Objective To explore the effect of composite electromagnetic stimulation combined with chin tuck against resistance(CTAR)on post-stroke dysphagia.Methods From January,2021 to December,2023,156 post-stroke patients with pharyngeal dysphagia in the First Peo-ple's Hospital of Yibin were randomly divided into CTAR group(n=51),neuromuscular electrical stimulation(NMES)+repetitive transcranial magnetic stimulation(rTMS)group(n=52)and combination group(n=53).On the basis of routine swallowing function training,they received CTAR,NMES+rTMS and NMES+rTMS+CTAR,respectively,for four weeks.They were assessed with Functional Oral Intake Scale(FOIS),Standardized Swal-lowing Assessment(SSA),Swallowing-Quality of Life(SWAL-QOL),Rosenbek Penetration Aspiration Scale(PAS),video fluoroscopic swallowing study(VFSS)(including the score of VFSS,pharyngeal transit time,and upward and forward displacement of hyoid bone),average surface electromyography(AMEG)of submental and hyoid muscles,before and after treatment.Results The inter-group effect,intra-group effect and interaction effect were significant in SSA,SWAL-QOL and AMEG of the two muscles(F>6.611,P<0.001).The inter-group effect and interaction effect were significant in FOIS,VFSS,pharyngeal transit time,upward displacement of hyoid bone and forward displacement of hyoid bone(F>3.451,P<0.05).Pairwise comparison results showed that pharyngeal transit time was shorter in the combination group than in NMES+rTMS group(P=0.048),forward displacement of hyoid bone was more in the combina-tion group than in CTAR group(P=0.002),and AMEG was higher in the combination group than in CTAR group and NMES+rTMS group(P<0.001).There was significant difference in the score of PAS among three groups(Hc=8.282,P=0.016),and it was the best in the combination group.Conclusion The combination of NMES+rTMS and CTAR is superior to single electromagnetic stimulation or CTAR in the treatment of post-stroke sysphagia.

Glaesserella parasuis is the causative agent of Gl?sser's disease in pigs.However,the pathogenic mechanisms underlying its virulence is not yet fully understood.The RuvB protein,a member of the AAA+superfamily,is implicated in various cellular processes,yet its specific role in the virulence of Glaesserella parasuis has not been fully characterized.In this study,we con-structed a RuvB gene deletion mutant,designated ΔRuvB,using the serotype 13 Glaesserella pa-rasuis strain ZJ1208 and a suicide plasmid-mediated natural transformation approach.To elucidate the functional role of the RuvB gene,we comprehensively evaluated the biological characteristics of the ΔRuvB strain through a series of assays,including growth kinetics,colony morphology,bac-terial staining,transmission electron microscopy(TEM),osmotic stress tolerance,high-tempera-ture tolerance,heat shock resistance,UV resistance,capsular polysaccharide quantification,serum bactericidal assays,and murine virulence experiments.Our findings revealed that the growth rate of ΔRuvB showed no significant difference compared to the parental strain.TEM revealed a notable increase in bacterial cell length;however,the number of outer membrane vesicles(OMVs)on the surface of ΔRuvB did not significantly increase.Notably,the ΔRuvB strain displayed a significant reduction in capsular polysaccharide production and serum resistance,as well as diminished toler-ance to UV radiation and high temperatures.Significant alterations were observed in its resistance to osmotic stress or oxidative stress.In the mouse toxicity challenge experiment,in com-parison with the parental strain ZJ1208,the mortality rate dropped by 20 percentage points,suggesting that the virulence of ΔRuvB has been weakened to some extent.Collectively,these results underscore the critical role of the RuvB gene in enhancing the environmental adaptability of Glaesserella parasuis.

