Deoxycytidine kinase participates in the regulation of ionizing radiation induced ferroptosis in triple-negative breast cancer cells / 中华放射肿瘤学杂志

Objective:To investigate the regulatory effect of deoxycytidine kinase (dCK) on ionizing radiation (IR) induced ferroptosis in triple-negative breast cancer (TNBC).Methods:TNBC cell line MDA-MB-231 was used to establish dCK knockdown and different phosphorylation phenotypes cell models, and were treated with ferroptosis activator Erastin and / or ferroptosis inhibitor ferrostatin-1 (Fer-1) combined with / without X-ray irradiation. Cell viability was detected by MTT assay. The level of reactive oxygen species (ROS) was measured by 2′,7′-dichlorofluorescin diacetate (DCFH-DA) staining. The expression levels of dCK, transferrin, transferrin receptor (TfR1), ferroportin (FPN) and ferritin heavy chain 1 (FTH1) were detected by Western blot. Statistical analysis was performed by SPSS 17.0 and Origin 2021 software. Measurement data with normal distribution were expressed by Mean ±SD. The comparison between two groups was conducted by Student t-test. The comparison among three or more groups was performed by one-way analysis of variance. Results:In MDA-MB-231 cells, IR induced cell death was observed and Erastin significantly promoted radiation induced cell death, while Fer-1 was able to reverse radiation induced cell death. Compared with the control group, IR induced cell death was increased, the level of ROS was suppressed in the dCK knockdown group. Erastin combined with IR induced reduced cell death and weakened ROS level. Fer-1 reduced the degree of IR induced cell death, and it could not inhibit the induction of ROS by IR.Compared with the control cells, the rate of cell death was decreased induced by IR, the level of ROS was decreased, the expression of FTH1 was down-regulated after IR in the dCK wild-type (dCK-WT ) or dCK hyperphosphorylated (dCK-S74E) MDA-MB-231 cells. In addition, Erastin promotes IR induced cell death and increased ROS levels, while Fer-1 significantly enhances the degree of reversal of IR induced ROS and cell death in these cells. Conclusions:dCK phosphorylation increases ferroptosis induced by IR in TNBC cells. Targeting dCK may be a novel therapeutic approach to overcome radioresistance in TNBC treatment.

The efficacy and safety of recombinant human thrombopoietin in the treatment of thrombocytopenia caused by tumor radiotherapy / 国际肿瘤学杂志

