Objective:To investigate the risk factors for liver cancer after splenectomy in patients with cirrhosis.Methods:The clinical data of 150 patients diagnosed with hepatitis B associated cirrhosis, portal hypertension, and hypersplenism who underwent splenectomy at Shaanxi Provincial People's Hospital and the First Affiliated Hospital of Xi'an Jiaotong University from March 2000 to November 2012 were retrospectively analyzed. There were a total of 150 patients included, 114 males and 36 females, aged (44±10) years old. General information, intraoperative conditions, and postoperative complications of the patients were documented. The postoperative progress of patients was monitored by telephone or outpatient follow-up. Based on the follow-up results regarding liver cancer presence, all patients were categorized into two groups: liver cancer group ( n=42) and non-liver cancer group ( n=108). Multivariate analysis was employed to identify factors influencing the liver cancer occurrence after splenectomy. Kaplan-Meier survival analysis along with log-rank test was utilized to assess overall survival and survival rate comparison. Results:Compared to the non-liver cancer group, the liver cancer group exhibited an increased prevalence of hypertension, direct bilirubin levels, prothrombin time, maximum spleen diameter, and postoperative thrombosis (all P<0.05). However, there was a significant reduction in the number of patients receiving long-term regular antiviral therapy and postoperative bleeding (all P<0.05). The multivariate analysis revealed that preoperative hypertension ( OR=6.310, 95% CI: 1.729-23.024, P=0.005), spleen diameter exceeding 12 cm ( OR=5.338, 95% CI: 1.234-23.094, P=0.025), and occurrence of postoperative thrombosis ( OR=8.652, 95% CI: 2.700-27.729, P<0.001) in patients with hepatitis B-related liver cirrhosis and portal hypertension were associated with an increased risk of developing liver cancer following splenectomy. Patients who receive long-term regular antiviral treatment after surgery ( OR=0.143, 95% CI: 0.038-0.545, P=0.004) have a lower risk of developing liver cancer. There was no statistically significant difference observed in the cumulative survival rate between the liver cancer group and the non-liver cancer group ( χ2=1.74, P=0.187). Conclusion:Preoperative hypertension, spleen diameter exceeding 12 cm, and postoperative thrombosis are independent risk factors for liver cancer in patients with hepatitis B-related cirrhosis and portal hypertension after splenectomy. Additionally, postoperative long-term antiviral therapy serves as an independent protective factor.

Objective:To investigate the manpower allocation and scientific research level of radiotherapists in radiotherapy units in mainland China, aiming to provide reference for the construction of radiotherapist teams.Methods:The questionnaire was designed and produced by the organizer, released in the professional committee, professional group and other channels of the radiotherapist industry, and filled out by the technical person in charge of the radiotherapy unit through the online questionnaire survey. The collection time started from mid-May 2021 to mid-June 2021.Results:A total of 558 effective questionnaires filled out by radiotherapy units. The radiotherapy institutions participating in the survey had a total of 5500 radiotherapists, including 3702 males and 1798 females, 3754 with a bachelor's degree, 371 who are currently studying or have obtained a master's degree, 21 who are currently studying or have already obtained a doctoral degree, 3642 with junior or lower titles, 1580 with intermediate titles, and 278 with senior titles. In 2020, radiotherapists from 193 units published articles, those from 81 units received project funding, and those from 56 units obtained patent authorization, and those from 15 units had scientific research transformation. The participating units had a total of 1080 large-scale radiation therapy equipment. In 2020, the daily average number of radiotherapy patients was 47 900, the average daily load of accelerator patients was 44.35, and the average workload index per capita was 8.71. The average daily radiotherapy patients in county-level or below, city-level, and provincial-level institutions were 25.78, 65.68, and 173.76, respectively, and the per capita workload index was 5.22, 8.09, and 10.11.Conclusions:Compared with the 2019 survey, the educational background of radiotherapists in mainland China has been improved, and the title structure has been optimized to a certain extent, and the workload of large-scale radiotherapy units is larger than that of grass-roots units.

