Objective To investigate the molecular mechanism of ferroptosis in glioblastoma(GBM)and to provide insights for identifying new therapeutic targets.Methods GSE108474 was selected from gene expression omnibus(GEO)database and differentially expressed genes(DEGs)in GBM were obtained by using GEO2R,compared with the gene set in the Ferroptosis database(FerrDb)to identify ferroptosis-related gene.GO and KEGG enrich-ment analyses were conducted using DAVID database.A protein-protein interaction network was created using String website.Hub genes with high connectivity were confirmed using Cytoscape software.Prognostic and immune infiltration analyses were performed using TIMER website.RNA expression levels and gene correlation analyses were carried out using GEPIA website.Differential expression of hub gene proteins was analyzed by using the HPA database.Tumor immune characteristic correlations were examined using TISIDB database.Differences in mRNA expression of hub genes between tumor cells A172 and U251MG and normal astrocytes HA1800 were compared u-sing the quantitative real-time PCR.Results Out of 5 331 differentially expressed genes,114 were related to fer-roptosis.GO and KEGG enrichment analysis suggested that these 114 genes might play roles in positive regulation of gene expression,and affect tumor progression through ferroptosis and autophagy pathways.10 hub genes were i-dentified in the protein-protein interaction network,among which cluster of differentiation 44(CD44),murine double minute 2(MDM2)and signal transducer and activator of transcription 3(STAT3)were found to be highly expressed in tumors with lower survival rates.CD44,MDM2 and STAT3 mRNA expression were higher in GBM cells compared to normal cells.Protein expression of CD44,MDM2 and STAT3 was higher in high-grade glioma tis-sues than that in normal tissues.The expression of three genes in the tumor was negatively correlated with ferropto-sis.Immune infiltration analysis revealed that CD44,MDM2 and STAT3 in the tumor were related to the infiltration of neutrophils,CD4+T cells,and dendritic cells,and the expression of three genes was related to various chemo-kines and their receptors.Conclusion CD44,MDM2 and STAT3 may play a role in tumor ferroptosis and immune regulation,which have the potential to become a therapeutic target for GBM.

Objective:To explore the probability of causation method ology of male breast cancer and to provide theoretical basis for the diagnosis of occupational radiogenic male breast cancer in China.Methods:Using the male excess relative risk model (EAR) fitted from the Japanese atomic bomb survivors and the female excess absolute risk model (ERR) provided by the Biological Effect of Ionizing Radiation Committee VII (BEIRVII), the breast dose and the probability of causation of the previous case of male breast cancer were calculated.Results:The average probability of causation ( PC) calculated by male ERR model was 94.6%, and the upper limit of 95% PC was 98.3%. Using female EAR model and female breast cancer incidence, the average PC was 70.3%, and the upper limit of 95% PC was 153.3%. when male breast cancer incidence was used, the average PC was 99.2%.By both methods, the male breast cancer patient could be determined to be caused by occupational radiation exposure. Conclusions:The upper limit of 95% PC calculated by female EAR model and female breast cancer incidence was higher than that by male ERR model.The uncertainty of probability of causation for female EAR model still need further research. Occupational radiogenic male breast was proposed to listed in occupational radiogenic neoplasms, which will make the list more perfect and scientific and reasonable to meet potential claims.

Objective: To investigate the mechanism of lncRNA XIST (XIST) on modulating gastric cancer progression via regulating miR-337-3p/HOXC8 axis. Methods: A total of 58 cases of gastric cancer tissues and corresponding para-cancerous tissues resected from March 2013 to January 2018 in Department of General Surgery, Kailuan General Hospital of Tangshan City were collected for this study; in addition, human gastric cancer cell lines (AGS, MGC803, HGC27) and human gastric mucosal GES-1 cells were also collected. qPCR was used to detect the expressions of XIST and miR-337-3p in above mentioned gastric tissues and cell lines. XIST-knockdown vectors, miR-337-3p mimics, miR-337-3p inhibitor and HOXC8-overexpression vectors were transfected into AGS cells. The proliferation and invasion of AGS cells were detected by CCK-8 and Transwell experiments respectively, and the expression levels of HOXC8, E-cadherin, N-cadherin and vimentin were detected by WB. The targeting relationships between XIST, miR337-3p and HOXC8 were verified by dual-luciferase reporter gene assay. Results: XIST was up-regulated in gastric cancer tissues and cell lines (all P<0.01). XIST knockdown significantly inhibited proliferation, invasion and EMT of AGS cells (P<0.05 or P<0.01). Moreover, XIST directly interacted with miR-337-3p and down-regulated its expression, while HOXC8 was the target gene of miR-3373p. Furthermore, XIST knockdown suppressed proliferation, invasion and EMT ofAGS cells through up-regulating the inhibitory effect of miR-337-3p on HOXC8 (P<0.05 or P<0.01). Conclusion: XIST knockdown can suppress the proliferation, invasion and EMT of AGS cells, which may be related with down-regulation of HOXC8 by targeting miR-337-3p.

