2.63%. Cumulative dose showed different degrees of PTV dose decrease ( P<0.05) and parotid dose was increased ( P<0.05). The γ pass ratio (2 mm/3%) between the cumulative dose and planned dose was 97.3%±2.7% and >95.0% in 86.7% of patients. Conclusions:Based on the log files and CBCT, the whole-process dose reconstruction of nasopharyngeal carcinoma patients can be carried out. According to the results of dose reconstruction, the radiotherapy effect of the target area and OAR can be quantitatively evaluated. In the case of high dose coverage and conformity of the original plan, the reconstruction results show that the cumulative dose coverage of the target area is decreased, whereas that of the parotid gland is increased.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Objective:To study the expression and significance of long noncoding RNA (lncRNA) LINC00657 in diffuse-type adenocarcinoma of esophagogastric junction (AEG).Methods:RT-PCR was used to determine the expression of LINC00657 in AEG tissues and AEG patient-derived tumor cells (PDCs). The expression of E-cadherin in AEG tissues and PDCs was detected. The Kaplan-Meier method was used to evaluate the correlation of LINC00657 expression with the overall survival (OS) of patients.Results:LINC00657 was highly expressed in AEG tissues [(1.41±0.12) vs. (0.61±0.11), t=276.038, P<0.01] and PDCs, while E-cadherin was significantly down-regulated. The expression of LINC00657 was retated to tumor diamer, invassion depth, lymph node metastasis, TNM staging (all P<0.05) In Kaplan-Meier analysis, high levels of LINC00657 were associated with poor prognosis for patients with diffuse-type AEG. In addition, a significant inverse relationship was observed between LINC00657 and E-cadherin expression ( r=-0.529, P<0.001). Conclusions:Elevated expression of LINC00657 in diffuse-type AEG tissues is associated with poor prognosis and may confer a malignant phenotype upon tumor cells.

Objective To conduct a computer simulation to evaluate the discrepancy between the cumulative doses calculated by four-dimensional computed tomography (4DCT) images and 4DCT scans (for real-time respiratory motions) due to the patient's irregular breathing.Methods A series of digital phantoms were generated from a patient's 4DCT images to simulate 4DCT images and 4DCT scans (for real-time respiratory motions) resulting from various irregular breathing curves.A six-field intensity-modulated radiotherapy plan was generated.Two cumulative doses in the target were calculated.The first one, named Dall, was calculated by tracking the point displacements in the target manifested on the 4DCT images;the second one, named D4D, was calculated based on the point displacements along the whole breathing motion during 4DCT scanning.Dose discrepancy between D4D and Dall was calculated to evaluate the correlation between breathing pattern and dose discrepancy in the target.Results The dose discrepancy in the target was correlated with mean motion excursion and the standard deviation of motion excursion.ΔDmin(ΔD99) in the target increased from 2.39%(2.04%) to 11.91%(5.24%) as the mean motion excursion increased from 5 mm to 15 mm, and increased from 5.93%(2.15%) to 14.65%(5.01%) as the standard deviation of motion excursion increased from 15% to 45% of the mean motion excursion.When the mean period increased from 3 s to 5 s or the standard deviation of period increased from 10% to 40% of the mean period,ΔDmin(ΔD99) in the target was greater than 6.0%(2.0%), but less than 9.0%(3.0%).When the target diameter was 2 cm, 3 cm, and 4 cm,ΔDminΔD99) in the target was 11.88%(5.50%), 6.91%(2.42%), and 7.53%(3.62%), respectively.Conclusions There is a large discrepancy between the cumulative doses calculated using 4DCT images and 4DCT scans (for real-time respiratory motions) when the patient has irregular breathing.This dose discrepancy depends on mean motion excursion and the standard deviation of motion excursion, but has little relationship with mean period, the standard deviation of period, and tumor volume.

As an important measure to reduce casualties and prevent secondary pollution, decontamination is an impor-tant link in the process of emergency response during chemical accidents.The decontamination effect is closely related to decontamination technology and equipment.Decontamination agent selection and development are an important part of a decontamination technology.In this paper, the development and use of cleaning agents, such as alkaline, oxidation and chlorination, adsorption (degradation), metal oxide and oxygen acid salt, chemical compounds, biological (enzymatic), and individual disinfection package, light decontamination equipment, multifunctional integrated large-scale decontamination equipment at home or abroad, are reviewed.By laying bare the gap between China and advanced countries in the related field, we hope to raise the concern of relevant professional counterparts and promote the development of domestic decontami-nation technology and equipment with decontaminant agents at the core.

