ObjectiveTo explore the application of virtual reality biofeedback training combined with oral localization therapy in dysphagia after oral cancer surgery. MethodsFrom May, 2023 to July, 2024, 86 patients with dysphagia after oral cancer surgery in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 43) and experimental group (n = 43). The control group received conventional swallowing function training, while the experimental group added virtual reality biofeedback training combined with oral positioning therapy, for four weeks. The Standardized Swallowing Function Assessment Scale (SSA), Functional Oral Intake Scale (FOIS) and M.D.Anderson Dysphagia Inventory (MDADI) were used for evaluation before intervention, and two weeks, four weeks and eight weeks after intervention. ResultsFor scores of SSA , the main effects of group (F = 150.190, P < 0.001, η²_p = 0.641) and time (F = 230.870, P < 0.001, η²_p = 0.733), as well as the interaction effect (F = 16.910, P < 0.001, η²_p = 0.168) were all significant. For scores of FOIS, the main effects of group (F = 59.601, P < 0.001, η²_p = 0.415) and time (F = 89.464, P < 0.001, η²_p = 0.516), as well as the interaction effect (F = 7.990, P < 0.001, η²_p = 0.087) were all significant. For scores of MDADI, the main effects of group (F = 33.133, P < 0.001, η²_p = 0.283) and time (F = 49.650, P < 0.001, η²_p = 0.371), as well as the interaction effect (F = 3.224, P = 0.023, η²_p = 0.037) were all significant. ConclusionVirtual reality biofeedback training combined with oral localization therapy could improve the swallowing function, oral feeding ability and overall quality of life of patients with dysphagia after oral cancer surgery.

[Objective] To study the molecular biological mechanism for a case of ABO blood group B subtype, and perform three-dimensional modeling of the mutant enzyme. [Methods] The ABO phenotype was identified by the tube method and microcolumn gel method; the ABO gene of the proband was detected by sequence-specific primer polymerase chain reaction (PCR-SSP), and the exon 6 and 7 of the ABO gene were sequenced and analyzed. Homologous modeling of Bw.03 glycosyltransferase (GT) was carried out by Modeller and analyzed by PyMOL2.5.0 software. [Results] The weakening B antigen was detected in the proband sample by forward typing, and anti-B antibody was detected by reverse typing. PCR-SSP detection showed B, O gene, and the sequencing results showed c.721 C>T mutation in exon 7 of the B gene, resulting in p. Arg 241 Trp. Compared with the wild type, the structure of Bw.03GT was partially changed, and the intermolecular force analysis showed that the original three hydrogen bonds at 241 position disappeared. [Conclusion] Blood group molecular biology examination is helpful for the accurate identification of ambiguous blood group. Homologous modeling more intuitively shows the key site for the weakening of Bw.03 GT activity. The intermolecular force analysis can explain the root cause of enzyme activity weakening.

Objective To compare the safety and efficacy of vancomycin in obese patients guided by trough concentration and AUC24h/MIC,and to provide data for individualized administration of vancomycin in obese patients.Methods We retrospectively collected the data of obese adult patients(BMI 30 kg/m2)who had severe infection caused by gram-positive cocci and treated with vancomycin intravenously in two Grade A tertiary hospitals in Shanghai from 2012 to 2024.The patients were assigned to trough concentration monitoring group or AUC24h/MIC monitoring group according to the therapeutic drug monitoring(TDM)method at the time of admission.Nephrotoxicity and efficacy were compared between the two groups of patients.Results A total of 22 obese patients were included in this study,including 12 in the trough concentration monitoring group and 10 in the AUC24h/MIC monitoring group.No significant difference was found between the two groups in gender,age,BMI,creatinine clearance before treatment,underlying disease,site of infection,pathogen type,or concomitant medications.The proportion of ICU admission was higher in AUC24h/MIC monitoring group.The length of ICU stay,vancomycin treatment duration,bacterial clearance rate and comprehensive efficacy rate did not show significant difference between the two groups.The average daily dose of vancomycin in trough concentration monitoring group was significantly lower than that in A UC24h/MIC monitoring group[(1.63±0.59)g vs(2.29±0.72)g,P=0.026].The average treatment duration was not significantly different between the two groups[(15.33±10.28)d vs(14.90±6.92)d,P=0.911].Compared with the trough concentration monitoring group,the initial peak concentration[(30.99±16.22)mg/L vs(19.41±5.42)mg/L,P=0.025]and overall peak concentration[(33.67±16.53)mg/L vs(22.08±3.96)mg/L,P=0.045]of vancomycin were lower in theAUC24h/MIC monitoring group,but the initial trough concentration[(11.03±8.66)mg/L vs(6.33±4.45)mg/L,P=0.139]and overall trough concentration[(13.75±9.74)mg/L vs(9.74±4.24)mg/L,P=0.218]were similar in the two groups.Vancomycin-associated nephrotoxicity did not occur in any group,but 41.7％of the patients in the trough concentration monitoring group reached the threshold of renal toxicity,i.e.trough concentration ≥15 mg/L.Conclusions Vancomycin treatment with conventional dosing regimen still have good clinical efficacy in obese adult patients.Vancomycin therapy guided by A UC24h/MIC can achieve the target value at lower concentration or exposure,which is promising for reducing vancomycin-associated nephrotoxicity.

