Objective To optimize preparation process of Zushima Gel Cream. Methods The comprehensive evaluation set sensory evaluation, initial adhesive force, viscous force, and peeling strength score as indexes. The mixing time, refining temperature, mixing speed, and powder adding sequence were investigation factors. Orthogonal experiment was used to optimize forming process. Results Conditions of optimized preparation process were as following: add Zushima powder in Viscomate NP-700 and glycerol; mixing time was 5 min; refining temperature was 40 ℃; mixing speed was 100 r/min. Conclusion The preparation process is good and optimized Zushima Gel Cream has a good adhesive force, good glossiness and excipients. The preparation process is good.

Objective:To explore the short-term clinical efficacy, safety and patients' prognostic influencing factors of CyberKnife for the treatment of brain metastases in non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was conducted. The clinical data of 58 NSCLC patients who received CyberKnife treatment for brain metastases at Jilin Cancer Hospital from July 2020 to January 2022 were retrospectively analyzed. At 3 months after CyberKnife treatment for brain metastases, and the efficacy of radiotherapy was evaluated on the basis of changes of brain metastases detected by contrast-enhanced magnetic resonance imaging (MRI) of the head. Overall survival (OS) and local recurrence-free survival (LRRFS) were analyzed in 58 patients by using the Kaplan-Meier method; the efficacy of cumulative brain metastasis volume for determining the survival of CyberKnife-treated NSCLC patients with brain metastases was analyzed by using the receiver operating characteristic (ROC) curve with the survival status of patients during the follow-up period as the gold standard, and the optimal cut-off value of cumulative brain metastasis volume was obtained; the clinical factors affecting OS and LRRFS of CyberKnife-treated NSCLC patients with brain metastases were analyzed by univariate and multivariate Cox proportional hazards models, and the adverse reactions associated with CyberKnife treatment were evaluated.Results:Among the 58 patients, 26 (44.8%) were male and 32 (55.2%) were female, with a median age [ M ( Q1, Q3)] of 64 years old (56 years old, 70 years old); there were 1-7 brain metastatic lesions in each patient, and there were 98 brain metastatic lesions in the 58 patients. There were 2 deaths (3.4%) within 3 months after CyberKnife treatment. At 3 months after treatment, there were 3 cases (5.4%) in complete remission, 36 cases (64.3%) in partial remission, 13 cases (23.2%) in stable disease, and 4 cases (7.1%) in disease progression in the remaining 56 patients. ROC curve analysis showed that the area under the curve for determining the survival of CyberKnife-treated NSCLC patients with brain metastases based on the cumulative brain metastasis volume was 0.593 (95% CI: 0.423-0.763), and the optimal cut-off value of cumulative brain metastasis volume was 15 cm 3. Median follow-up time was 12.6 months (7.5 months, 17.9 months). The 6- and 12-month OS rates were 91.3% and 79.5%, respectively, and the 6- and 12-month LRRFS rates were 93.0% and 89.2%, respectively. Multivariate Cox regression analysis showed that the Karnofsky functional status score (>70 points vs. ≤70 points, HR= 0.103, 95% CI: 0.019-0.545, P = 0.007), control of extracranial tumor (controlled vs. uncontrolled, HR = 0.145, 95% CI: 0.049-0.429, P < 0.001), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.105, 95% CI: 0.028-0.399, P = 0.001) were independent influencing factors for poor OS, and the control of extracranial tumor (controlled vs. uncontrolled, HR = 0.062, 95% CI: 0.006-0.616, P = 0.018), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.440, 95% CI: 0.007-0.292, P = 0.001), and target area total bioequivalent dose (BED) (≤60 Gy vs. >60 Gy, HR = 5.299, 95% CI: 1.020-27.530, P = 0.047) were independent influencing factors for poor LRRFS. Only grade 1-2 headache [53.5% (31/58)], nausea and vomiting [36.2% (21/58)] and other adverse reactions occurred after treatment, and no ≥grade 3 adverse reactions occurred. Conclusions:CyberKnife treatment for NSCLC brain metastases has high local control rate and short-term survival rate with mild adverse effects. Karnofsky functional status score, control of extracranial tumor and cumulative brain metastasis volume may affect OS of CyberKnife-treated NSCLC patients with brain metastases, and the control of extracranial tumor, cumulative brain metastasis volume and total BED may affect local recurrence.