Purpose To develop a nomogram combined radiomics,clinical and CT morphographic features for the prediction of the acquired T790M mutation in patients with advanced non-small cell lung cancer with resistance after the duration of first-line epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitor(TKI)treatment.Materials and Methods The chest CT images and clinical data of 116 patients who underwent secondary biopsy after disease progression during first-line TKI treatment for advanced non-small cell lung cancer with EGFR sensitive mutations,from December 2016 to December 2022 in Shaoxing People's Hospital were retrospectively analyzed.All patients were randomly divided into a training cohort(n=81)and a validation cohort(n=35),at a ratio of 7︰3.The regions of interest of the lesion were delineated,and radiomics features were extracted.Feature selection was performed via the maximum relevance minimum redundancy and the least absolute shrinkage and selection operator methods.Clinical features were selected via univariate and multivariate Logistic regression.A nomogram combined clinical and radiomics features was subsequently constructed.The predictive ability of the combined model was evaluated via receiver operator characteristic curve,calibration curves and decision curve analysis.Results The progression-free survival of first-line EGFR-TKIs(OR=1.086,P=0.041),initial EGFR profile(OR=0.280,P=0.021),vascular convergence(OR=4.050,P=0.036)and air bronchogram(OR=3.265,P=0.030)were highly correlated with the acquired T790M mutation.The combined model demonstrated good predictive performance for acquired T790M mutation,both in the training set(AUC=0.867,95%CI 0.790-0.944)and the validation set(AUC=0.895,95%CI 0.786-1.000).The calibration curve showed good calibration power,and the decision curve analysis demonstrated a significant net benefit.Conclusion A radiomics-clinical nomogram based on CT radiomics has the potential to predict acquired T790M mutation and could be a complementary tool for T790M mutation detection after resistance to first-or second-generation EGFR-TKIs.

The aim of this paper was to investigate the serotypes,virulence factors and drug resist-ance of clinical isolates of Pasteurella rnultocida of porcine origin in recent years.Morphological screening and polymerase chain reaction(PCR)were used to isolate and identify 119 isolates from nasal swabs and lung tissue samples sent from swine farms in Zhejiang Province from 2010 to 2024.The isolates of Pasteurella multocida were subjected to capsular polysaccharide serotyping,lipopolysaccharide serotyping,virulence factor detection and drug resistance analysis by PCR and Kirby-Bauer disc agar diffusion method(K-B).The results showed that there were 64 strains(53.7％)of A-type,54 strains(45.3％)of D-type and 1 strain(0.9％)of F-type among the capsu-lar polysaccharide serotypes,and 10 strains(8.4％)of L1-type,20 strains(16.8％)of L3-type,86 strains(72.2％)of L6-type,and 3 strains(2.6％)of undetermined type among the lipopolysaccha-ride serotypes.The amplification results of 10 virulence genes showed that the detection rate of virulence genes hgbA,higbB and fimA was over 86.0％,the detection rate of toxA was 8.4％,while the virulence gene tbpA was not detected.There were also differences in the distribution vir-ulence genes in different capsular polysaccharide serotypes.Virulence factor pfhA was detected in type A and F but not in type D.The detection rate of adhesin gene tadD in serotype A(92.2％)was significantly higher than that of type D(9.3％),and,on the contrary,the detection rate of ad-hesin gene hsf-l in serotype D(90.7％)was significantly higher than that of type A(20.3％).Drug resistance analysis revealed that Pasteurella multocida showed high susceptibility to antimi-crobial drugs such as amoxicillin,ampicillin,cephalosporins,doxycycline,fosfenicol and ciprofloxa-cin,and showed strong resistance to antimicrobial drugs such as lincomycin,cotrimoxazole,genta-micin and amikacin,and there were 54 multi-drug resistant strains(78.3％).In summary,capsular polysaccharide serotypes were dominated by type A and D,lipopolysaccharide serotypes were dom-inated by L6,the distribution of some virulence genes varied greatly among different serotypes,and the proportion of multi-resistant strains was high,which provide reference for the prevention and control of this disease.