Purpose To investigate the expression of POLR2M in colorectal cancer(CRC)and its effects on cell growth,apoptosis and invasion.Methods GEPIA2.0,TCGA and Kaplan-Meier Plotter databases were used to ana-lyze the differential expression of POLR2M in CRC tissues and normal adjacent tissues,and to evaluate its prognostic significance using the Log-rank test.Quantitative real-time PCR(qRT-PCR)was used to detect the expression of POLR2M in human colorectal cancer cell lines SW480,HCT-8,RKO,LOVO,DLD-1,HCT-116,SW620 and human normal colorectal cell line FHC.DLD-1 and RKO cells were stably transfected with lentivirus,and the POLR2M groups were up-regulated into the control group(LV-NC)and experimental group(LV-POLR2M),and the transient transfec-tion of SW620 and SW480 cells with interfering fragments of SiRNA was used to down-regulate the POLR2M groups into the control group(Si-NC)and experimental group(Si-POLR2M),and the transfection efficiency of each group was verified.CCK-8,plate cloning,Transwell and scratch healing assays were used to detect cell proliferation,invasion and migration.Flow cytometry was used to detect the effects of POLR2M on cell cycle and apoptosis.Results GE-PIA2.0,TCGA and Kaplan-Meier Plotter database analysis showed that the expression of POLR2M in colorectal cancer was significantly higher than in normal adjacent tissues(P＜0.05),and the expression of POLR2M was closely associ-ated with the histological type of colorectal cancer and lymph node metastasis(P＜0.05),but not with the age,gen-der,tumor grade and vascular invasion of patients(P＞0.05).The prognosis of patients with POLR2M overexpression was poor(P＜0.05).The results of qRT-PCR showed that compared with FHC cells,the mRNA expression of POLR2M in SW480,HCT-8,RKO,LOVO,DLD-1,HCT-116 and SW620 cell lines was increased(F=97.7,P＜0.05),and POLR2M stable overexpression and interference cell lines were successfully constructed.Compared with the LV-NC group,the viability,colony number,number of cells passing through the chamber and cell mobility of DLD-1 and RKO cells in the LV-POLR2M group were significantly increased(P＜0.05).Compared with the Si-NC group,the viability,colony number,number of cells passing through the chamber,and cell mobility of SW620 and SW480 cells in the Si-POLR2M group were significantly decreased(P＜0.05).Downregulation of POLR2M induced cell cycle arrest in G1 phase and promotes apoptosis(P＜0.05).Conclusion POLR2M may play a role as a pro-tumor gene in CRC,and its high expression can significantly promote the proliferation and invasion of CRC cells.

Objective:To identify factors influencing treatment-free remission (TFR) outcomes in children and adolescent patients with chronic myeloid leukemia (CML) after imatinib (IM) discontinuation.Methods:This multicenter retrospective study analyzed 36 children and adolescent patients with CML from eight hematology centers in China (December 1, 2016, to September 27, 2024) who discontinued IM therapy with documented post-cessation outcomes. Clinical characteristics and molecular response dynamics were assessed. Univariate analysis and multivariate Cox proportional hazards regression models were employed to assess factors associated with TFR outcomes.Results:A total of 36 patients were documented, comprising 17 males and 19 females. The median ages at CML diagnosis and IM discontinuation were 11 years ( IQR: 5,16) and 20 years ( IQR: 14,25), respectively. The median time from IM initiation to first deep molecular response (DMR) was 21 months ( IQR: 13, 38). Pre-discontinuation, patients received IM for a median duration of 96 months ( IQR: 84, 121) and maintained DMR for 74 months ( IQR: 63, 89). With a median post-discontinuation follow-up of 38 months ( IQR: 15, 68), cumulative TFR rates at 6, 12, 24, and 36 months were 74.1%, 60.7%, 60.7%, and 56.0%, respectively, generating an overall TFR rate of 58.3%. Fifteen patients lost major molecular response at a median of 5 months post-discontinuation ( IQR: 3, 11). All 15 patients resumed tyrosine kinase inhibitor therapy, comprising 13 who restarted IM and 2 who switched to dasatinib. By the last follow-up, 13 (86.7% ) patients regained DMR after a median treatment duration of 5 months ( IQR: 3, 17), and no disease progression occurred in any patient. Withdrawal syndrome occurred in 2 (5.6% ) patients. Univariate analysis revealed significantly higher TFR rates in patients with pre-discontinuation IM duration of ≥100 months vs <100 months (82.4% vs 36.8%, P=0.017) and pre-discontinuation DMR duration of ≥72 months vs <72 months (84.2% vs 29.4%, P=0.003). Multivariate Cox analysis identified pre-discontinuation DMR duration as an independent protective factor for TFR ( HR=5.419, 95% CI: 1.524–19.272, P=0.009) . Conclusion:DMR duration was identified as an independent protective factor influencing TFR outcomes in children and adolescent patients with CML after IM discontinuation. Patients who maintained DMR for ≥72 months before IM discontinuation demonstrated a significantly higher TFR rate.

