Objective To compare the dosimetric differences in the heart and its substructures between two hybrid plans for hypofractionated whole-breast radiotherapy after breast-conserving surgery in patients with early-stage left-sided breast cancer. Methods A total of 46 patients with early-stage left-sided breast cancer who underwent hypofractionated whole-breast radiotherapy were randomly selected. Two hybrid radiotherapy plans were used, including hybrid intensity-modulated radiotherapy (H_IMRT) and hybrid volumetric-modulated arc therapy (H_VMAT). The heart and its substructures were contoured, including left anterior descending (LAD), left ventricle (LV), right coronary artery (RCA), and right ventricle (RV). The heart and substructure doses, as well as monitor units, were compared between H_IMRT and H_VMAT. Results Both hybrid plans met the clinical requirements. H_IMRT significantly outperformed H_VMAT for the heart (V₁₀, V₃₀, and D_mean), LAD (V₃₀, V₄₀, D_max and D_mean), LV (V₁₀, V₂₀ and D_mean), RCA (D_max, D_mean), and RV (V₅, V₁₀, D_mean) (P < 0.001). Additionally, H_IMRT was significantly superior to H_VMAT for heart V₅, LAD V₂₀, and RV V₂₀ (P = 0.005, 0.035 and 0.037). For LAD (V₁₅, V₄₀) and LV (V₅, V₂₅), H_IMRT was slightly better than H_VMAT, and the difference was not statistically significant. Conclusion Both H_IMRT and H_VMAT hybrid radiotherapy plans are suitable for hypofractionated whole-breast radiotherapy after breast-conserving surgery in patients with early-stage left-sided breast cancer. H_IMRT is slightly better than H_VMAT in dose sparing for the heart and its substructures.

BACKGROUND:How to effectively promote bone regeneration and bone reconstruction after bone injury has always been a key issue in clinical bone repair research.The use of biological and degradable materials loaded with bioactive factors to treat bone defects has excellent application prospects in bone repair. OBJECTIVE:To investigate the effect of polylactic acid-glycolic acid copolymer(PLGA)composite scaffold modified by lysine-grafted graphene oxide nanoparticles(LGA-g-GO)on osteogenic differentiation and new bone formation. METHODS:PLGA was dissolved in dichloromethane and PLGA scaffold was prepared by solvent evaporation method.PLGA/GO composite scaffolds were prepared by dispersing graphene oxide uniformly in PLGA solution.LGA-g-GO nanoparticles were prepared by chemical grafting method,and the PLGA/LGA-g-GO composite scaffolds were constructed by blending LGA-g-GO nanoparticles at different mass ratios(1%,2%,and 3%)with PLGA.The micromorphology,hydrophilicity,and protein adsorption capacity of scaffolds of five groups were characterized.MC3T3 cells were inoculated on the surface of scaffolds of five groups to detect cell proliferation and osteogenic differentiation. RESULTS AND CONCLUSION:(1)The surface of PLGA scaffolds was smooth and flat under scanning electron microscope,while the surface of the other four scaffolds was rough.The surface roughness of the composite scaffolds increased with the increase of the addition of LGA-g-GO nanoparticles.The water contact angle of PLGA/LGA-g-GO(3%)composite scaffolds was lower than that of the other four groups(P<0.05).The protein adsorption capacity of PLGA/LGA-g-GO(1%,2%,and 3%)composite scaffolds was stronger than PLGA and PLGA/GO scaffolds(P<0.05).(2)CCK-8 assay showed that PLGA/LGA-g-GO(2%,3%)composite scaffold could promote the proliferation of MC3T3 cells.Alkaline phosphatase staining and alizarin red staining showed that the cell alkaline phosphatase activity in PLGA/LGA-g-GO(2%,3%)group was higher than that in the other three groups(P<0.05).The calcium deposition in the PLGA/GO and PLGA/LGA-g-GO(1%,2%,and 3%)groups was higher than that in the PLGA group(P<0.05).(3)In summary,PLGA/LGA-g-GO composite scaffold can promote the proliferation and osteogenic differentiation of osteoblasts,and is conducive to bone regeneration and bone reconstruction after bone injury.

[Objective] To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo, and to provide a basis for improving the blood screening strategy. [Methods] A total of 12 227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology, enzymology, and nucleic acid testing. Furthermore, HEV gene sequencing was performed for genotyping analysis, and donors with reactive nucleic acid testing results were followed up to confirm their infection status. [Results] The reactivity rate of HEV Ag, anti-HEV IgM and anti-HEV IgG was 0.098%, 0.899% and 29.198%, respectively. There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders, donation frequencies and donation types (P>0.05). The reactivity rate increased significantly with age (P<0.05). The rate of ALT disqualification (ALT>50U/L) was significantly higher than that in non-reactive samples (P<0.05). The HEV Ag reactivity rate (0.098%) was not correlated with gender, donation frequency, donation type or age. One HEV RNA positive case was found, with a positive rate of 0.008%(1/12 227). It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis. Apart from HEV Ag reactivity, all other blood safety screening items were non-reactive, suggesting this case might be in the acute infection phase. The follow-up results showed that all indicators of the donor's previous blood donation were non-reactive. [Conclusion] Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV (TT-HEV) to a certain extent, and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.