Objective:To observe the efficacy and safety of recombinant human thrombopoietin (rhTPO) in the treatment of radiation induced thrombocytopenia (RIT) .Methods:From January 2019 to March 2021, 204 cases (including 101 cases of radiotherapy alone and 103 cases of concurrent chemoradiotherapy) were collected retrospectively after radiotherapy and with decreased in blood platelet count <75×10 9/L in Jilin Cancer Hospital. These patients received rhTPO 15 000 U, once a day, subcutaneous, for at least 4 consecutive days, or met the withdrawal criteria blood platelet count ≥100×10 9/L, or the absolute value of blood platelet increase ≥50×10 9/L. The characteristics of blood platelet decline, treatment efficacy, and safety were analyzed. Results:The numbers of radiotherapy treatments with platelets lower than 75×10 9/L in the radiotherapy alone group and the concurrent chemoradiotherapy group were 19 (13, 22) and 13 (10, 17) times, respectively, indicating that patients in the concurrent chemoradiotherapy group experienced platelet decline earlier ( Z=-5.27, P<0.001), the lowest values of platelet decline in the two groups were 68 (45, 74) ×10 9/L and 62 (44, 74) ×10 9/L, respectively, with no statistically significant difference ( Z=-1.15, P=0.252). After received rhTPO treatment, the numbers of days that the two groups of patients had platelets <50×10 9/L were 7 (3, 13) d and 7 (5, 11) d, respectively, with no statistically significant difference ( Z=-1.13, P=0.281). After the patients received radiotherapy, rhTPO was started when the platelet count dropped to <75×10 9/L. The number of days required to recover to 75×10 9/L was 4 (2, 10) d in the radiotherapy alone group and 4 (2, 8) d in the concurrent chemoradiotherapy group, with no statistically significant difference ( Z=-1.07, P=0.285) ; the number of days required for platelets to recover to 100×10 9/L or for the absolute value to increase by 50×10 9/L was 8 (6, 14) d in the radiotherapy alone group and 11 (8, 16) d in the concurrent chemoradiotherapy group. The recovery time of the concurrent chemoradiotherapy group was longer than that of the radiotherapy alone group ( Z=-3.64, P<0.001). Regardless of the baseline level, there was no statistically significant difference in the number of days for platelets to recover to 75×10 9/L after rhTPO treatment between the radiotherapy alone group and the concurrent chemoradiotherapy group ( Z=-1.42, P=0.155; Z=-0.97, P=0.332). The number of days required for the two groups of patients to recover to 100×10 9/L or for the absolute value to increase by 50×10 9/L were 8 (6, 14) d and 11 (8, 16) d, respectively, with a statistically significant difference ( Z=-3.64, P<0.001). The numbers of days required for the two groups of patients with baseline platelets ≥50×10 9/L to recover to 100×10 9/L or for the absolute value to increase by 50×10 9/L were 8 (4, 12) d and 10 (8, 16) d, respectively, with a statistically significant difference ( Z=-3.12, P=0.002). However, there was no statistically significant difference in the number of days required for the two groups of patients with baseline platelets <50×10 9/L to recover to 100×10 9/L or for the absolute value to increase by 50×10 9/L ( Z=-1.88, P=0.061). The total platelet elevation rate of rhTPO within 20 days of radiotherapy treatment for both groups of patients was 93.63% (191/204), of which 95.05% (96/101) was for radiotherapy alone and 92.23% (95/103) for concurrent chemoradiotherapy, with no statistically significant difference ( χ2=0.68, P=0.410). In addition, there was no statistically significant difference in gender ( χ2=3.47, P=0.063), age ( χ2=2.79, P=0.095), TNM staging ( χ2=5.07, P=0.167), and baseline platelet count ( χ2=0.62, P=0.822) between the two groups.During the radiotherapy cycle, 27 patients (13.23%) received blood platelet infusion, and 158 patients (77.45%) completed the radiotherapy plan without interruption. No rhTPO-related adverse reactions were found. Conclusion:rhTPO in the treatment for RIT can effectively promote the recovery of blood platelet without any adverse reactions, and has good safety.

Construction of competency norm of clinical nursing teachers in tertiary first-class hospitals in northwest China / 中华医学教育探索杂志

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Treatment of acetabular anterior column fracture with percutaneous screw fixation with laser-assisted axial fluoroscopy / 中华骨科杂志

Objective:To investigate the feasibility and clinical efficacy of percutaneous screw fixation for acetabular anterior column fracture with laser-assisted axial fluoroscopy.Methods:Data of 20 patients (22 sided) with acetabular anterior column fracture treated by percutaneous screw fixation with laser-assisted axial fluoroscopy from January 2017 to December 2018 were retrospectively analyzed. There were 11 males and 9 females with an average of 42.1±3.2 years (range, 24-68 years). There were 7 cases of unilateral acetabular anterior column fracture, 2 cases of bilateral acetabular anterior column fracture (4 sides), 7 cases of anterior column with ipsilateral sacral fracture, and 4 cases of anterior column with sacroiliac joint injury. There were 3 hips of Area I, 6 Area II, 13 Area III of acetabular anterior column fractures according to Nakatani partition. The time from injury to surgery was 5 days (range, 3-11 days). All patients with acetabular anterior column fractures were fixed by percutaneous screw fixation with laser-assisted axial fluoroscopy, and patients with sacral fracture or sacroiliac joint injury were fixed by percutaneous sacroiliac screws with Starr frame-assisted reduction. The time of operation, the number of intraoperative fluoroscopy and the amount of intraoperative bleeding were recorded. Matta scoring criteria were used to assess fracture reduction quality, and hip function was assessed at the last follow-up according to the modified Merle D' Aubigné and Postel scoring system.Results:The average operative time was 22±10 min (range, 20-40 min) with an average times of intraoperative fluoroscopy of 30±8 times (range, 21-45 times), and the amount of intraoperative blood loss was 20±5 ml (range, 10-40 ml). 20 patients were followed up after operation for a period of 14±3.1 months (range, 12-18 months). The quality of postoperative fracture reduction was assessed according to the Matta acetabular fracture reduction criteria: anatomical reduction in 18 hips, satisfactory reduction in 2 hips, unsatisfactory reduction in 2 hips, with an excellent and good rate of 91% (20/22). The fracture healing time was 13±2.2 weeks (range, 11-16 weeks). At the lastest follow-up, hip function was assessed according to the modified Merle D' Aubigné and Postel scoring system: excellent 18, good 3, fair 1, and the satisfactory rate was 95%(21/22). No major neurological, vascular injury, wound infection and ectopic ossification were found during follow-up.Conclusion:Using laser-assisted axial fluoroscopy percutaneous screw to treat acetabular anterior column fracture, the operation is simple. And there is low risk to damage important blood vessels and nerves. This method can shorten the operation time of acetabular anterior column fracture, reduce the amount of blood loss during the operation, and the outcome is satisfactory.