Objective:To evaluate the effect of image-guided with cone-beam computed tomography (CBCT) based on volumetric modulated arc therapy (VMAT)-flattening filter free (FFF) on the setup errors of stereotactic body radiotherapy (SBRT) in patients with spinal metastatic tumors.Methods:The clinical data of 15 patients with spinal metastatic tumors who underwent SBRT in Jilin Cancer Hospital from August 2020 to January 2022 were retrospectively analyzed. The radiotherapy dose of bone metastasis was 32 Gy per 4 times and CBCT scanning was performed before and after radiotherapy. Every patient received radiotherapy 4 times; all 15 patients underwent SBRT 60 times in total and 120 CBCT volume images were finally obtained and analyzed. The systematic error (Σ) and random error (σ) were calculated at different correction threshold levels. The translational setup error and rotational setup error at the left-right (X axis), head-foot (Y axis) and front-back (Z axis) directions before and after radiotherapy were compared, which were expressed as Σ ± σ.Results:The pre-SBRT and post-SBRT translational setup errors were (0.14±0.27) cm and (0.07±0.19) cm, respectively ( P<0.001) in the X direction, (-0.05±0.33) cm and (0.00±0.19) cm, respectively ( P = 0.001) in the Y direction, (-0.13±0.19) cm and (-0.02±0.14) cm, respectively ( P = 0.012) in the Z direction. The pre-SBRT and post-SBRT rotational setup errors were (-0.31±0.76)° and (-0.09±0.34)°, respectively ( P < 0.001) in the X direction, (-0.13±0.88)° and (-0.07±0.36) °, respectively ( P < 0.001) in the Y direction, (0.10±0.51)° and (0.16±0.38)°, respectively ( P < 0.001) in the Z direction. Conclusions:CBCT correction could reduce Σ and σof the translational setup and rotational setup, increase the accuracy of SBRT based on VMAT-FFF for patients with spinal metastatic tumors.

Objective:To understand the cognition degree and demand of the middle-aged and elderly people for wisdom pension and analyze its influencing factors.Methods:This was a cross-sectional study. From March to June 2019, the convenient sampling was used to select 486 middle-aged and elderly people in Nankai District of Tianjin as the research objects. The self-designed general information questionnaire, Wisdom Pension Cognition Questionnaire and Wisdom Pension Demand Questionnaire were used for the investigation.Results:A total of 486 questionnaires were distributed and 445 valid questionnaires were recovered, with an effective recovery rate of 91.56%. A total of 73.5 % (327/445) of the middle-aged and elderly people had high awareness of smart home appliances, 70.0 % (312/445) of smart phones, 65.2% (290/445) of WeChat and 64.9 % (289/445) of QQ. Those with a demand of more than 50% were smart stoves (63.4%) , one-button pagers (53.3%) , harmful gas and smoke alarm devices (51.7%) , community video surveillance devices (50.1%) , contacting relatives and friends by phone (59.8%) and access to information through television (66.0%) . Occupation, income of month, frequency of mobile phone use, whether to use computers and whether there was broadband at home were the common influencing factors of cognition and effective demand (all P<0.05) . The cognitive level of middle-aged and elderly people on wisdom pension was positively correlated with their demands ( r=0.486, P<0.01) . Conclusions:The middle-aged and elderly people have a low overall awareness of wisdom pension and have high but differentiated demands for wisdom pension products and services. Multi-sectoral departments of the society should cooperate and jointly promote the development of wisdom pension services.

Objective:To compare the dosimetric differences between accelerated partial breast irradiation intensity modulated radiation therapy (APBI-IMRT) and whole breast irradiation with simultaneous integrated boost intensity modulated radiotherapy (WBI-SIB-IMRT) for early-stage breast cancer after breast-conserving surgery.Methods:A total of 35 patients with early-stage breast cancer in Jilin Province Cancer Hospital between July 2009 and December 2014 after breast-conserving surgery were enrolled. The targeted regions of APBI-IMRT and WBI-SIB-IMRT were created for each patient. The dosimetric difference comparison of the targeted region and normal tissues was evaluated by using dose volume histogram (DVH).Results:There was no significant difference in the dosimetric comparison of gross tumor volume (GTVtb) and planning gross tumor volume (PGTVtb) after correction of cumulative radiation effect (CRE) between WBI-SIB-IMRT group and APBI-IMRT group (both P > 0.05). The dose of clinical target volume (CTV) and planning target volume(PTV) in APBI-IMRT group was higher than that in WBI-SIB-IMRT group [CTV: (4 720±71) cGy vs. (3 889±79) cGy, t = 3.184, P = 0.027; PTV: (4 675±164) cGy vs. (3 807±199) cGy, t = 2.751, P = 0.032] after CRE correction. Compared with WBI-SIB-IMRT group, the dose of ipsilateral lung tissue and left heart tissue in APBI-IMRT group was decreased after CRE correction [(558.5±8.9) cGy vs. (1 304.9±34.4) cGy, t = -7.328, P = 0.001; (35.5±5.3) cGy vs. (843.0±41.5) cGy, t = -8.137, P = 0.001]. V 5/3.6 Gy, V 10/7.3 Gy, V 15/10.9 Gy, V 20/14.6 Gy, V 25/18.2 Gy and V 30/21.9 Gy of the ipsilateral lung and V 30/21.9Gy, V 40/29.2Gy of left heart in all breast cancer patients after two chemotherapy treatments had significant differences (all P = 0.001). Conclusion:Compared with WBI-SIB, APBI-IMRT can improve the dose distribution in target area and reduce the volume of high dose irradiation in organs at risk.