People with AIDS are highly prone to opportunistic infections,among which pulmonary infections are the most common,with high incidence and fatality rates.How to effectively prevent or reduce the occurrence of HIV-related lung infections(HRLI)is of great practical significance.From the perspective of traditional Chinese medicine(TCM),HRLI and AIDS share common pathological mechanisms,including qi deficiency,spleen defi-ciency,phlegm-heat or phlegm-dampness obstructing the lungs.Based on the TCM theory of"preventing disease before it occurs",the three-level prevention approach includes:the first step"preventing disease before it occurs"emphasizes strengthening the body's defense mechanisms by tonifying the spleen and benefiting qi,and nourishing the lungs and kidneys to strengthen the exterior and protect the body;the second step"preventing the progression of disease once it occurs"emphasizes the removal of pathogenic factors while strengthening the body's defenses.Based on the principles of syndrome differentiation and treatment in TCM,focuses are kept on the spleen tonifying and phlegm resolving,pathogenic factors dispelling and dampness eliminating,while protecting the spleen and nourishing other organs.The third step"preventing relapse after recovery"emphasizes replenishing deficiencies and enhancing immunity.Adopting the three-level prevention approach and early intervention can reduce the inci-dence of HRLI,which is a new idea for the prevention and treatment of HRLI with TCM.

Sj?gren's syndrome(SS)is one of the common rheumatic diseases in clinical practice.Modern medicine commonly uses drugs such as artificial tears,saliva,glucocorticoids,immunosuppressants,and biologics to control the condition.Clinical practice has shown that in addition to modern medical basic treatment,the use of traditional Chinese medicine(TCM)can help improve the clinical efficacy of SS.According to the symptoms and signs of Sj?gren's syndrome in TCM,it is classified as"dryness and obstruction",and the core pathogenesis of the disease is spleen deficiency and deficiency of body fluids.Subsequently,toxic and pathogenic factors gather,leading to the decline of internal organs.The initial causes are spleen damage,unstable barrier,and invasion of pathogenic factors.The core link is spleen dysfunction,insufficient body fluid,and dryness arising from it.Spleen deficiency generates evil,obstruction of qi,and lack of body fluids are the root causes of illness.The main treatment method is the"spleen strengthening method",which treats spleen deficiency,dampness and stagnation,and the body fluid is not distributed.The treatment focuses on strengthening the spleen and qi,supplementing the lungs and generating fluids.Spleen deficiency leads to loss of vitality,blood stasis obstructs blood vessels,and the treatment is to strengthen the spleen,soothe the liver,remove blood stasis,and unblock the orifices.The spleen yang is not vigorous,and qi transformation is impaired.The treatment is to invigorate the spleen and warm the stomach,promote yang circulation,and promote diuresis.

Objective:To investigate the application of Galectin-9 and Pentraxin3 in cardiotoxicity assessment during anthracycline chemotherapy in breast cancer patients.Methods:A total of 143 breast cancer patients who received anthracycline chemotherapy in Department of Breast, Shanxi Provincial People’s Hospital from Oct. 2021 to Oct. 2023 were separated into cardiotoxic group ( n=47) and non-cardiotoxic group ( n=96) according to whether cardiotoxicity occurred. Clinical data of patients were collected and the risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression. The predictive efficacy of serum Galectin-9 and Pentraxin3 levels on cardiotoxicity was evaluated by receiver operating characteristic curve (ROC) . Results:There was no statistically significant difference in age, body mass index, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, smoking history, drinking history, underlying disease (hypertension, diabetes, hyperlipidemia) , tumor stage, pathological type, tumor size, anthracycline type, or dose between the two groups ( t=1.07, 1.22, 0.96, 0.43, 1.07, 0.50; χ 2=0.12, 1.20, 0.14, 0.01, 0.47, 0.14, 3.32, 3.83, 1.91, 3.18, P > 0.05) ; The levels of troponin and B-type brain natriuretic peptide in cardiotoxicity group were higher than those in non-cardiotoxicity group ( t=13.48, 10.28, P < 0.05) , and serum Galectin-9 and Pentraxin3 levels were also higher ( t=22.53, 17.92, P < 0.05) . Multivariate Logistic regression analysis showed that high levels of troponin, B-type brain natriuretic peptide, Galectin-9 and Pentraxin3 were all influential factors in the occurrence of cardiotoxicity ( OR=2.221, 2.050, 1.925, 1.976, P < 0.05) . ROC curve analysis showed that the area under curve of serum Galectin-9 for predicting cardiotoxicity was 0.722, the predictive sensitivity was 68.09%, and the specificity was 77.08%; The area under the curve of miR-135 for predicting cardiotoxicity was 0.636, the predictive sensitivity was 44.68%, and the specificity was 82.29%. Conclusion:Serum Galectin-9 and Pentraxin3 have high expression levels in breast cancer patients treated with anthracyclines, which are influential factors for the occurrence of cardiotoxicity after chemotherapy, and have high predictive value for the occurrence of cardiotoxicity in patients.