Angiosarcoma is a rare malignant tumor of soft tissue in adults. However, tumor ulcers caused by foot angiosarcoma are rarely reported in the literature. This paper outlines a case of foot angiosarcoma misdiagnosed as diabetic foot ulcer. It was treated as diabetic foot ulcer in other hospitals without notable improvement. In consideration of its special clinical characteristics and treatment process, pathological biopsy was performed after admission, and angiosarcoma was confirmed. The purpose of this article is to emphasize that foot angiosarcoma or other tumor ulcers in diabetes patients are easily misdiagnosed as diabetic foot ulcers. If there is no obvious improvement in treatment, pathological tissue biopsy should be performed as early as possible.

Objective To investigate the effect of Yangxue Rougan pills on a rat model of liver fibrosis induced by multiple factors and the mechanism of action of Yangxue Rougan pills in the treatment of liver fibrosis. Methods A total of 50 male rats were randomly divided into blank control group, multi-factor model group, Fuzheng Huayu capsule group, and high-, middle-, and low-dose Yangxue Rougan pill groups. The rats in the blank control group were given normal water and feed, and those in the other groups were given modified high-fat low-protein diet and 5% alcohol, as well as subcutaneous injection of olive oil solution containing 40% carbon tetrachloride and intraperitoneal injection of pig serum 0.5 mL per rat, twice a week for 12 consecutive weeks. Since week 7, the rats in the high-, middle-, and low-dose Yangxue Rougan pill groups were given Yangxue Rougan pills at a dose of 9.5, 4.75, and 2.38 g/kg, respectively, those in the Fuzheng Huayu capsule group were given Fuzheng Huayu capsules at a dose of 0.75 g/kg, and those in the blank control group and the multi-factor model group were given an equal volume of distilled water by gavage every day for 6 consecutive weeks. The rats were treated at week 12. HE staining and Masson staining were used to observe the degree of liver fibrosis in rats, and PCR and Western blot were used to measure the expression of TGF-β1, Smad3, and Smad7 in the liver. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett's t -test was used for further comparison between two groups. Results Compared with the blank control group, the multi-factor model group had a severely damaged lobular structure and a significantly higher degree of liver fibrosis, with the formation of pseudolobules with different sizes; compared with the multi-factor model group, the Yangxue Rougan pill groups had a significant improvement in the degree of liver fibrosis, with the most significant therapeutic effect in the high- and middle-dose Yangxue Rougan pill groups. Compared with the blank control group, the multi-factor model group had significant increases in the expression of TGF-β1 and Smad3 and a significant reduction in the expression of Smad7 in liver tissue (all P < 0.05); compared with the multi-factor model group, the Yangxue Rougan pill groups had a significant reduction in the expression of TGF-β1 and a significant increase in the expression of Smad7 (all P < 0.05); compared with the multi-factor model group, the high- and middle-dose Yangxue Rougan pill groups had a significant reduction in the expression of Smad3 (both P < 0.05). Conclusion Yangxue Rougan pills can significantly inhibit liver fibrosis in rats by downregulating the expression of TGF-β1 and Smad3 and upregulating the expression of Smad7, and therefore, the TGF-β1/Smad signaling pathway is one of the mechanisms of action of Yangxue Rougan pills in improving liver fibrosis.

