With the rapid development of radiotherapy technology, the therapeutic outcomes of tumor patients have improved significantly, enabling effective disease control. However, during radiotherapy, the skin as the first barrier of the human body is inevitably exposed to radiation, leading to superficial skin injury. This injury often manifests as blistering, cracking, bleeding, and ulceration, resulting in wounds that are difficult to heal and potentially affecting the effectiveness of the treatment. At present, the therapeutic effect of drugs on radiation-induced skin injury remains limited, and the development of new drugs depends on the elucidation of the mechanisms. Therefore, it is crucial to investigate the mechanisms of radiation-induced skin injury. This article reviews these mechanisms, including DNA damage, oxidative stress, inflammatory response, and vascular damage and fibrosis, and summarizes the therapeutic drugs and targeted proteins in recent years, aiming to provide a reference for the further development and clinical application of drugs for radiation-induced skin injury.

BACKGROUND:Nanocomposite hydrogel has great research prospects and application potential in the treatment of osteoarthritis. OBJECTIVE:To review the research progress of nanocomposite hydrogel in osteoarthritis and cartilage repair. METHODS:Databases such as CNKI and PubMed were searched.The English key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,electrostatic interaction,covalent crosslinking",and the Chinese key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,physical encapsulation,electrostatic effect,covalent cross-linking".After an initial screening of all articles based on inclusion and exclusion criteria,71 articles with high correlation were retained for review. RESULTS AND CONCLUSION:In cell or animal experiments,nanocomposite hydrogel has the effect of improving osteoarthritis.Nanocomposite hydrogel can promote cartilage repair,improve the internal environment of osteoarthritis,and achieve the therapeutic purpose of osteoarthritis by improving the mechanical environment between joints,carrying targeted drugs,and promoting the chondrogenesis of seed cells.At present,the research of nanocomposite hydrogel in osteoarthritis disease still has a huge space to play.It is expected to open up a new way for the clinical treatment of osteoarthritis by continuing to deepen the research of material preparation and actively carrying out cell and animal experiments.

With the rapid development of radiotherapy technology, the therapeutic outcomes of tumor patients have improved significantly, enabling effective disease control. However, during radiotherapy, the skin as the first barrier of the human body is inevitably exposed to radiation, leading to superficial skin injury. This injury often manifests as blistering, cracking, bleeding, and ulceration, resulting in wounds that are difficult to heal and potentially affecting the effectiveness of the treatment. At present, the therapeutic effect of drugs on radiation-induced skin injury remains limited, and the development of new drugs depends on the elucidation of the mechanisms. Therefore, it is crucial to investigate the mechanisms of radiation-induced skin injury. This article reviews these mechanisms, including DNA damage, oxidative stress, inflammatory response, and vascular damage and fibrosis, and summarizes the therapeutic drugs and targeted proteins in recent years, aiming to provide a reference for the further development and clinical application of drugs for radiation-induced skin injury.

With the development of population aging, the incidence of lower limb artery ischemic diseases is gradually increasing. Although various treatments such as medication and endovascular surgery are currently available, patients with compromised microcirculation in the distal limbs and poor outflow pathways often do not achieve satisfactory results. Additionally, these treatments can be costly, and long-term patency rates are not ideal. The amendment in situ autologous great saphenous vein arterialization surgery utilizes the patient′s great saphenous vein to provide arterial blood in a retrograde manner and re-establishes blood supply to the tissues through the venous microcirculation system in the distal foot. This approach can achieve good limb salvage results and long-term patency. Therefore, this article aims to elaborate on the methods and value of amendment in situ autologous great saphenous vein arterialization surgery.