Sj?gren's syndrome(SS)is one of the common rheumatic diseases in clinical practice.Modern medicine commonly uses drugs such as artificial tears,saliva,glucocorticoids,immunosuppressants,and biologics to control the condition.Clinical practice has shown that in addition to modern medical basic treatment,the use of traditional Chinese medicine(TCM)can help improve the clinical efficacy of SS.According to the symptoms and signs of Sj?gren's syndrome in TCM,it is classified as"dryness and obstruction",and the core pathogenesis of the disease is spleen deficiency and deficiency of body fluids.Subsequently,toxic and pathogenic factors gather,leading to the decline of internal organs.The initial causes are spleen damage,unstable barrier,and invasion of pathogenic factors.The core link is spleen dysfunction,insufficient body fluid,and dryness arising from it.Spleen deficiency generates evil,obstruction of qi,and lack of body fluids are the root causes of illness.The main treatment method is the"spleen strengthening method",which treats spleen deficiency,dampness and stagnation,and the body fluid is not distributed.The treatment focuses on strengthening the spleen and qi,supplementing the lungs and generating fluids.Spleen deficiency leads to loss of vitality,blood stasis obstructs blood vessels,and the treatment is to strengthen the spleen,soothe the liver,remove blood stasis,and unblock the orifices.The spleen yang is not vigorous,and qi transformation is impaired.The treatment is to invigorate the spleen and warm the stomach,promote yang circulation,and promote diuresis.

Objective:To investigate the application of Galectin-9 and Pentraxin3 in cardiotoxicity assessment during anthracycline chemotherapy in breast cancer patients.Methods:A total of 143 breast cancer patients who received anthracycline chemotherapy in Department of Breast, Shanxi Provincial People’s Hospital from Oct. 2021 to Oct. 2023 were separated into cardiotoxic group ( n=47) and non-cardiotoxic group ( n=96) according to whether cardiotoxicity occurred. Clinical data of patients were collected and the risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression. The predictive efficacy of serum Galectin-9 and Pentraxin3 levels on cardiotoxicity was evaluated by receiver operating characteristic curve (ROC) . Results:There was no statistically significant difference in age, body mass index, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, smoking history, drinking history, underlying disease (hypertension, diabetes, hyperlipidemia) , tumor stage, pathological type, tumor size, anthracycline type, or dose between the two groups ( t=1.07, 1.22, 0.96, 0.43, 1.07, 0.50; χ 2=0.12, 1.20, 0.14, 0.01, 0.47, 0.14, 3.32, 3.83, 1.91, 3.18, P > 0.05) ; The levels of troponin and B-type brain natriuretic peptide in cardiotoxicity group were higher than those in non-cardiotoxicity group ( t=13.48, 10.28, P < 0.05) , and serum Galectin-9 and Pentraxin3 levels were also higher ( t=22.53, 17.92, P < 0.05) . Multivariate Logistic regression analysis showed that high levels of troponin, B-type brain natriuretic peptide, Galectin-9 and Pentraxin3 were all influential factors in the occurrence of cardiotoxicity ( OR=2.221, 2.050, 1.925, 1.976, P < 0.05) . ROC curve analysis showed that the area under curve of serum Galectin-9 for predicting cardiotoxicity was 0.722, the predictive sensitivity was 68.09%, and the specificity was 77.08%; The area under the curve of miR-135 for predicting cardiotoxicity was 0.636, the predictive sensitivity was 44.68%, and the specificity was 82.29%. Conclusion:Serum Galectin-9 and Pentraxin3 have high expression levels in breast cancer patients treated with anthracyclines, which are influential factors for the occurrence of cardiotoxicity after chemotherapy, and have high predictive value for the occurrence of cardiotoxicity in patients.