ObjectiveTo explore the effect of home exercise on pain, function and quality of life after operation for rotator cuff injury. MethodsFrom June, 2023 to June, 2024, 45 patients after operation for rotator cuff injury were selected from Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University and Xuzhou Central Hospital, and randomly divided into conventional group (n = 15), home-based group (n = 15) and combined group (n = 15). The conventional group received an eight-week routine rehabilitation program in hospital, the home-based group received an eight-week home exercise prescription training, and the combined group first received four weeks of routine rehabilitation in hospital, and followed by four weeks of home exercise prescription training. They were assessed with Visual Analogue Scale for pain (VAS), University of California at Los Angeles shoulder rating scale (UCLA), Constant-Murley Score (CMS), range of motion (ROM) of shoulder, and the Short-form of Health Survey-36 (SF-36) before treatment, and four and eight weeks after treatment. ResultsVAS scores decreased in all the three groups four and eight weeks after treatment (Z > 2.964, P < 0.001), which was the most in the home-based group four weeks after treatment (|Z| > 2.531, P < 0.05). The main effect of time was significant in scores of UCLA, CMS, and physical health and mental health of SF-36 (F > 498.102, P < 0.001), which improved after treatment (P < 0.001). The main effect of group was significant in score of mental health of SF-36 (F = 7.408, P = 0.002), which was the most in the home-based group four and eight weeks after treatment (P < 0.01). The interaction was significant in score of physical health of SF-36 (F = 10.138, P < 0.001), which was the least in the home-based group four weeks after treatment (P < 0.05). The main effect of time was significant in every direction of ROM, which improved after treatment (P < 0.001). The interaction was significant in ROM of abduction and external rotation (F > 4.059, P < 0.01), and almost significant in ROM of flexion (F = 2.412, P = 0.055). However, ROM of flexion was less in the home-based group than in the combined group four weeks after treatment (P = 0.047), which was less in the home-based group than in the conventional group eight weeks after treatment (P = 0.042); ROM of abduction was the least in the home-based group four weeks after treatment (P < 0.01), which was less in the home-based group than in the combined group eight weeks after treatment (P = 0.046); ROM of external rotation was less in the home-based group than in the combined group four weeks after treatment (P = 0.022). ConclusionHome exercise is effective on pain, function and quality of life in patients after operation for rotator cuff injury. There are benefits with both home exercise and institution-based rehabilitation, and almost the same in a whole eight weeks after treatment.

Objective To compare the dosimetric difference between the biological function based on equivalent uniform dose (EUD) and the physical function based on dose volume (DV) in the intensity modulated radiotherapy for stage Ⅲ non-small cell lung cancer. Methods Four different radiotherapy plans were designed for 15 stage Ⅲ non-small cell lung cancer patients: Group A, physical function optimization (DV + DV) was used for target area and organs at risk; GroupB, in the target region, biological function optimization conditions were added on the basis of physical function optimization, and physical function optimization of organs at risk (DV－EUD + DV) was added. Group C, biological function optimization (EUD + EUD) was used for target area and organs at risk. Group D, in the target area, physical function optimization conditions were added on the basis of biological function optimization, and biological function optimization of organs at risk (EUD－DV + DV) was added. The differences in dosimetric parameters of the four plans were compared. Results Target area: PTV: D_2%, D_98%, D_50%, D_105% and D_max values of group C (P < 0.05) is the highest while group B and group D were relatively small (P > 0.05); The homogeneity index: the results of the group B and the group D were better than those of the other two groups (P < 0.05). conformity index: The results of the four groups were similar (P>0.05). Organ at risk: lung tissue mean dose (MLD), V₅, V₁₀, V₂₀, V₃₀ and heart V₃₀, V₄₀, D_mean dose parameters were similar (P > 0.05). Spinalcord: Group C and group D D_1% were better than the other two groups (P < 0.05). There was no statistical difference in the number ofmonitor unit (MU) among the four groups (P > 0.05). Conclusion The optimization method combining physical and biological function optimization in the target area can improve the conformity of the target area on the premise of ensuring the treatment. The Spinalcord load would be significantly reduced when using biological function optimization or the combination of biological function and physical function optimization.