Minimal invasive subcutaneous internal fixator in treatment of anterior pelvic ring instability-analysis of effects and complications / 中华骨科杂志

Objective@#To investigate the incidence of complications following minimal invasive subcutaneous internal fixator (INFIX) for the treatment of anterior pelvic ring instability, and to analyze control measures.@*Methods@#Data of 42 patients with anterior pelvic ring instability who were treated by anterior subcutaneous internal fixation in our hospital from January 2016 to December 2017 were retrospectively analyzed. There were 15 females and 27 males with an average age of 45.4 years (range, 18-67 years). There were 26 traffic injuries, 10 falling injuries, 3 crush injuries and 3 low energy injuries. According to Tile classification, 24 cases of B2 type, 16 cases of B3 type, 1 case of C1 type and 1 case of C2 type. According to Young-Burgess classification, there were 20 cases of LCI, 18 cases of LCII, 1 case of LCIII, 1 case of APCI, 1 case of APCII, and 1 case of VS. Fourteen cases were combined with limb fractures, and 11 cases were combined with thoracic or abdominal injuries requiring surgical treatment, while 16 cases were with brain injuries. For type APC2, LC1, and some LC2 fractures, fixation for the anterior pelvic ring is enough with INFIX technique alone. For some LC2, LC3, or VS fractures, the anterior and posterior ring were both fixed. Postoperative reduction was evaluated by Matta radiological criteria. Lateral thigh numbness and pain, quadriceps muscle power were recorded during follow-up, and clinical efficacy was evaluated by Majeed score at 6 months after operation.@*Results@#All the 42 patients were followed up for 6 to 12 months, with an average of 9.3 months. Matta standard evaluation for fracture reduction showed that 28 cases were excellent, 14 cases good, and the excellent and good rate was 100%. The early complication rate (within 3 month after operation) was 23.8% (10/42) including 6 cases of lateral femoral cutaneous nerve injury and 2 cases of femoral nerve injury. The symptoms were obviously relieved after the treatment of nutrient nerve and hyperbaric oxygen; 1 case had incision infection which was healed after anti-infection therapy and internal plant removal; 1 case suffered from superior gluteal artery injury which was controlled by pressure hemostasis. Six months after surgery, no case had lost reduction. At 6 months follow-up, the Majeed score was 72-96, with an average of 84.96, of which 32 were excellent and 10 were good, thus the excellent and good rate was 100% (42/42).@*Conclusion@#INFIX is an effective internal fixation method for the treatment of unstable anterior pelvic ring injury. However, it has a high rate of early complications, among which nerve injury has the highest incidence.