Objective:To understand the health status,influencing factors and spatial distribution of the Chinese floating population and to evaluate the health equity of the floating population.Methods:All the data were collected from the 2017 Migrant Population Dynamic Monitoring Survey in China,binary Logistic regression was used to analyze the factors that might affect the health of the floating population,and the concentration index method was used to evaluate the health equity of the floating population.Spa-tial autocorrelation analyses the spatial aggregation of health status and health equity.Results:The un-healthy rate of the floating population in China was 2.71％.Age and gender show a statistically signifi-cant impact on self-rated health;that is,as age increases,the self-rated health of the migrant population gradually deteriorates,and women are more likely to think that they are unhealthy.Fairness analysis shows that the concentration index of the floating population is 0.021 7,the urban household registration floating population is 0.021 6,and the rural household registration floating population is 0.021 9.It is shown that the fairness of the health status of the floating population is biased towards the high-income class,and the rural household registration floating population's health unfairness is greater than that of the urban household registration migration population.Moreover,Moran's i=0.211 for self-rated health and Moran's i=0.291 for the unhealthy rate indicate that self-rated health has a spatial aggregation trend.Moran's i=0.136 showed the characteristics of spatial clustering,and the two-week prevalence fairness of the floating population was mainly in the northern and southeastern coastal areas.Conclusion:In general,the health status of the floating population in China is relatively good.The main influencing factors of health included gender and age.The central tendency of health inequity is reflected in the south-east coastal and northern regions,which are characterized by poverty.Attention to spatial aggregation is not only helpful to analyze the reasons of floating population,but also to study the health differences between different regions and health-related factors,to improve the overall health level of the whole population.

OBJECTIVE To establish a quality standard for rice-fired Glehnia littoralis . METHODS Appearance observation ， powder microscopic identification and thin-layer chromatography （TLC）identification were performed for the samples of rice-fired G. littoralis decoction piece. According to the relevant methods stated in 2020 edition of Chinese Pharmacopoeia （part Ⅳ），the contents of moisture ，total ash ，acid-insoluble ash ，water-soluble extract and acid-soluble extract were determined. The contents of psoralen，zanthoxylin，bergapten，imperatorin and isoimperatorin were determined by high performance liquid chromatography （HPLC）. RESULTS The rice-fired G. littoralis decoction pieces were round-like small segments ，slightly rough ，yellow（peeled） or dark yellowish brown （with peel ），special gas and slightly sweet taste. The powder was yellowish white. Under the microscope ， secretions and secretory cells ，ducts，gelatinized starch granules ，ray cells ，parenchyma cells ，etc. could be seen. TLC showed the spots developed clearly. In the chromatogram of the test sample ，there was the same blue fluorescent spot at the corresponding position of the chromatogram of isoimperatorin control sample. The moisture ，total ash ，acid-insoluble ash ，water-soluble extract and ethanol-soluble extract from 9 batches of samples were 5.82％-6.27％，3.19％-3.59％，0.21％-0.27％，24.91％-30.30％ and 20.66％ -25.83％ ，respectively. The linear range of psoralen ，zanthotoxin，bergapten，imperatorin and isoimperatorin were 0.240-2.400，0.320-3.200，0.224-2.240，0.292-2.920，0.208-2.080 µg/mL（all r＞0.999 0）. Limits of quantitation were 0.032 0， 0.030 0，0325 0，0.032 0，0.045 0 µg，respectively. Limits of detection were 0.100 8，0.089 6，0.071 5，0.090 0，0.132 0 µg， respectively. RSDs of prescision ，stability（24 h）and reprodu- cibility tests were less than 3％. Average recoveries were 100.56％ （RSD＝1.36％ ，n＝6），100.73％（RSD＝2.25％ ，n＝6）， 100.36％（RSD＝0.98％，n＝6），98.24％（RSD＝0.40％，n＝6） E-mail：853063968@qq.com and 99.40％（RSD＝0.35％，n＝6），respectively. The contents of above five components were 5.85-13.31，8.63-33.38，6.23- E-mail：shixiaofeng2005@sina.com 15.25，6.12-12.98，5.52-10.77 µg/g，respectively. The total contents were 34.20-83.47 µg/g. CONCLUSIONS It is preliminarily proposed that the moisture ，total ash and acid-insoluble ash should not exceed 7.30％，4.10％，0.30％. The water-soluble extract and ethanol-soluble extract are no less than 21.00％ and 18.00％，respectively. The total content of coumarin should not be less than 52.03 µg/g（with peel ）and 26.34 μg/g（peeled）. Established quality standard can be used for the quality control of rice-fired G. littoralis .