Objective To investigate the effect of different fractionated radiotherapy of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) on peripheral blood lymphocytes in patients with breast cancer. Methods This retrospective analysis enrolled 40 patients with early breast cancer who underwent radiotherapy post breast conserving surgery in Xuzhou Central Hospital from November 2019 to August 2021. The patients were randomly divided into the observation group (HFRT, n = 20) and the control group (CFRT, n = 20). Changes in peripheral blood lymphocyte count (PLC) before and during radiotherapy were compared between the two groups. Results The baseline PLC was comparable between the observation group and the control group (1.53 ± 0.54 vs 1.64 ± 0.56, P > 0.05). In both groups, the PLC declined steadily during radiotherapy, and the incidence of lymphopenia in the observation group was lower than that in the control group (32.5% vs 50.0%, P > 0.05); the PLC nadir was higher in the observation group than in the control group (0.91 ± 0.28 vs 0.55 ± 0.22, P < 0.001). The ratio of the PLC nadir during treatment to baseline was significantly higher in the observation group than in the control group (0.64 ± 0.24 vs 0.38 ± 0.21, P < 0.05). Conclusion Patients with breast cancer receiving HFRT show a lower risk of radiation-induced lymphopenia versus those receiving CFRT.

Objective To preliminarily study the effectiveness and safety of stereotactic ablative brachytherapy (SABT) for lung metastases from cervical cancer. Methods We analyzed the clinical data of 18 patients with cervical cancer with lung metastasis treated with SABT to compare gross tumor volume (V_GTV) and squamous cell carcinoma (SCC) antigen before and after SABT. The clinical benefit rate (CBR) and adverse reactions were recorded. Results After SABT treatment, there were significant decreases in V_GTV (t=1.708, P<0.05) and the SCC antigen level (t=1.704, P<0.05). CBR reached 94.4%. Adverse reactions of grades 3-4 did not occur in any patient. Fourteen patients had mild complications, including 1 case of bloody sputum and 1 case of a small pneumothorax. Ten cases developed mild radiation-induced lung injury, with grade 2 radiation pneumonitis in 4 cases. The Karnofsky performance status score and needle depth were not associated with the occurrence of adverse reactions, while the radius of GTV and interstitial lung disease were associated with the occurrence of adverse reactions. Conclusion SABT is a safe and effective alternative to the treatment of lung metastases from cervical cancer.

【Objective】 To investigate the predictive factors of clinical T1 (cT1) stage renal cell carcinoma (RCC) escalation to T3a (pT3a), hoping to identify high-risk patients with occult pT3a features. 【Methods】 A total of 666 patients with cT1 RCC who underwent radical or partial nephrectomy were involved and divided into upstaging group and non-upstaging group. The independent predictive factors of cT1 to pT3a stage were determined with univariate and multivariate logistic regression analyses. A model was established. The area under the receiver operator characteristic (ROC) curve (AUC) and calibration plot were used to assess the predictive model’s discrimination and calibration. 【Results】 The upgrading rate was 11.4% (n=76). The RENAL score, neutrophil-to-lymphocyte ratio (NLR), prognosis nutrition index (PNI) and Cystatin C (Cys C) were correlated to pT3a upgrading. Our model exhibited good discrimination (AUC=0.726, 95%CI:0.662-0.791) and decent calibration. In the internal validation, the high C-index value of 0.717 was still attainable. 【Conclusions】 RENAL score, NLR, PNI, and Cys C can be used to predict the risk of postoperative pT3a stage escalation in patients with cT1 stage renal cancer. Urologists can complete risk stratification and treatment based on these indicators.

Objective To explore the radiosensitizing effect of arsenic trioxide (ATO) in cervical cancer, and to further explore the underlying mechanism related to DNA damage repair. Methods Human cervical cancer cells (Siha and Hela cells) were cultured in vitro, treated with different concentrations of ATO, and the cell proliferation was detected by CCK-8 assay. The cells were divided into four groups: control group, radiotherapy (IR) group, ATO group, and radiotherapy + ATO (IR + ATO) group. Radiosensitization ratio was determined by plate cloning assay, cell cycle and apoptosis by flow cytometry, the expression of γH2AX by immunofluorescence, the expression of Cyclin B1, PTEN, and RAD51 by Western blot, and the expression of RAD51 mRNA by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Results CCK-8 showed that ATO at concentrations of 1 μM and higher could significantly inhibit the proliferation of Siha and HeLa cells. Plate cloning showed that ATO had a radiosensitizing effect on cervical cancer, and the radiosensitization ratios were 1.37 and 1.30, respectively. Flow cytometry showed that the proportion of cell cycle arrest was significantly higher in the IR + ATO group than that in the control group (P < 0.001). The apoptosis rate was significantly higher in the IR + ATO group than that in the control group (P < 0.01). Western blotting showed that the expression levels of PTEN and RAD51 proteins significantly decreased (P < 0.05) and the expression level of Cyclin B1 protein significantly increased (P < 0.05) in the IR + ATO group. Conclusion ATO achieves radiosensitization in cervical cancer through blocking the DNA homologous recombination repair pathway by consuming PTEN.