Objective:To investigate the efficacy of dual plate fixation in the treatment of proximal humeral fracture with comminuted calcar.Methods:From July 2018 to April 2020, 25 patients (7 males and 18 females) were treated operatively for proximal humeral fractures with calcar comminution using anterior plate and lateral Philos plate. The data of patients who were followed up for more than 12 months was retrospectively analyzed. The mean age was 58.3 years (range 33-79 years). There were 13 right sides (all principal sides) and 12 left sides (all non-principal sides). The causes of injuries included: falling on flat ground (12 cases), traffic accidents (11 cases) and falling from height (2 cases). According to Neer classification, there were 7 cases of two-part fractures, 16 cases of three-part fractures and 2 cases of four-part fractures. A number of parameters including patient demographics, mechanism of injury, operative time, time to union, the range of shoulder motion, visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley shoulder joint score, neck-shaft angle and the complications were recorded.Results:All of 25 patients were operated and followed up for 24.7 months (range 14 to 36 months). The operation time was 124.3 min (75-185 min), and the blood loss was 178.4 ml (100-350 ml). All patients had healed fractures at the last follow-up, and the neck-shaft angle was 132.88°±8.11° immediately after surgery, and 132.68°±8.36° at the last follow-up. All 25 patients healed completely in 4.7 months (range 3-5 months). Range of shoulder joint motion were forward flexion 161.20°±13.01° (range 140°-180°), external rotation 37.60°±7.65° (range 20°-45°), and internal rotation T 4-L 4 levels. VAS score was 0.36±0.81 points (range 0-3 points), while ASES score was 87.32±8.78 points (range 57.7-100 points) and Constant-Murley score was 89.40±8.37 points (range 60 to 100 points). Overall satisfaction score (Constant-Murley score) was excellent in 23 cases, and good in 2 cases. No obvious complications occurred. Conclusion:The combination of anterior plate and lateral Philos plate in the treatment of proximal humerus fractures with comminuted calcar can achieve stable fixation and satisfactory postoperative results.

Objective:To investigate and analyze the basic occupational situation of Chinese radiotherapists and to provide references for the development and construction of the radiation therapist team in China.Methods:Between May 7, 2021 and June 15, 2021, this survey was conducted using a self-designed questionnaire, which was distributed and collected in the form of online survey to conduct a statistical analysis of the basic situation of radiotherapists in 30 provincial-level administrative regions in China.Results:A total of 2 928 valid questionnaires were collected from 30 provincial-level administrative regions. The ratio of male to female and average age of the participants were 69∶31 and 35 years (18-65), respectively. According to the survey result, 84.7% of the participants came from Tertiary A-level hospitals. In terms of educational background, the participants with doctoral, master, undergraduate, junior-college, and technical-secondary degrees accounted for 0.2%, 6.9%, 76.6%, 14.9%, and 1.4%, respectively. In terms of title, full senior technologists, associate senior technologist, technologist-in-charge, technologist, and technician in the participants accounted for 0.5%, 5.8%, 32.5%, 52.2%, and 8.2%, respectively. The participants with years of employment of 0-, 5-, 10-, 20-y accounted for 33.74%, 25.79%, 25.51%, and 14.96%, respectively. The majors of the participants included medical imaging/imaging technology (45.9%), clinical medicine (19.1%), and biomedical engineering (11.9%).Conclusions:Chinese radiotherapists tend to be younger and are rapidly increasing in number. Employers should attach importance to the career planningand continuing education of radiotherapists to improve their technical skills, in order to fully satisfy the demand for radiotherapists in the new era.

To detect the expression of galectin-13 in allergic diseases and provide a new way for the diagnosis and treatment of allergic diseases. A retrospective analysis method was used to screen 216 patients with allergic diseases with house dust mites or aspergillus as allergens who visited the Department of Allergy and Department of Respiratory of Tongji Hospital attached Tongji Medical College, Huazhong University of Science and Technology from March 2018 to May 2021. These allergic diseases included allergic asthma, allergic bronchopulmonary aspergillosis, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, allergic urticaria. 25 subjects without underlying diseases were selected as healthy controls. The galectin-13 content in serum in each group were detected, and the Pearson correlation was used to determine the correlation between the galectin-13 content in serum in each group and blood eosinophil count, blood specific IgE, the score scale of allergic disease. The expression of Galectin-13 was increased in allergic asthma group (71.44±39.44) pg/ml, allergic bronchopulmonary aspergillosis group (100.10±47.62) pg/ml, allergic rhinitis group (54.11±24.81) pg/ml and dermatitis group (44.12±19.51) pg/ml. The expression of galectin-13 was not significantly increased in allergic urticaria group (32.75±10.29) pg/ml and the allergic conjunctivitis group (30.55±9.87) pg/ml. The galectin-13 content in serum, was positively correlated with blood eosinophil count( r s=0.54, P<0.001) and house dust mite specific IgE ( r s=0.51, P<0.001) in allergic asthma group, and was positively correlated with blood eosinophil count( r s=0.63, P=0.025) and aspergillus fumigatus specific IgE ( r s=0.58, P=0.046) in allergic bronchopulmonary aspergillosis group. It was positively correlated with blood eosinophil count ( r s=0.52, P=0.000 2) and house dust mite specific IgE ( r s=0.41, P=0.005) in allergic rhinitis group. In allergic conjunctivitis group, the expression of galectin-13 was positively correlated with conjunctivitis symptom score ( r s=0.47, P=0.048). In atopic dermatitis group, the expression of galectin-13 was positively correlated with blood eosinophil count ( r s=0.58, P<0.001) and house dust mite specificity IgE ( r s=0.47, P=0.002). In allergic urticaria group, the expression of galectin-13 was not significantly correlated with blood eosinophil count or house dust mite specific IgE. Galectin-13 may be related to the occurrence and progress of allergic diseases and may be involved in the occurrence of eosinophilic inflammation.