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*

Objective:To investigate the influence of the depth of invasion on the prognosis of pT1 stage mid-thoracic esophageal cancer patients undergoing left thoracotomy.Methods:Retrospectively analyze the clinicopathological data of 139 patients with pT1N0M0 stage of mid-thoracic esophageal cancer who meet the enrollment criteria. Firstly, the prognosis and influencing factors of the whole group were analyzed. The differences in prognosis, local recurrence and distant metastasis between PT1A and PT1B patients were compared, and the influence of different infiltration depth on prognosis and treatment failure of patients was analyzed. SPSS 19.0 statistical software was used for statistical analysis.Results:The 1-year, 3-year and 5-year overall survival(OS) and disease-free survival(DFS) were 95.0%, 87.8%, 82.0% and 91.4%, 84.2%, 77.0%, respectively. There were significant differences in OS( χ2=7.500, P=0.006) and DFS( χ2=7.354, P=0.007) at 1, 3 and 5 years between pT1a and pT1b patients. Cox multivariate analysis showed that pT stage and pathological type were independent prognostic factors for OS and DFS( P<0.05). There were no significant differences in OS( χ2=0.734, P=0.693) and DFS( χ2=0.7690, P=0.681) of pT1a tumors with different invasion depths. There were significant differences in OS( χ2=15.368, P<0.001) and DFS( χ2=27.470, P<0.001) at 1, 3 and 5 years of pT1b tumors with different invasion depths. The recurrence rate of pT1b(23.8%) was significantly higher than that of pT1a(5.3%)( χ2=5.274, P=0.022). The distant metastasis rate of the former(10.9%) was also significantly higher than that of the latter(0)( χ2=4.494, P=0.034). There were significant differences in local recurrence rate( χ2=17.051, P<0.001) and distant metastasis rate( χ2=15.460, P<0.001) among pT1b patients with different infiltration depths. Logistic multivariate analysis showed that the depth of infiltration was an independent factor affecting the occurrence of local recurrence in stage pT1b patients after treatment( P<0.001). Pathological type( P=0.003) and infiltration depth( P=0.027) were independent factors affecting the occurrence of distant metastasis. Conclusion:pT1a period and pT1b period after the prognosis and treatment of patients with different failure modes, and pT1b period in patients with different infiltration depth and the prognosis of patients and its failure mode after treatment significantly related, infiltration depth of pT1b period after treatment in patients with the independence of the influencing factors of failure, suggest that clinical doctors should pay attention to pT1b period in patients with postoperative adjuvant therapy. This conclusion needs to be confirmed by large prospective studies of cases.

Objective    To explore the feasibility of early chest tube removal following single-direction uniportal video-assisted thoracoscopic surgery (S-UVATS) anatomical lobectomy. Methods    The clinical data of consecutive VATS lobectomy by different surgeons in Xuzhou Central Hospital between May 2019 and February 2022 were retrospectively reviewed. Finally, the data of 1 084 patients were selected for analysis, including 538 males and 546 females, with a mean age of 61.0±10.1 years. These patients were divided into a S-UVATS group with 558 patients and a conventional group (C-UVATS) with 526 patients according to the surgical procedures. The perioperative parameters such as operation time, blood loss were recorded. In addition, we assessed the amount of residual pleural effusion and the probability of secondary thoracentesis when taking 300 mL/d and 450 mL/d as the threshold of chest tube removal. Results    Tumor-negative   surgical margin was achieved without mortality in this cohort. As compared with the C-UVATS group, patients in the S-UVATS group demonstrated significantly shorter operation time (P<0.001), less blood loss (P=0.002), lower rate of conversion to multiple-port VATS or thoracotomy (P=0.003), but more stations and numbers of dissected lymph nodes as well as less suture staplers (P<0.001). Moreover, patients in the S-UVATS demonstrated shorter chest tube duration, less total volume of thoracic drainage and shorter postoperative hospital stay, with statistical differences (P<0.001). After excluding patients of chylothorax and prolonged air leaks>7 d, subgroup analysis was performed. First, assuming that 300 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, patients in the S-UVATS group would report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Second, assuming that 450 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, the S-UVATS group would also report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Further multivariable logistic regression analysis indicated that S-UVATS was significantly negatively related to drainage volume>1 000 mL (P<0.05); whereas combined lobectomy, longer operation time, more blood loss and air leakage were independent risk factors correlated with drainage volume>1 000 mL following UVATS lobectomy (P<0.05). Conclusion    The short-term efficacy of S-UVATS lobectomy is significantly better than that of the conventional group, indicating shorter operation time and less chest drainage. However, early chest tube removal with a high threshold of thoracic drainage volume probably increases the risk of secondary thoracentesis due to residual pleural effusion.

