Objective:This study aimed to investigate the characteristic expression of programmed death-ligand 2(PD-L2)and epithelial-mesenchymal transition(EMT)-related biomarkers in head and neck squamous cell carcinoma(HNSCC)and their mechanism of action in HNSCC metastasis.Methods:Tumor tissue samples from 94 patients with HNSCC were collected from Tianjin Medical University Cancer Hos-pital from January 2018 to July 2023,and their correlation with clinicopathological parameters,including lymph node metastasis,was statist-ically assessed.Western blot was used to detect PD-L2 expression in HNSCC tumor tissues.PD-L2 overexpression and knockdown stably-transfected monoclonal cell lines were generated using lentiviral vectors.Transwell assays were performed to explore the effect of PD-L2 on the invasive migration of the HNSCC cell lines.Additionally,RNA sequencing was used to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined by Western blot to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through EMT pathway activation.Additionally,RNA sequencing was employed to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined with Western blot analysis to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through the EMT pathway activation.Results:High expression of PD-L2 is positively correlated with N staging(P<0.05),and elevated PD-L2 expression predicts a poor prognosis in HNSCC patients.Conclusions:PD-L2 regulates the EMT pathway to promote HNSCC metastasis.Targeting PD-L2 is expected to provide a new strategy for the treatment of metastatic HNSCC.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

Objective:To discuss the clinical value of pan-immune inflammation index(PIV)in predicting the major adverse cardiovascular events(MACE)within 1 year after percutaneous coronary intervention(PCI)in the elderly patients with coronary heart disease,and to clarify the role of inflammatory response in postoperative recovery and prognosis of the patients with coronary heart disease.Methods:A total of 150 elderly patients with coronary heart disease who underwent PCI from July 2020 to August 2023 were selected as the research subjects;according to the occurrence of MACE within 1 year after operation,they were divided into MACE group(n=28)and non-MACE group(n=122);the baseline data and biochemical indicators of the patients were collected,and PIV was calculated;multivariate Logistic regression was used to analyze the influencing factors of MACE within 1 year after PCI in the elderly patients with coronary heart disease;receiver operating characteristic(ROC)curve was used to analyze the predictive value of PIV for MACE within 1 year after PCI in the elderly patients with coronary heart disease.Results:Compared with non-MACE group,the levels of total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C),neutrophils(NEUT),platelets(PLT)counting and PIV in the patients in MACE group were significantly increased(P<0.05);there were no significant differences in other data between two groups(P>0.05).The multivariate Logistic regression analysis results showed that the levels of TC(OR=1.571,95％CI:1.088-2.270)and LDL-C(OR=32.506,95％CI:8.880-118.994)and PIV(OR=1.014,95％CI:1.010-1.019)were the influencing factors of MACE within 1 year after PCI in the elderly patients with coronary heart disease(P<0.05).The ROC curve analysis results showed that the area under the ROC curve(AUC)of PIV for predicting MACE was 0.857(95％CI:0.762-0.951),the sensitivity was 0.821,the specificity was 0.959,the maximum Youden index was 0.780,and the best cut-off value was 778.805(P<0.01).Conclusion:PIV has important predictive value for MACE within 1 year after PCI in elderly patients with coronary heart disease.

Objective:This study aimed to investigate the characteristic expression of programmed death-ligand 2(PD-L2)and epithelial-mesenchymal transition(EMT)-related biomarkers in head and neck squamous cell carcinoma(HNSCC)and their mechanism of action in HNSCC metastasis.Methods:Tumor tissue samples from 94 patients with HNSCC were collected from Tianjin Medical University Cancer Hos-pital from January 2018 to July 2023,and their correlation with clinicopathological parameters,including lymph node metastasis,was statist-ically assessed.Western blot was used to detect PD-L2 expression in HNSCC tumor tissues.PD-L2 overexpression and knockdown stably-transfected monoclonal cell lines were generated using lentiviral vectors.Transwell assays were performed to explore the effect of PD-L2 on the invasive migration of the HNSCC cell lines.Additionally,RNA sequencing was used to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined by Western blot to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through EMT pathway activation.Additionally,RNA sequencing was employed to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined with Western blot analysis to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through the EMT pathway activation.Results:High expression of PD-L2 is positively correlated with N staging(P<0.05),and elevated PD-L2 expression predicts a poor prognosis in HNSCC patients.Conclusions:PD-L2 regulates the EMT pathway to promote HNSCC metastasis.Targeting PD-L2 is expected to provide a new strategy for the treatment of metastatic HNSCC.

