Objective To investigate the level Ⅰb contouring,dose analysis and regional recurrence in level Ⅰb lymph node-negative (Ⅰb-negative) nasopharyngeal carcinoma (NPC) patients treated by intensity-modulated radiotherapy (IMRT).Methods One hundred ninety newly-diagnosed,Ⅰb-negative NPC patients treated by IMRT were enrolled.Level Ⅰb contouring and dose prescribing in this cohort were classified into planned prophylactic irradiation (PPI) group (56 cases) and non-planned prophylactic irradiation (non-PPI) group (134 cases).The mean dose (Dmean) of the level Ⅰb bilaterally and submandibular glands (SMGs) was recorded for comparison.Results After a median follow-up of 47 months,there was no level Ⅰb regional recurrences noted in the entire group.The mean doses of level Ⅰb and the submandibular glands were significantly lower in the non-PPI group than those in the PPI group as follows:(50.81±5.37) Gy vs (59.68±3.32) Gy for the left level Ⅰb,(51.55±5.02) Gy vs (59.66±3.85) Gy for the left submandibular gland,(51.55±5.02) Gy vs (59.66±3.85) Gy for the right level Ⅰb and (57.25±4.69) Gy vs (63.41±2.88) Gy for the right submandibular gland (all P =0.000).Conclusion In this retrospective analysis of non-randomized single institute data,it seems unlikely that PPI to level Ⅰb is necessary in Ⅰb-negative NPC patients treated by IMRT.

Objective To identify the sequence of hepatitis B virus S gene"a"determinant in patients with positive HBsAg and anti-HBs.Methods Nested-PCR Was used to amplify the HBV S gene in 4 patients with positive HBsAg and anti-HBs,and the PCR products were sequenced directly or after cloning.The sequences of"a" determinants were then analyzed by sequence alignment.Results Direct sequencing of PCR products showed that there was one amino acid (aa)residue in"a"determinant less conserved region emerging polymorphism in all 4 patients.Clone sequencing showed that aa residue at 126 of "a"determinant in patient 1 miSht be Thr,Ile and Set,at 134 might be Phe and Set;the aa at 126 in patient 2 misht be Ala and Thr.and in patient 3 might be Ile and Asn;aa polymorphism was not found in patient 4.Conclusion The polymorphism of"a"determinant in HBV S gene might be associated with positivity of both HBsAg and anti-HBs in hepatitis B patients.

Background: and Purpose Collateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids. Methods: The study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation. Results: This study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84). Conclusions In patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Objective Exploring the relationship between changes in serum Golgi apparatus transmem-brane glycoprotein 73(GP73)and chitosanase 3-like protein 1(CHI3L1)levels and liver fibrosis and lesion sever-ity in patients with hepatitis B(CHB).Methods Using a case-control study,80 patients diagnosed with CHB infection and developing liver fibrosis in the Infectious Disease Department of Changsha First Hospital from June 2020 to June 2023 were selected as the liver fibrosis group,while 120 patients diagnosed with CHB infection but not developing liver fibrosis in the Infectious Disease Department of our hospital were selected as the control group.The serum GP3,CHI3L1,liver function,and fibrosis indicators of the two groups of patients were compared,and the liver fibrosis group was divided into mild according to Scheuer system standards Perform stratified analysis on patients with significant liver fibrosis.Results The serum GP3 and CHI3L1 levels in the liver fibrosis group were significantly higher than those in the control group,with statistical significance(P＜0.05);The ROC curves were plotted using serum GP3,CHI3L1,and GP3+CHI3L1,respectively.The sensitivity for diagnosing liver fibrosis in CHB patients was 62.81%,60.94%,and 96.33%,with specificity of 80.66%,80.05%,and 75.30%.The AUC values under the curves were 0.792,0.756,and 0.908,respectively;The levels of ALT,AST,HA,LN,PC III NP,C IV,and CG in the liver fibrosis group were higher than those in the control group,and the PLT measurement values were lower than those in the control group,with statistical significance(P＜0.05);49 patients with moderate to severe liver fibrosis(33 in S2 phase and 16 in S3 phase)and 31 patients with mild liver fibrosis(all in S1 phase)had significantly higher serum GP3 and CHI3L1 levels than mild patients,with statistical significance(P＜0.05);The levels of DBIL,ALT,AST,HA,LN,PC III NP,C IV,and CG in patients with moderate to severe liver fibrosis were higher than those in the mild group,and the PLT measurement values were lower than those in the mild group,with statistical significance(P＜0.05).Conclusion The serum GP3 and CHI3L1 levels in CHB patients with liver fibrosis are significantly elevated,and there is a certain correlation with the degree of liver fibro-sis.The combination of these two indicators is beneficial for diagnosing liver fibrosis in CHB patients.

Rolling circle amplification is a rapid, sensitive and isothermal single-stranded DNA amplification technique that can be used with staining or probes to amplify the detection signal. This technology has been widely used in biological detection and other aspects. The present paper introduces how to design rolling circle amplification, summarize its application in the detection of pathogens, nucleic acid tumor markers, proteins, biological small biomolecules, and viruses in recent years and prospects for future development.
DNA, Single-Stranded ; Nucleic Acid Amplification Techniques

Objective To summarize the clinical experience of the treatment for complex aortic coarctation with extra anatomic bypass and anatomic correction techniques. Methods The clinical data of patients with complex aortic coarctation treated in the First Affiliated Hospital of Nanjing Medical University and Friendship Hospital of Ili Kazakh Autonomous Prefecture between April 2012 and November 2020 were retrospectively reviewed. Results A total of 12 patients were enrolled, including 5 males and 7 females aged 11-54 (34.3±16.2) years. Extra anatomic bypass grafting was performed in 8 patients and anatomic correction was performed in 4 patients. The operations were successful in all patients. There was no perioperative death. The average cardiopulmonary bypass time was 203.0±46.0 min (7 median incision patients), and the average intraoperative blood loss was 665.0±102.0 mL. The average postoperative ventilator support time was 32.3±7.5 h, and the average postoperative hospital stay time was 10.2±4.3 d. The mean drainage volume of median incision was 1 580.0±360.0 mL, and the mean drainage time was 9.3±2.7 d. The mean drainage volume of left thoracotomy was 890.0±235.0 mL, and the mean drainage time was 4.8±2.5 d. One patient had a transient hoarse after operation and recovered 6 months later. The follow-up period ranged from 2 to 10 years with an average time of 81.0±27.0 months. All patients had a recovery of hypertension, cardiac afterload after 2 years postoperatively. One patient who received an artificial blood vessel replacement in situ was examined stenosis recurrence at the third year after discharge. Others were asymptomatic during the follow-up period. There were no death or other complications. Conclusion The treatment strategy for complex aortic coarctation should be individualized according to the anatomical features and concomitant heart diseases. Extra anatomic bypass technique is a safe and feasible choice.