Minimal invasive subcutaneous internal fixator in treatment of anterior pelvic ring instability?analysis of effects and complications / 中华骨科杂志

Objective To investigate the incidence of complications following minimal invasive subcutaneous internal fixator (INFIX) for the treatment of anterior pelvic ring instability, and to analyze control measures. Methods Data of 42 patients with anterior pelvic ring instability who were treated by anterior subcutaneous internal fixation in our hospital from January 2016 to December 2017 were retrospectively analyzed. There were 15 females and 27 males with an average age of 45.4 years (range, 18-67 years). There were 26 traffic injuries, 10 falling injuries, 3 crush injuries and 3 low energy injuries. According to Tile classi?fication, 24 cases of B2 type, 16 cases of B3 type, 1 case of C1 type and 1 case of C2 type. According to Young?Burgess classifica?tion, there were 20 cases of LCI, 18 cases of LCII, 1 case of LCIII, 1 case of APCI, 1 case of APCII, and 1 case of VS. Fourteen cas?es were combined with limb fractures, and 11 cases were combined with thoracic or abdominal injuries requiring surgical treat?ment, while 16 cases were with brain injuries. For type APC2, LC1, and some LC2 fractures, fixation for the anterior pelvic ring is enough with INFIX technique alone. For some LC2, LC3, or VS fractures, the anterior and posterior ring were both fixed. Postoper?ative reduction was evaluated by Matta radiological criteria. Lateral thigh numbness and pain, quadriceps muscle power were re? corded during follow?up, and clinical efficacy was evaluated by Majeed score at 6 months after operation. Results All the 42 pa?tients were followed up for 6 to 12 months, with an average of 9.3 months. Matta standard evaluation for fracture reduction showed that 28 cases were excellent, 14 cases good, and the excellent and good rate was 100% . The early complication rate (within 3 month after operation) was 23.8% (10/42) including 6 cases of lateral femoral cutaneous nerve injury and 2 cases of femoral nerve injury. The symptoms were obviously relieved after the treatment of nutrient nerve and hyperbaric oxygen; 1 case had incision in?fection which was healed after anti?infection therapy and internal plant removal; 1 case suffered from superior gluteal artery injury which was controlled by pressure hemostasis. Six months after surgery, no case had lost reduction. At 6 months follow?up, the Ma?jeed score was 72-96, with an average of 84.96, of which 32 were excellent and 10 were good, thus the excellent and good rate was 100% (42/42). Conclusion INFIX is an effective internal fixation method for the treatment of unstable anterior pelvic ring inju?ry. However, it has a high rate of early complications, among which nerve injury has the highest incidence.

Immortalization of spleen fibroblastic reticular cells infected by severe fever thrombocytopenia syndrome virus / 中华实验和临床病毒学杂志

Objective@#To isolate, purify and culture fibroblastic reticular cells (FRCs) of mouse in spleen, to develop a reliable and robust method to immortalize primary mouse FRCs, to filter stable FRCs cell lines, to prove that the clones can be infected by SFTSV in vitro.@*Methods@#After purifying FRCs by fluorescence activated cell sorting (FACS) from autoMACS-enriched stroma cells of mouse spleen, we infected FRCs by simian virus 40 large T antigen in vitro, screened the FRCs clones with puromycin, compared primary and immortalized FRCs by RNA sequencing(RNA-seq) technology, infected the clones with severe fever with thrombocytopenia syndrome virus (SFTSV) in vitro.@*Results@#We succeed in culturing purified FRCs from spleen, isolated four stable FRCs clones, two of which have a purity of 99%, survived for more than 50 passages, express the key FRCs marker podoplanin and do not express CD31 and CD45. Clone 01 lost the typical FRCs-like morphology, the rate of expansion of which is quite different from that of primary FRCs and Clone 02. Clone 02 can be infected with SFTSV, which has the same gene expression pattern and immunophenotype with primary FRCs.@*Conclusions@#The stable FRCs clone Clone 02 has FRCs-like morphology and express key FRCs surface markers podoplanin (GP38 or PDPN) and do not express endothelial cell markers CD31 and leukocyte common antigen CD45. The RNA expression profiles identified by RNA-seq are also characteristic of FRCs. Infected with SFTSV in vitro, Clone 02 will be a new platform to study SFTSV.