Objective : To investigate the effects of Lin28 overexpression on the proliferation and osteogenic differentiation of human dental pulp stem cells (hDPSCs) through mTOR signaling pathway. Methods : After transfecting lentiviral vectors of Lin28 gene in hDPSCs , the relative expression of Lin28 was detected by Real⁃time PCR. CCK⁃8 assay was applied to detect the effect on cell proliferation. qRT⁃PCR was used to research the expression levels of alkaline phosphatase (ALP) , osteopontin (OPN) and osteocalcin (OCN) . Western blot assay was processed to investigate the effects on the relative expression levels of ALP and OPN proteins. Alizarin red staining was utilized to detect the mineralized nodules. Results : Compared with the control group , the cell proliferation of transfection group was promoted (P < 0. 05) ; The mRNA and protein expression levels of ALP , OPN and OCN in transfection group were significantly lower than those in control group (P < 0. 05) , the expression level of ALP apparently decreased after the addition of mTOR inhibitor rapamycin (P < 0. 05) ; Alizarin red staining showed that the size and number of mineralized nodules formed in transfection group were markedly declined compared with empty carrier group (P < 0. 05) . Conclusion Overexpression of Lin28 can inhibit the osteogenic differentiation of hDP⁃ SCs through suppress mTOR signaling pathway.

Objective To observe the effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in inauxiliary treatment of ischemic stroke and its clinical efficacy. Methods 142 cases of patients with ischemic stroke, were randomly divided into experimental group and control group. Control group(n=71) were treated with conventional therapy. Test group(n=71) were treated with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of conventional therapy. Hemorheological changes, nerve function improvement and treatment efifcacy in two groups before and after treatment were observed and analyzed. Results After treatment, the plasma viscosity and hematocrit in control group were 1.91±0.35, (49.58±1.04)%; while experimental group were 1.17±0.28, (38.97±1.31)%, the differences between two groups were signiifcant(P<0.05). Before treatment, the neurological function score in control group was 22.49±1.21, while experimental group was 23.18±1.74, there was no signiifcant difference between two groups. After treatment, the neurological function score in control group was 10.58±0.94, while experimental group was 4.62±2.05, the difference was signiifcant(P<0.05). The total effective rate was 80.3%in control group ,while 88.7% in experimental group, the difference was signiifcant(P<0.05). Conclusion The clinical efifcacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in auxiliary treatment of ischemic stroke was accurate, and it can alleviate the symptom of patients.

Objective To explore the optimal radiotherapy method by comparing the dosimetric differences of target and organs at risk of four radiotherapy plans for left sided breast cancerafter breast-conserving surgery. Methods Twenty-three patients with left breast cancer were randomly selected and given PTV 25 fractions, 50 Gy prescription dose.TheHybrid_IMRT, rj_IMRT, VMAT and t_VMAT plans were designed for each patients. Dosimetric differences were compared, including dose volume histograms of target and OARs, target homogeneity indexes (HI), conformal indexes (CI) and the machine MUs. Results Target Dosimetric comparison, HI: t_VMAT plan target has highest HI and had significant difference (P ≤ 0.001); The target CI of VMAT plans were 0.967 ± 0.016, had significant difference compared with the other 3 plans (P < 0.05). The CI of rj_ IMRT were 0.942 ± 0.018 better than that of IMRT and t_VMATs. Dosimetric comparison of OARs, left_lung mean dose (MLD_L): rj_IMRT were （8.76 ± 1.52） Gy which were best of 4 plans, and had statistical significance (P < 0.05). Heart mean dose: rj_IMRT were （4.68 ± 0.87） Gy were better than that of VMAT (P < 0.05). Conclusion All of these four plans could be applied in clinical treatments, while the limitations of treatment equipment, patients’ physical conditions and some other factors should be considered before selecting an appropriate one.

Objective: Investigate osteogenic differentiation of canine periodontal ligament stem cells ( cPDLSCs) via over-expression ephrinB2 in cPDLSCs． Methods : cPDLSCs were isolated from the premolars and molars of Beagle．After transfected with EfnB2-GFP-Bsd and GFP-Bsd empty Vector，cPDLSCs were induced to osteogenic differentiation．Western blot was used to invest the expression of ephrinB2 protein．The effect of osteogenic differentiation of EfnB2-cPDLSCs and Vector-cPDLSCs were analyzed by RT-PCR , CCK-8，Alizarin-red S staining and ALP. Results: There was no significant difference in cell proliferation between EfnB2-cPDLSCs and Vector-cPDLSCs．While EfnB2-cPDLSCs displayed an enhanced ALP activity and more prominent mineralized nodules compared with Vector-cPDLSCs．The odonto-/ osteogenic genes in EfnB2-cPDLSCs were also highly enhanced． Conclusion The results of our study indicated that ephrinB2 gene-transfected cPDLSCs showed enhanced osteogenic differentiation.