Objective To explore the clinical effect of Tongbi capsule combined with acupuncture for the patients with knee osteoarthritis and explore the mechanism of inflammatory response and hemorrheology. Methods According to the random table method, 88 KOA patients in our hospital from February 2016 to January 2017 were divided into the control group and the research group with 44 in each group. Patients in the control group were treated bycelecoxib capsule, while the patients in the research group were treated by Tongbi capsule combined with acupuncture. The treatment courses of two groups were two months. The clinical total effective rate of two groups of patients were compared after treatment. At the same time, the osteoarthritis index visual scale (WOMAC) and morning stiffness, joint tenderness index score were detected and compared after the treatment.The levels of serum tumor necrosis factor-α(TNF-α), interleukin (IL)-1β and IL-6 were detected by enzyme linked immunosorbent assay before and after the treatment. The hemorheology indexes were tested by automatic biochemical analyzer. In addition, the incidence of adverse reactions of two groups of patients was observed during treatment. Results The clinical total effective rate of the research group was 93.18％ (41/44), which was significantly higher than the control group72.73％ (32/44), and the difference was statistically significant (χ2=6.510, P=0.011). After treatment, the WOMAC (31.26 ± 6.12 vs. 36.17 ± 7.09, t=-3.477), joint tenderness index (1.75 ± 0.46 vs. 2.11 ± 0.54, t=-3.366) and morning stiffness score (1.62 ± 0.53 vs. 2.14 ± 0.51, t=-4.690) of the research group were significantly lower than those of the control group (P<0.05). The levels of TNF-α (7.36 ± 1.45 pg/ml vs. 8.02 ± 1.54 pg/ml, t=-2.070), IL-1β (27.82 ± 5.22 μg/ml vs. 33.05 ± 5.17 μg/ml, t=-4.722), IL-6 (2.81 ± 0.58 ng/ml vs. 3.34 ± 0.53 ng/ml, t=-4.475) of the research group were significantly lower than those of the control group (P<0.05). The whole blood high shear viscosity (12.09 ± 3.46 mPa?s vs. 14.22 ± 3.51 mPa?s, t=-2.867), whole blood low shear viscosity (2.53 ± 0.68 mPa?s vs. 3.32 ± 0.71 mPa?s, t=-5.330), whole blood viscosity (1.35 ± 0.29 mPa?s vs. 1.60 ± 0.41 mPa?s, t=-3.302), erythrocyte sedimentation rate (7.10 ± 2.06 mm/h vs. 8.02 ± 2.13 mm/h, t=-2.059), fibrinogen (2.71 ± 0.53 g/L vs. 3.42 ± 0.65 g/L, t=-5.615) and erythrocyte deformation index (0.57 ± 0.16 vs. 0.71 ± 0.19, t=-3.739) of the research group were significantly lower than those of the control group (P<0.05). The incidence of adverse reactions of control group was 11.37％ (5/44), while the incidence of adverse reactions of resarch group was 6.82％ (3/44), which the difference of the incidence of adverse reactions between two groups showed no statistical significance (χ2=0.550, P=0.458). Conclusions The Tongbi capsule combined with acupuncture can reduce the degree of inflammation, and also improve hemorheology indexes of KOA patients.

With the increasing use of contrast agents,contrast medium-induced acute kidney injury(CI-AKI)has become one of the most important causes of hospital-acquired AKI.The study of adult population showed that the incidence of CI-AKI was approximately 11.0%,CI-AKI extend the patient's prolonged hospitalization,in-creased mortality and increased rates of cardiovascular events.However,little research is available regarding CI-AKI incidence,risk factors,prognostic impact and preventive measures in the pediatric population.How to improve the pre-vention and treatment level of CI-AKI in children is a challenge for pediatricians.