Objective:To analyze categories and influencing factors of fall risk perception of elderly inpatients with chronic heart failure (CHF) based on latent profile analysis for providing references on improving their levels of fall risk perception.Methods:During December 2022 and July 2023, the elderly inpatients with CHF were selected as survey subjects through convenience sampling from department of geriatrics of Nanjing Drum Tower Hospital, and they were taken a cross-sectional investigation using a general information questionnaire, Hospital Anxiety Depression Scale, Multidimensional Chronic Disease Self-management Effectiveness Scale, Nurse-patient Trust Scale and Fall Risk Perception Questionnaire for Patients.Their categories of fall risk perception were analyzed by latent profile analysis.The influence factors of their different categories of fall risk perception were analyzed by unordered multi-class Logistic regression analysis.Results:There were 279 patients in final investigation, which contained 148 males and 131 females, and their age were during 60 to 78 (68.58 ± 6.37) years old. The score of fall risk perception of elderly inpatients with CHF was (42.12 ± 13.74).Among the fall risk perception categories of elderly CHF patients, the percentage of patients low risk perception group was 12.55% (35/279), percentage of patents from physical risk perception group was 17.20%(48/279), percentage of patents from environmental risk perception group was 56.99% (159/279) and percentage of patents from high risk perception group was 13.26% (37/279).Compared to high-risk perception group, unordered multi-class logistic regression analysis showed that male, no fall experience, self-management effectivenessand level of patient′s trust on nursewere significant influencing factors of fall risk perception of low risk perception group ( OR values were 0.023-55.980, all P<0.05); no having other chronic diseases, less than 5 years long course of disease, 5 to 10 years long course of disease, self-management effectiveness and level of trusting nurse were significant influencing factors of fall risk perception of physical risk resulting in perception group ( OR values were 0.027-1.711, all P<0.05); less than 7 days long hospital stay, 7 to 14 days long hospital stay, abnormal vision, self-management effectiveness and level of patient′s trust on nurse were significant influencing factors of fall risk perception of environmental risk resulting in perception group ( OR values were 0.907-6.482, all P<0.05). Conclusions:The level of fall risk perception of elderly inpatients with CHF was low and could be divided into low risk perception group, physical risk perception group, environmental risk perception group and high risk perception group. Their fall risk perception was influenced by gender, fall experience, having chronic diseases, course of disease, hospital stay, abnormal vision, self-management effectiveness, and level of patient′s trust on nurse.Clinical medical staff should provide personalized health education to different categories of fall risk perception of elderly inpatients with CHF, in order to improve their level of fall risk perception.

The Multi-Attribute Utility Instrument (MAUI) is currently a common method for health utility measurement. It converts scores from multiple dimensions of health status into a single utility value through the construction of utility value set,which is then used for the calculation of Quality-Adjusted Life Years (QALYs). Selecting an appropriate method for constructing the value set of MAUI is crucial for accurately measuring health utility values. The Multi-Attribute Utility Function (MAUF),as an important method for constructing the utility value set,has been widely applied internationally. It focuses on introducing the theoretical basis of the application of MAUF,the construction methods in different MAUI,and their application situations,aiming to provide references and insights for the methodological research on the construction of the utility value set for the MAUI in China.

As key tools of diagnosis and treatment of cardiac arrhythmias,medical devices of cardiac electrophysiology are complex in composition and diverse in variety,bringing heavy economic burden to arrhythmia patients.Thus,it is crucial to scientifically select the medical devices of cardiac electrophysiology that meet the needs of clinic and management,and that have reasonably price.Based on clinical usage and management of medical devices of cardiac electrophysiology,an expert consensus of the assessment on the comprehensive value of medical devices of cardiac electrophysiology has been formed by China Association of Medical Equipment-Application Evaluation Branch,so as to provide references for medical institutions in grasping and identifying the essential value points of medical devices of cardiac electrophysiology.

Objective:To test a new method with thermoluminescent dosimeters (TLDs) to determine the β-ray and γ-ray doses of β-γ mixed radiation fields.Methods:TLDs for personal dose monitoring were irradiated in the reference radiation fields of β-rays ( 90Sr/ 90Y, 85Kr) and γ-rays ( 137Cs). Across the range of 2.0-15.0 mSv, the linearity of TLD response and normalized response with respect to 137Cs were determined at the depths of Hp(10) and Hp(0.07). Using TLD detector readings at the depths of Hp(10) and Hp(0.07), β- and γ-ray doses in the mixed radiation fields were determined, and the result were verified. Results:For Hp(10) and Hp(0.07) under γ-ray exposure and Hp(0.07) under β-ray exposure, the coefficient of determination ( R2) were all >0.998. For the 90Sr/ 90Y source and 85Kr source, the average values of response values normalized with respect to 137Cs at different doses were 1.14 and 0.18, respectively; and the normalized response values derived from the slope values of the dose-response curves for the two sources were 1.17 and 0.18, respectively. The ratios of measurements of Hp(10) to Hp(0.07), kR, for the 85Kr source were close to 0, while the kR values for the 137Cs source were close to 1. Using the average value of kR and the slope value of kR for calculation, the maximum relative deviations between the calculated values and conventional values for Hp(10) γ, Hp(0.07) γ, and Hp(0.07) β were 6.1% and 6.0%, respectively. Conclusions:This method can be applied for the assessment of β-ray and γ-ray doses in β-γ mixed radiation fields of a single β source and single γ source.

The Multi-Attribute Utility Instrument (MAUI) is currently a common method for health utility measurement. It converts scores from multiple dimensions of health status into a single utility value through the construction of utility value set,which is then used for the calculation of Quality-Adjusted Life Years (QALYs). Selecting an appropriate method for constructing the value set of MAUI is crucial for accurately measuring health utility values. The Multi-Attribute Utility Function (MAUF),as an important method for constructing the utility value set,has been widely applied internationally. It focuses on introducing the theoretical basis of the application of MAUF,the construction methods in different MAUI,and their application situations,aiming to provide references and insights for the methodological research on the construction of the utility value set for the MAUI in China.