Objective To explore the effect of composite electromagnetic stimulation combined with chin tuck against resistance(CTAR)on post-stroke dysphagia.Methods From January,2021 to December,2023,156 post-stroke patients with pharyngeal dysphagia in the First Peo-ple's Hospital of Yibin were randomly divided into CTAR group(n=51),neuromuscular electrical stimulation(NMES)+repetitive transcranial magnetic stimulation(rTMS)group(n=52)and combination group(n=53).On the basis of routine swallowing function training,they received CTAR,NMES+rTMS and NMES+rTMS+CTAR,respectively,for four weeks.They were assessed with Functional Oral Intake Scale(FOIS),Standardized Swal-lowing Assessment(SSA),Swallowing-Quality of Life(SWAL-QOL),Rosenbek Penetration Aspiration Scale(PAS),video fluoroscopic swallowing study(VFSS)(including the score of VFSS,pharyngeal transit time,and upward and forward displacement of hyoid bone),average surface electromyography(AMEG)of submental and hyoid muscles,before and after treatment.Results The inter-group effect,intra-group effect and interaction effect were significant in SSA,SWAL-QOL and AMEG of the two muscles(F>6.611,P<0.001).The inter-group effect and interaction effect were significant in FOIS,VFSS,pharyngeal transit time,upward displacement of hyoid bone and forward displacement of hyoid bone(F>3.451,P<0.05).Pairwise comparison results showed that pharyngeal transit time was shorter in the combination group than in NMES+rTMS group(P=0.048),forward displacement of hyoid bone was more in the combina-tion group than in CTAR group(P=0.002),and AMEG was higher in the combination group than in CTAR group and NMES+rTMS group(P<0.001).There was significant difference in the score of PAS among three groups(Hc=8.282,P=0.016),and it was the best in the combination group.Conclusion The combination of NMES+rTMS and CTAR is superior to single electromagnetic stimulation or CTAR in the treatment of post-stroke sysphagia.

Glaesserella parasuis is the causative agent of Gl?sser's disease in pigs.However,the pathogenic mechanisms underlying its virulence is not yet fully understood.The RuvB protein,a member of the AAA+superfamily,is implicated in various cellular processes,yet its specific role in the virulence of Glaesserella parasuis has not been fully characterized.In this study,we con-structed a RuvB gene deletion mutant,designated ΔRuvB,using the serotype 13 Glaesserella pa-rasuis strain ZJ1208 and a suicide plasmid-mediated natural transformation approach.To elucidate the functional role of the RuvB gene,we comprehensively evaluated the biological characteristics of the ΔRuvB strain through a series of assays,including growth kinetics,colony morphology,bac-terial staining,transmission electron microscopy(TEM),osmotic stress tolerance,high-tempera-ture tolerance,heat shock resistance,UV resistance,capsular polysaccharide quantification,serum bactericidal assays,and murine virulence experiments.Our findings revealed that the growth rate of ΔRuvB showed no significant difference compared to the parental strain.TEM revealed a notable increase in bacterial cell length;however,the number of outer membrane vesicles(OMVs)on the surface of ΔRuvB did not significantly increase.Notably,the ΔRuvB strain displayed a significant reduction in capsular polysaccharide production and serum resistance,as well as diminished toler-ance to UV radiation and high temperatures.Significant alterations were observed in its resistance to osmotic stress or oxidative stress.In the mouse toxicity challenge experiment,in com-parison with the parental strain ZJ1208,the mortality rate dropped by 20 percentage points,suggesting that the virulence of ΔRuvB has been weakened to some extent.Collectively,these results underscore the critical role of the RuvB gene in enhancing the environmental adaptability of Glaesserella parasuis.

The aim of this paper was to investigate the serotypes,virulence factors and drug resist-ance of clinical isolates of Pasteurella rnultocida of porcine origin in recent years.Morphological screening and polymerase chain reaction(PCR)were used to isolate and identify 119 isolates from nasal swabs and lung tissue samples sent from swine farms in Zhejiang Province from 2010 to 2024.The isolates of Pasteurella multocida were subjected to capsular polysaccharide serotyping,lipopolysaccharide serotyping,virulence factor detection and drug resistance analysis by PCR and Kirby-Bauer disc agar diffusion method(K-B).The results showed that there were 64 strains(53.7％)of A-type,54 strains(45.3％)of D-type and 1 strain(0.9％)of F-type among the capsu-lar polysaccharide serotypes,and 10 strains(8.4％)of L1-type,20 strains(16.8％)of L3-type,86 strains(72.2％)of L6-type,and 3 strains(2.6％)of undetermined type among the lipopolysaccha-ride serotypes.The amplification results of 10 virulence genes showed that the detection rate of virulence genes hgbA,higbB and fimA was over 86.0％,the detection rate of toxA was 8.4％,while the virulence gene tbpA was not detected.There were also differences in the distribution vir-ulence genes in different capsular polysaccharide serotypes.Virulence factor pfhA was detected in type A and F but not in type D.The detection rate of adhesin gene tadD in serotype A(92.2％)was significantly higher than that of type D(9.3％),and,on the contrary,the detection rate of ad-hesin gene hsf-l in serotype D(90.7％)was significantly higher than that of type A(20.3％).Drug resistance analysis revealed that Pasteurella multocida showed high susceptibility to antimi-crobial drugs such as amoxicillin,ampicillin,cephalosporins,doxycycline,fosfenicol and ciprofloxa-cin,and showed strong resistance to antimicrobial drugs such as lincomycin,cotrimoxazole,genta-micin and amikacin,and there were 54 multi-drug resistant strains(78.3％).In summary,capsular polysaccharide serotypes were dominated by type A and D,lipopolysaccharide serotypes were dom-inated by L6,the distribution of some virulence genes varied greatly among different serotypes,and the proportion of multi-resistant strains was high,which provide reference for the prevention and control of this disease.