Comparison of Monaco and Pinnacle treatment planning systems in volumetric modulated arc therapy optimization for lung cancer / 中华放射医学与防护杂志

Objective To compare the performances of Monaco and Pinnacle treatment planning systems (TPS) for volumetric modulated arc therapy (VMAT) optimization regarding lung cancer.The TPS was compared in terms of dose distributions,treatment delivery parameters and quality control results.Methods For 20 patients,including 10 cases of left lung cancer and l0 cases of right lung cancer,two VMAT plans were generated for each case:one with Monaco 3.0 TPS and the other with Pinnacle 9.2 TPS.Two plans were compared among plan dosimetrie distribution.conformity index and homogeneity index of the targets,the average dose,maximum dose,minimum dose and interested dose volume histograms of organs at risk(OAR,and delivery time and MUs of the therapy plans,the accuracy of treatment plans dose verification.Results Monaco provided better PTV coverage than Pinnacle (t =5.927-12.034,P ＜ 0.05) except Dminof PTV.Monaco had a worse sparing effect on lung than Pinnacle (t =3.545-7.485,P ＜0.05) except V10of diseased side lung and V5of total lung.In addition,Monaco had a better sparing effect on heart(t =2.836-4.011,P ＜0.05).Monaco had fewer delivery time(t =9.780,P ＜0.05)and MUs(t =5.304,P ＜0.05)of the therapy plans,and the pass rate of QA was better than Pinnacle(t =4.937,P ＜ 0.05).Conclusions For lung cancer patients,VMAT treatment plans obtained with Monaco and Pinnacle could offer clinically acceptable dose distributions.Pinnacle might have a better sparing effect on lung and fewer delivery time and MUs of the therapy plans.Monaco had a better PTV coverage and heart sparing.Moreover,Monaco had better accuracy of treatment plans dose verification.

Effects of horizontal beam on IMRT plan for lung cancer / 中华放射医学与防护杂志

Objective To explore the effect of horizontal beam on IMRT plan for lung cancer.Methods Totally 18 patients were enrolled,including 10 cases of left lung cancer and 8 cases of right lung cancer.Two intensity modulated radiation therapy (IMRT) plans were generated:one was the normal IMRT plan and another was the IMRT plan including a horizontal beam (H-IMRT).MUs,sub-field and the dose distribution of target and organs at risk (OARs) were compared.Results There were no statistically significant differences between two plans in D Dminand D of PTV,the V30 and D of the ipsilateral lung,V20 and V30 of the contralateral lung,and V30 of the total lung.When the horizontal beam was added,the PTV heterogeneity index (HI) and conformity index (CI) were significantly increased (t=-9.33,10.88,P＜0.05),the other dose index in lung was inferior (t =-1.55--7.58,P＜ 0.05),whleheart sparing were clearly better (t =1.84-3.99,P＜0.05),the number of MUs and segments were less(t =12.57,3.19,P ＜ 0.05).Conclusions IMRT in the treatment of lung cancer can further improve the PTV coverage when the horizontal beam is added.However,the increasing lung volume of low dose irradiation is not conducive to lung protection.

Influence of health education on clinical effect and treatment compliance in middle aged and aged patients with degenerative osteoarthritis / 中国实用护理杂志

Objective To evaluate the effect of health education on clinical effect and treatment compliance in middle aged and aged patients with knee degenerative osteoarthritis (KOA or KDOA). Methods 60 cases of patients with KOA were randomly divided into the intervention group and the control group with 30 patients in each group. The control group was given the conventional clinical care intervention; on the basis of the control group, the intervention group was given health education nursing intervention. After intervention the clinical effect and treatment compliance of the two groups were observed and evaluated. Results After intervention, the total clinical effective rate of the intervention group was 93.3%, the control group was 73.3%, the difference was significant between the two groups; the excellent and good rate of treatment compliance of the intervention group was 100.0%, the control group was 76.7%, the difference was significant between the two groups. Conclusions Health education can improve the clinical effect and treatment compliance of middle aged and aged patients with KOA, and it is worthy of being popularized.

Exploring methods of the difficulty estimate of medical microbiology examination questions / 中华医学教育探索杂志

In the item bank construction of medical microbiology examination questions,the accurate difficulty coefficient is an important parameter to guarantee the quality of the bank.Thus,the accurate difficulty estimate plays an important role in the item bank construction of examination questions.Methods of estimating the difficulty of medical microbiology test questions were explored,based on the knowledge points,the type of test questions,the structure of test questions and the degree of students’ familiarity with the questions and so on.Finally,the feasibility of methods was confirmed through the simulated tests.