Objective To explore the effect of nursing project management on reducing the incidence of perioperative pressure injury during laparoscopic pancreaticoduodenectomy. Methods The pressure ulcers conditions of 41 cases undergoing laparoscopic resection of pancreatic duodenal from December 2014 to July 2015 were investigated to find out the causes of the incidence of pressure ulcers, and we made pertinent measures for continuous quality improvement. From August 2015 to March 2016, 45 patients underwent laparoscopic pancreatoduodenectomy received nursing project management nursing care. Two groups of patients in terms of the incidence of pressure ulcers, pressure ulcer risk assessment accuracy and implementation rate of patient skin specification handover were compared. Results The incidences of laparoscopic resection of pancreatic duodenal ulcer decreased from 24.39% before the improvement of the project to 2.22%, the accuracy of nurse on the laparoscopic resection of pancreatic duodenal ulcer risk assessment increased from 75.60% to 95.55%, the implementation rate of patient skin specification handover increased from 82.93% to 97.78%, the differences were statistically significant (P<0.05). Conclusions The implementation of nursing program can reduce the incidence of pressure injury and improve the quality of nursing in perioperative period of laparoscopic pancreaticoduodenectomy.

Chinese national standard GBZ 97-2017 Judgment Standards for Occupational Radiogenic Neoplasms was published and will replace the current version Judgment Criteria for Cause of Radiogenic Neoplasms from November 1 in 2017. Background on which this new national standard was based, its main modifications and the necessity, choice for judgment value, choice for types of neoplasms were explained. Uncertainty of methodology not-modified in the GBZ 97-2017 was discussed. Possible misunderstood issues were explained. Finally, advices on correct application of the GBZ 97-2017 were proposed.

Objective To investigate the value of quantitative analysis of the left ventricular longitudinal strain in patients with hypertrophic cardiomyopathy (HCM) and with normal left ventricular ejection fraction (LVEF) by using two-dimensional speckle tracking imaging.Methods Twenty-eight HCM patients with normal LVEF (all of the cases were non obstructive HCM),who were diagnosed by clinical and ultrasound echocardiography between January 1,2015 and January 1,2016 in the First Affiliated Hospital of Dalian Medical University,served as the experimental group.And twenty healthy volunteers served as the healthy control group.The peak longitudinal strain (LPS) of the left ventricle and the systolic peak of the left ventricle were calculated by the STE technique.The indexes such as the transmural gradient (△ LS=LPSEndo-LPSEpi)and the transmural gradient percentage (△ LS％=△ LS/LPSEndo) were calculated.The Peak systolic longitudinal strain of endocardium (LPSEndo),the peak systolic longitudinal strain of mid-cardium (LPSMid),the peak systolic longitudinal strain of epicardium (LPSEpi),the peak systolic longitudinal strain of basal segment (LPSb),the peak systolic longitudinal strain of middle segment (LPSm),the peak systolic longitudinal strain of apical segment (LPSa),the global peak systolic longitudinal strain (GLPS) and other left ventricular myocardial strain,such as △ LS,△ LS％,in both the HCM group and the healthy control group,were analyzed by using independent samples t test comparison.For each layer of the left ventricle and the overall myocardial longitudinal strain,two independent sample t test was used for comparison between groups,and LSD-t test was used for intra-group comparison.Results (1) There was a gradient of LPS among the three layers and the three segments in both of the two groups:LPSEndo and LPSMid [(18.36±4.97)％ vs (13.80±4.23)％,(26.41±2.93)％ vs (22.19±2.49)％],the difference was statistically significant (t=5.550,8.529,P ＜ 0.05);LPSEndo and LPSEpi [(18.36±4.97) ％ vs (11.91 ±3.63)％,(26.41±2.93)％ vs (19.43±2.20)％],the difference was statistically significant (t=5.550,8.529,P ＜ 0.05);There was significant difference between LPSMid and LPSEpi in the healthy control group [(22.19 ± 2.49)％ vs (19.43 ± 2.20)％,t=3.709,P ＜ 0.05)],that was,LPSEndo ＞ LPSMid ＞ LPSEpi.LPSa and LPSm,the difference was statistically significant (t=4.029,6.839,P ＜ 0.05);LPSa and LPSb,the difference was statistically significant (t=5.304,9.887,P ＜ 0.05);There was significant difference between LPSm and LPSb in the healthy control group (t=4.170,P ＜ 0.05);that was,LPSa ＞ LPSm ＞ LPSb.In the HCM group,LPS in the 3 layers,3 segments,and the whole left ventricular wall were lower than that of the the healthy control group,the differences were statistically significant [GLPS:(14.63± 3.75)％ vs (22.68±2.51)％,t=-8.347;LPSEndo to LPSEpi:t=-6.477,-7.909,-8.242;LPSa to LPSb:t=-6.647,-8.790,-7.267;all P ＜ 0.05).(2) Compared with the healthy control group,both the segmental gradient and global transmural gradient in the HCM group were found reduced,but the difference had no statistical significance (all P ＞ 0.05).(3) The transmural gradient percentage both in the healthy control group and the HCM group were reduced from the apical segment to the basal segment,the difference were statistically significant (HCM group:t=9.985,5.969;healthy control group:t=17.513,7.043;all P ＜ 0.05).Compared with the healthy control group,the △ LS％a and the △ LS％m of HCM group were significantly higher [(58.86± 11.32)％ vs (43.70±4.73)％,(28.43± 11.48)％ vs (20.30± 3.66)％],and the difference was statistically significant (t=5.634,3.049,all P ＜ 0.05).Conclusions (1) Using 2D-STI could accurately determine the regional or the global left ventricular systolic function in patients with HCM.(2) The transmural gradient percentage can be more sensitive to reflect the change of the transmural gradient,and more research needed to explore its value for clinical application.