Purpose To develop a nomogram combined radiomics,clinical and CT morphographic features for the prediction of the acquired T790M mutation in patients with advanced non-small cell lung cancer with resistance after the duration of first-line epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitor(TKI)treatment.Materials and Methods The chest CT images and clinical data of 116 patients who underwent secondary biopsy after disease progression during first-line TKI treatment for advanced non-small cell lung cancer with EGFR sensitive mutations,from December 2016 to December 2022 in Shaoxing People's Hospital were retrospectively analyzed.All patients were randomly divided into a training cohort(n=81)and a validation cohort(n=35),at a ratio of 7︰3.The regions of interest of the lesion were delineated,and radiomics features were extracted.Feature selection was performed via the maximum relevance minimum redundancy and the least absolute shrinkage and selection operator methods.Clinical features were selected via univariate and multivariate Logistic regression.A nomogram combined clinical and radiomics features was subsequently constructed.The predictive ability of the combined model was evaluated via receiver operator characteristic curve,calibration curves and decision curve analysis.Results The progression-free survival of first-line EGFR-TKIs(OR=1.086,P=0.041),initial EGFR profile(OR=0.280,P=0.021),vascular convergence(OR=4.050,P=0.036)and air bronchogram(OR=3.265,P=0.030)were highly correlated with the acquired T790M mutation.The combined model demonstrated good predictive performance for acquired T790M mutation,both in the training set(AUC=0.867,95%CI 0.790-0.944)and the validation set(AUC=0.895,95%CI 0.786-1.000).The calibration curve showed good calibration power,and the decision curve analysis demonstrated a significant net benefit.Conclusion A radiomics-clinical nomogram based on CT radiomics has the potential to predict acquired T790M mutation and could be a complementary tool for T790M mutation detection after resistance to first-or second-generation EGFR-TKIs.

Objective:To explore the effects of pharmaceutical services through enterprise WeChat for outpatients with cancer pain.Methods:A retrospective study was conducted on patients who were first diagnosed and/or previously treated for cancer pain and visited Outpatient Department of the First Affiliated Hospital of Soochow University from January 1, 2020 to January 30, 2023. The outpatients were divided into conventional pharmaceutical services management group (conventional group) and pharmaceutical services management group through enterprise WeChat (enterprise WeChat group) based on whether they received pharmaceutical services for cancer pain through enterprise WeChat. Prescription appropriateness, changes in cancer pain and life quality evaluation indicators after treatment in patients between the 2 groups were recorded and compared.Results:A total of 174 patients were included, with 87 patients in each group. There were no significant differences in age and gender between the 2 groups (all P>0.05). Before the pharmaceutical services management for cancer pain through enterprise WeChat, the differences in the proportion of patients with pain free, mild, moderate, and severe pain after pain relief treatments between the 2 groups were not significant (all P>0.05). In the conventional group, 13 out of 87 patients (14.9%) had inappropriate prescriptions, and 2 out of 87 (2.3%) in the enterprise WeChat group, with statistically significant difference (χ 2=8.828, P<0.05). After management with enterprise WeChat, the patients of pain-free increased from 19 to 55 (63.2%) in the enterprise WeChat group, and from 18 to 41 (47.1%) in the conventional group. The difference in the proportion of pain-free patients between the 2 groups was statistically significant (χ 2=4.555, P=0.033). The differences in the scores of various indicators of life quality between the 2 groups before management with enterprise WeChat were not significant (all P>0.05). After the management with enterprise WeChat, life quality scores in all the 8 dimensions were significantly higher than those in the conventional group (all P<0.05). Conclusion:The utilization of enterprise WeChat could improve the treatment effect of cancer pain, enhance their life quality, help improve the quality of pharmaceutical services, and have certain promotion and utilization value.