To detect the expression of galectin-13 in allergic diseases and provide a new way for the diagnosis and treatment of allergic diseases. A retrospective analysis method was used to screen 216 patients with allergic diseases with house dust mites or aspergillus as allergens who visited the Department of Allergy and Department of Respiratory of Tongji Hospital attached Tongji Medical College, Huazhong University of Science and Technology from March 2018 to May 2021. These allergic diseases included allergic asthma, allergic bronchopulmonary aspergillosis, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, allergic urticaria. 25 subjects without underlying diseases were selected as healthy controls. The galectin-13 content in serum in each group were detected, and the Pearson correlation was used to determine the correlation between the galectin-13 content in serum in each group and blood eosinophil count, blood specific IgE, the score scale of allergic disease. The expression of Galectin-13 was increased in allergic asthma group (71.44±39.44) pg/ml, allergic bronchopulmonary aspergillosis group (100.10±47.62) pg/ml, allergic rhinitis group (54.11±24.81) pg/ml and dermatitis group (44.12±19.51) pg/ml. The expression of galectin-13 was not significantly increased in allergic urticaria group (32.75±10.29) pg/ml and the allergic conjunctivitis group (30.55±9.87) pg/ml. The galectin-13 content in serum, was positively correlated with blood eosinophil count( r s=0.54, P<0.001) and house dust mite specific IgE ( r s=0.51, P<0.001) in allergic asthma group, and was positively correlated with blood eosinophil count( r s=0.63, P=0.025) and aspergillus fumigatus specific IgE ( r s=0.58, P=0.046) in allergic bronchopulmonary aspergillosis group. It was positively correlated with blood eosinophil count ( r s=0.52, P=0.000 2) and house dust mite specific IgE ( r s=0.41, P=0.005) in allergic rhinitis group. In allergic conjunctivitis group, the expression of galectin-13 was positively correlated with conjunctivitis symptom score ( r s=0.47, P=0.048). In atopic dermatitis group, the expression of galectin-13 was positively correlated with blood eosinophil count ( r s=0.58, P<0.001) and house dust mite specificity IgE ( r s=0.47, P=0.002). In allergic urticaria group, the expression of galectin-13 was not significantly correlated with blood eosinophil count or house dust mite specific IgE. Galectin-13 may be related to the occurrence and progress of allergic diseases and may be involved in the occurrence of eosinophilic inflammation.