Objective    To explore the treatment outcome of carotid endarterectomy combined with vertebral artery transposition in patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery. Methods    From June 2017 to September 2020, patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery treated with carotid endarterectomy combined with vertebral artery transposition in Fuwai Hospital were retrospectively analyzed. Results    Finally 12 patients were enrolled, including 10 males and 2 females with an average age of 67.8±6.0 years. Twelve patients were successfully operated and the follow-up time was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 83.5%±11.8% to 24.9%±14.3% (P<0.001). The stenosis degree of carotid artery decreased from 85.6%±11.0% to 0% (P<0.001). Postoperative follow-up showed that the symptoms of symptomatic patients before surgery improved. The 1-year and 3-year patency rates were 100.0%, and there were no peripheral nerve injury complications, perioperative deaths or strokes. Conclusion    Carotid endarterectomy combined with vertebral artery transposition can treat ipsilateral carotid artery  stenosis and vertebral artery stenosis at the same time, improve blood supply to the brain, improve patients' symptoms and has high promotion value.

Objective:To investigate the promoting effect of Difrarel ? on retinal function following panretinal photocoagulation (PRP) in the eyes with diabetic retinopathy. Methods:A non-randomized controlled study was performed.A total of 108 eyes of 108 patients with non-proliferative diabetic retinopathy (NPDR) were enrolled in Tongren Ophthalmology Center and Beijing Daxing District People's Hospital from December 2014 to February 2020.The patients were divided into PRP group and PRP+ Difrarel ? group according to different therapies under patients' selection.Difrarel ? was orally administered after PRP in 56 patients of PRP+ Difrarel ? group, and only PRP was given in 52 patients of PRP group.The visual acuity, 30°~60° circular visual field and multifocal electroretinogram were examined before and 1 day, 1 month, 3 months, 6 months, 12 months after PRP.The central macular thickness (CMT) was measured by optical coherence tomography, and fundus neovascularization was observed by fluorescein fundus angiography at 6 and 12 months after PRP.The study protocol was approved by an Ethics Committee of Beijing Daxing District People's Hospital (No.2021-F4). Results:Visual improvement rate was 57.14% (32/56) and 32.69% (17/52) in PRP+ Difrarel ? group and PRP group at the end of following-up, respectively, showing a significant difference between two groups ( χ2=3.56, P<0.05). The visual field mean sensitivity was significantly different at different time points in two groups ( Fgroup=4.77, P<0.05; Ftime=6.51, P<0.05), and was lower after PRP than those before treatment in both groups (both at P<0.05), and was significantly higher in PRP+ Difrarel ? group than PRP group at 3, 6, 12 months after PRP (all at P<0.05). The P1 amplitude density in 3 to 5 rings in PRP+ Difrarel ? group were higher than those in PRP group, and the differences were statistically significant (all at P<0.05). There was no significant difference in CMT between the two groups at different time points ( Fgroup=3.57, P>0.05; Ftime=1.23, P>0.05). No new blood vessels and non-perfusion area were found in both groups. Conclusions:Oral Difrarel ? can improve retinal function after PRP in the eyes with NPDR.

Objective    To investigate the treatment of modified vertebral-carotid transposition (VCT) in patients with severe stenosis or occlusion at V1 segment of vertebral artery. Methods    A retrospective study of 13 patients with severe stenosis or occlusion at V1 segment of vertebral artery treated by modified VCT in our hospital from October 2016 to December 2018 was done. There were 10 males and 3 females with an average age of 70.5±7.1 years. Results    The operation was successful in this series of patients. The follow-up duration was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 86.8%±7.5% to 17.4%±14.5%. All patients achieved remission of symptoms after the surgery. Temporary peripheral nerve injury occurred in 6 patients. Four patients with neurological complications relieved during follow-up. The patency rate was 100.0% at postoperative 1 and 3 years. There was no perioperative death, stroke or re-intervention. Conclusion    Modified VCT can precisely restore the distal blood flow of patients with severe stenosis or occlusion at V1 segment of vertebral artery, and relieve their symptoms.