Objective: To evaluate left atrial (LA) function and synchrony in lone atrial fibrillation (LAF) patients by two-dimensional speckle tracking echocardiography (2D-STE) and to explore the predictive value of 2D-STE parameters for AF recurrence after ablation procedure. Methods: Our research included in 2 groups: LAF group,n=50 patients diagnosed in our hospital from 2013-06 to 2015-05; it was further divided into 2 subgroups as Non-LA enlargement subgroup,n=34 and LA enlargement subgroup,n=16 and Control group,n=35 healthy subjects. With sinus rhythm, 2D-STE was conducted to obtain LA peak ventricular systolic longitudinal strain (PALS), strain rate (SRs) and atrial contraction longitudinal strain (ACLS), strain rate (SRa). Standard deviation for the time to peak (TPSD) of regional strain was calculated. TPSD during ventricular systole was named as SDs and TPSD during ventriculardiastole was named asSDa. Results: Compared with Control group, LAF group had reduced PALS (28.34±8.57) vs (38.73±6.13), SRs (1.17±0.31) vs (1.57±0.25), ACLS (14.11±4.91) vs (18.86±3.57 ) and SRa (-1.41±0.58) vs (-1.90±0.30), allP<0.05; while elevated SDs (8.11±3.00) % vs (4.67±1.48) % and SDa (5.57±2.26) % vs (3.11±1.13) %, bothP<0.05. Furthermore, Compared with Control group, Non-LA enlargement subgroup had decreased PALS, SRs, ACLS and SRa, allP<0.05; while increased SDs and SDa, bothP<0.05. Logistic regression analysis indicated that compared with traditional parameters, SDs and SDa could more effectively distinguish LAF patients from normal subjects (SDs with the sensitivity 83%, speciifcity 72% and SDa with the sensitivity 81%, speciifcity 76%). Elevated SDa and SDs were the best predictors for post-operative AF recurrence (SDs with the sensitivity 80%, speciifcity 71% and SDa with the sensitivity 86%, speciifcity 79%). Conclusion: 2D-STE may detect LA dysfunction and dyssynchrony in LAF patients, abnormal parameters could be found in LAF patients without LA enlargement. SDs and SDa were the best predictors for post-operative AF recurrence.

Objective: To study the value of speckle tracking echocardiography (STE) for assessing left ventricular remodeling (LVR) in patients of acute ST-elevation myocardial infarction (STEMI) with late percutaneous coronary intervention (PCI). Methods: A total of 127 STEMI patients with elective PCI were enrolled. Echocardiography was conducted within 48 hours of admission and the patients were followed-up for 6-9 (median 7.8) months after discharge. LVR was deifned by left ventricular end-systolic volume (LVESV) elevation >15% than the ifrst echocardiography. The patients were divided into 2 groups: LVR group,n=41 and Non-LVR group,n=84. Results: There were significant differences between 2 groups in left ventricular global longitudinal strain (GLS), longitudinal Ts-SD, radial strain (RS) and longitudinal postsystolic index. Further Logistic regression analysis indicated that GLS (OR=0.39, 95% CI 0.26-0.57,P<0.01) and RS (OR=1.07, 95% CI 1.02-1.13,P=0.01) were the independent predictors for LVR occurrence; ROC presented that the optimal cut-off value for GLS was -10.85% (sensitivity 89.7%, specificity 91.7%) and for RS was 28.46% (sensitivity 82.1%, speciifcity 66.7%). Conclusion: STE measured GLS and RS were the independent predictors for LVR occurrence in STEMI patients with late PCI.