Objective: To evaluate the short-term efficacy of one-stage reverse shoulder arthroplasty in the treatment of complex proximal humeral fractures in the elderly. Methods: Data of 43 elderly patients with complex proximal humeral fractures who were treated by reverse shoulder arthroplasty from July 2017 to January 2019 were retrospectively analyzed. There were 12 males and 31 females with an average age of 72 years (range, 66-78 years). All fractures were fresh and close which caused by trauma. The average time from injury to operation was 8.0 days (range, 6-11 days). According to Neer classification, 21 cases (48.8%, 21/43) were three-part fractures, 22 cases (51.2%, 22/43) four-part fractures. Visual analogue scale (VAS), Neer shoulder replacement evaluation system and Constant-Murley score were used to evaluate the postoperative results. Results: All operations were successfully completed. The average operation time was 141.3 minutes (range, 120-170 minutes. The mean blood loss was 407 ml (range, 250-700 ml) and intraoperative blood transfusion was 446.5 ml (range, 400-800 ml). All patients were followed up for 10.9 months (range, 6 to 16 months). All patients were discharged within 7 days after operation, and no wounds related complications occurred. The bigger and lesser tuberosities of all patients healed completely within 8 weeks. At the latest follow-up, no loosening or dislocation of prosthesis occurred, and the forward elevation was 133.0° (range, 100°-165°); external rotation was 29.5° (range, 20°-35°); internal rotation was 46.7° (range, 30°-60°). VAS score was 0.8 (range, 0-3). The Neer score was 87 (range, 73-98), with 20 cases (46.5%, 20/43) excellent, 16 cases (37.2%, 16/43) good, and 7 cases (16.3%, 7/43) fair. Constant-Murley score was 88.7 (range, 70-98). A 71-year-old patient had symptoms of axillary nerve injury after operation and recovered completely 6 weeks after the operation, which did not affect the functional rehabilitation exercise or the stability of the prosthesis. During the follow-up, no other complications such as infection, acromial stress fracture and scapular notching were found in all patients. Conclusion The short-term effect of one-stage reverse shoulder arthroplasty for the treatment of complex proximal humeral fractures in the elderly is satisfactory.

Objective: To study the toxicological effects of Nao-de-kang on rats. Methods: According to the digital table, SD rats were randomly divided into blank group and Nao-de-kang small dose group(3.85g/kg), high dose group(7.71g/kg) and maximum tolerated dose group(77.14g/kg), 20 rats in each group, half male and half female.All groups were treated for 12 weeks, and the maximum tolerated dose group was treated for 1 week.The animal activity during treatment, the blood routine indicators, blood biochemical index and the organs for pathological examination were recorded and compared. Results: There was no mortality in the dose group of rats in the experimental period.The weights of 4 groups had no statistically significant differences during treatment(F=0.688, 0.540, 0.121, 0.065, 0.128, 0.239, 0.199, 0.378, 0.127, 0.446, 0.906 and 0.665, P=0.562, 0.585, 0.886, 0.937, 0.880, 0.788, 0.820, 0.687, 0.881, 0.642, 0.410 and 0.518), male and femal′s red blood cell(RBC)(♀: F=0.178, P=0.910, ♂: F=0.119, P=0.948), hemoglobin(HGB)(♀: F=0.046, P=0.987, ♂: F=0.072, P=0.975), hematokrit(HCT)(♀: F=0.126, P=0.944, ♂: F=0.054, P=0.983), platelet(PLT)(♀: F=0.515, P=0.675, ♂: F=0.500, P=0.685), white blood cell(WBC)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), eosnophils(Eos)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), lymphocyte(Lym)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), neutrophilic granulocyte(Neu)(♀: F=0.134, P=0.939, ♂: F=0.090, P=0.999), alanine aminotransfease (ALT)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), aspartate aminotransferase(AST)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), total protein(TP)(♀: F=0.665, P=0.579, ♂: F=0.343, P=0.795), albumin(ALB)(♀: F=0.533, P=0.663, ♂: F=0.668, P=0.577), triglyceride(TG)(♀: F=0.843, P=0.480, ♂: F=0.561, P=0.644), cholesterol(CHOL)(♀: F=0.245, P=0.864, ♂: F=0.046, P=0.987), glucose(GLU)(♀: F=0.216, P=0.884, ♂: F=0.095, P=0.963), urea nitrogen(BUN)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894)and creatinine(Cr)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894) had no statistically significant differences. Conclusion Nao-de-kang has no obvious side effect.