Objective:To investigate the changes of cognitive function and self-care ability in patients with mild cognitive impairment after stroke after sensory integration therapy.Methods:One hundred patients with mild cognitive impairment after stroke were divided into control group and intervention group according to the random number table method. The control group was given the routine health education path and rehabilitation training, and the intervention group was given the cognitive rehabilitation through sensory integration therapy on the basis of the control group. The cognitive function and self-care ability of the patients were evaluated by the Montreal cognitive assessment(MoCA) and daily self-care ability scale(ADL) before and after intervention.Results:After intervention, the total MoCA score, visual space, nominalization, language, abstraction and memory scores of the intervention group were 26.02±1.15, 3.50±0.76, 2.98±0.14, 2.90±0.30, 2.84±0.37 and 3.18±0.69, respectively, while those of the control group were 23.32±1.90, 2.86±1.20, 2.78±0.42, 2.82±0.39, 1.58±0.54 and 2.82±0.94, respectively. The difference between the two groups was statistically significant ( t value was -18.296--2.064, all P<0.05). The scores of attention and directional force in the intervention group were 5.44±0.67 and 5.18±0.85, respectively, while those in the control group were 5.32±0.84 and 5.14±0.78, respectively. There was no statistically significant difference between the two groups ( t value was -1.288, -0.704, P>0.05).After intervention, the total ADL score, stool, urine, toilet, eating, dressing and bathing scores of the intervention group were 65.00±5.98, 5.90±2.19, 6.40±2.27, 7.40±2.72, 7.80±2.70, 7.50±2.53 and 5.50±1.52, respectively, The control group was 53.60±10.20, 3.50±3.23, 5.00±3.50, 5.50±3.23, 5.40±3.76, 5.90±3.45, and 4.40±2.79, respectively. The difference between the two groups was statistically significant ( t value was -7.573~-2.615, all P<0.05). Conclusions:Sensory integration therapy can improve the cognitive function and self-care ability of patients with mild cognitive impairment after stroke.

OBJECTIVE： To optimize the extraction technology of osthole from the pine needles of Cedrus deodara. METHODS： HPLC method was adopted to determine the content of osthole. Based on single factor test， ethanol volume fraction， extraction time and material-solvent ratio were selected as influential factors， and the content of osthole was selected as response value. Box-Behnken design-response surface methodology was used to optimize the extraction technology of osthole in pine needles of C. deodara. Validation test was conducted. RESULTS： The optimal extraction technology was as follows as ethanol volume fraction of 88％， material-solvent ratio of 1 ∶ 20 （g/mL）， extracting for 2 times， lasting for 57 min each time. Under this technology， average content of osthole was 0.675 7 mg/g （RSD＝1.78％， n＝3）， and the relative error of which to predicted value 0.680 9 mg/g was 0.59％. CONCLUSIONS： The optimal extraction technology is simple and feasible，and it can be used for the extraction of osthole from the pine needles of C. deodara.  

Objective: The aim was to investigate the genotype distribution of two major epitopes of large surface protein (PreS1) of hepatitis B in Chinese patients and to explore the association between the genotypes of these two epitopes, and to determine whether PreS1 full-length genotype could be revealed according to the polypeptide sequence of key epitopes. Methods: HBV DNA was extracted from the serum of patients for PCR amplification. 278 samples amplified successfully were sequenced and compared with the known HBV sequences in Genbank to determine the two key epitopes of HBV PreS1 genotype (amino acid epitope 21-47 and 94-117, abbreviated as P21 and P94) and PreS1 full-length genotypes. The correlation among three genotyping approaches was analyzed by Cohen’s kappa coefficient to verify the consistency between the key-epitope genotyping and the full-length preS1 genotyping. Results: 232 samples were successfully sequenced. The genotyping based on the kind of P21 epitope protein sequence, 201 cases for genotype C, 23 cases for genotype B and 8 cases for uncertain genotypes and genotyping based on the form of P94 epitope protein sequence, 199 cases for genotype C, 25 cases for genotype B and 8 cases for indeterminate genotypes. Lastly, the genotyping based on sequence of the full-length PreS1 sequence, 207 and 25 cases for genotype C and B. P21 or P94 epitope genotyping and PreS1 full length genotyping were highly consistent, respectively, 96.55% and 96.12%, and the two epitopes (P21and P94) genotyping have parallel consistency (93.10%). Conclusion In this study, an innovatively genotyping method based on the amino acid sequence of key epitopes was proposed. The genotypes of HBV in china were mainly B and C genotypes, and the genotypes of key conserved epitopes of HBV PreS1 were highly consistent with the full-length genotyping ( > 96%). Moreover, genotyping with one or two key epitopes can be used in place of the full-length genotyping.