OBJECTIVE To establish a model for chlorpyrifos(CPF)whole-body dynamic inhalation exposure in SD rats and investigate the injury effects after acute exposure by CPF. METHODS By optimizing the aerosol parameters ,the animal acute dynamic inhalation exposure of CPF was established. Absorption sampling-gas phase detecting technology was used to monitor the concentration of CPF in the whole-body dynamic-inhalation exposure cabin by exploring the relationship between the concentration , particle size of CPF aerosol and the CPF inhalation time in the exposure cabin via a particle size detector. Using Bliss method,specific pathogen free SD male rats were allocated to the environment of CPF exposure at different lethal concentrations and time points. The symptoms and deaths of these SD male rats in different groups were recorded within the following 10 d. Based on the median lethal concentra?tion time(LCt50),the values of plasma cholinesterase(ChE)were checked at different time points after being exposed at different doses. RESULTS The mean concentrations of CPF aerosol at nine time points was 160.6 mg · m-3,the relative standard deviation value was 6.9%;the geometrical mean of aerosol particle size was 1.1 μm,and the geometric standard deviation was 1.8. The results met the technical requirements of Organization for Economic Cooperation and Development regarding acute inhalation exposure. Under these equipment conditions,the LCt50 of CPF acute inhalation of SD male rats was 1654.2 mg · m-3 · h,suggesting that plasma ChE inhibitory rate was higher with the increase in the exposing dose,and that there was a significant difference as compared with the controls(P<0.05). CONCLU?SION The model for whole-body dynamic-inhalation exposure of CPF is applicable to rats,which can serve as an experimental platform and technical support to inhalation vulnerability and the research on prevention and cure of organophosphate industrial products and nerve agents.

Mercury is one of the common heavy-metal toxins,which can cause damage throughout the body in a variety of ways. Cases of renal toxicity of mercury poisoning are increasing clinically. However,little is known about nephrotoxicity mechanisms,and treatment remains unsatisfactory. The mechanism of mercury toxic nephropathy is reviewed in this paper,including the direct toxic effect on the kidney,the injury to the biomembrane system,generation of Hg-metallothionein,imbalance of intra?cellular calciumion,oxidative damage,induced apoptosis,and immune injury. Besides,the mechanism and limitation of common therapies,potential developments of the field are discussed. This review will facilitate further investigations therapies about both the mechanism and treatment of mercury toxic nephropathy.

ObjectiveTo determine thallium in whole blood by atomic absorption detection method, and to investigate the eliminating effect of hemoperfusion (HP) for thallium in blood.Methods The blood of Beagle dogs which had not exposed to thallium before were obtained for preparation of thallium nitrate (TlNO3)-containing solution in three concentrations according to the conversion formula based on animal weight and volume of blood. HP was performed in the simulated in vivo environment. The content of TlNO3 in blood of the next group was determined on the amount of TlNO3 for the last HP of the former dose group. Thallium quantity in different samples was measured with atomic absorption spectrometer blood samples before and after HP. Finally, the thallium concentration in blood was analyzed statistically.Results Thallium concentrations showed a good linear relationship in the range of 0-200μg/L (r = 0.998 4). The intra-day precision (RSD) was lower than 4.913%, the intra-day recovery rate was 96.2%-111.9%; the inter-day precision (RSD) was lower than 7.502%, the inter-day recovery rate was 89.6%-105.2%. The concentration of thallium in blood was significantly reduced after HP per time in high, middle, and low dose groups [(453.43±27.80) mg/L to (56.09±14.44) mg/L in high dose group,F = 8.820,P = 0.003;(64.51±13.60) mg/L to (3.19±0.23) mg/L in middle dose group,F = 36.312,P = 0.000; (5.40±0.98) mg/L to (0.38±0.25) mg/L in low dose group,F = 46.240,P = 0.000]. The adsorption rate of four times of HP in high, middle and low dose group were (87.63±2.48)%, (95.06±1.54)% and (92.76±4.87)%, respectively, without significant difference (F = 4.231,P = 0.070 ).Conclusions The method for measuring thallium was established, and it shows a very stable, simple, sensitive for determination of thallium. HP can effectively remove thallium from blood. Thallium concentration can be reduced by 90% after four times of HP. HP is also effective even when thallium concentration is not high.