In order to further standardize the vaccination of kidney transplant candidates and recipients in China, the Branch of Organ Transplantation of Chinese Medical Association has organized experts in kidney transplantation and infectious diseases. Based on the "Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice", and in combination with the clinical reality of infectious diseases and vaccination after organ transplantation in China, as well as referring to relevant recommendations from home and abroad in recent years, these guidelines are formulated from aspects such as epidemiology, types of vaccines, vaccination principles, target population, and specific vaccine administration. The "Guidelines for Vaccination of Kidney Transplant Candidates and Recipients in China" aims to provide theoretical reference for medical workers in the field of kidney transplantation in China, regarding the vaccination of kidney transplant candidates and recipients. It is expected to better guide the vaccination of kidney transplant candidates and recipients, reduce the risk of postoperative infection, and improve survival outcomes.

Objective: To report the clinical data of two patients with prostatic hyperplasia and bladder uric acid stones，so as to provide reference for clinical practice. Methods: Clinical data of two patients successfully undergoing blue laser lithotripsy in Department of Urology，Zhenba County People's Hospital were retrospectively analyzed，including clinical manifestations，surgical methods，treatment outcomes and complications. Results: Both patients sought medical care due to progressive dysuria or hematuria.B ultrasound and magnetic resonance imaging confirmed bladder calculi and prostatic hyperplasia.One patient also had large blood clots in the bladder cavity.Both patients received transurethral blue laser prostate vaporization + transurethral bladder stone holmium laser lithotripsy.The stone surface was dark yellow，with no obvious pores，fine particles or spike protrusion.Blue laser produced an “ablative” phenomenon similar to vaporization，and then stones became smaller and fragmented.The lithotripsy lasted for 11 min and 8 min，respectively.There were multiple bladder mucosal injuries due to constant drift of stones during operation.Stone composition analysis suggested uric acid stones.After 3 months of follow-up，both patients had smooth postoperative urination，good urine control，and no stone recurrence. Conclusion: Blue laser can be applied to crush uric acid stones，and the bladder mucosa should be protected during lithotripsy.

ObjectiveTo observe the effect of the hypertension chronic disease management platform-assisted traditional Chinese medicine （TCM） comprehensive antihypertensive regimen on blood pressure control in the real world， and evaluate patients' satisfaction with this regimen. MethodsA total of 160 patients with primary hypertension were recruited， and the patients were asked to use the hypertension chronic disease management platform for self-management and to decide whether to apply TCM comprehensive antihypertensive regimen （including Baduanjin for lowering blood pressure， acupoint massage， and Chinese medicinal tea）. One month later， the changes in patients' blood pressure and the application rate of each treatment regimen were investigated. Logistic regression analysis was used to analyze the correlation between each regimen and blood pressure changes. Sensitivity analysis was performed by excluding some patients with comorbidities that might affect the use of the regimens to verify the reliability of the research results. Interaction analysis was conducted to explore whether there was a synergistic effect between the regimens， and patient satisfaction was also surveyed. ResultsA total of 149 patients were finally included. Compared with patients who did not use TCM comprehensive antihypertensive regimen regularly， those who used it regularly had a more significant decrease in diastolic blood pressure （P＜0.05）. The results of Logistic regression analysis showed that the decrease in systolic blood pressure was associated with the use of TCM decoctions， and the decrease in diastolic blood pressure was associated with the use of TCM decoctions and regular use of TCM comprehensive antihypertensive regimen （P＜0.05）. Sensitivity analysis suggested that the above research results were stable. The results of interaction analysis showed that there was no interactive effect between antihypertensive Baduanjin and acupoint massage， antihypertensive Baduanjin and Chinese medicinal tea， or acupoint massage and Chinese medicinal tea on systolic and diastolic blood pressure （P＞0.05）. One hundred and thirty patients （130/149， 87.25%） thought the hypertension chronic disease management platform was helpful or very helpful， and 111 patients （111/149， 74.50%） thought TCM comprehensive antihypertensive regimen was helpful or very helpful. ConclusionRegular use of TCM comprehensive antihypertensive regimen helps reduce the diastolic blood pressure level in patients with primary hypertension， and patients have a high degree of satisfaction with the use of the hypertension chronic disease management platform and TCM comprehensive antihypertensive regimen.

In recent years, the application of artificial intelligence (AI) in the field of biology has witnessed remarkable advancements. Among these, the most notable achievements have emerged in the domain of protein structure prediction and design, with AlphaFold and related innovations earning the 2024 Nobel Prize in Chemistry. These breakthroughs have transformed our ability to understand protein folding and molecular interactions, marking a pivotal milestone in computational biology. Looking ahead, it is foreseeable that the accurate prediction of various physicochemical properties of proteins—beyond static structure—will become the next critical frontier in this rapidly evolving field. One of the most important protein properties is thermodynamic stability, which refers to a protein’s ability to maintain its native conformation under physiological or stress conditions. Accurate prediction of protein stability, especially upon single-point mutations, plays a vital role in numerous scientific and industrial domains. These include understanding the molecular basis of disease, rational drug design, development of therapeutic proteins, design of more robust industrial enzymes, and engineering of biosensors. Consequently, the ability to reliably forecast the stability changes caused by mutations has broad and transformative implications across biomedical and biotechnological applications. Historically, protein stability was assessed via experimental methods such as differential scanning calorimetry (DSC) and circular dichroism (CD), which, while precise, are time-consuming and resource-intensive. This prompted the development of computational approaches, including empirical energy functions and physics-based simulations. However, these traditional models often fall short in capturing the complex, high-dimensional nature of protein conformational landscapes and mutational effects. Recent advances in machine learning (ML) have significantly improved predictive performance in this area. Early ML models used handcrafted features derived from sequence and structure, whereas modern deep learning models leverage massive datasets and learn representations directly from data. Deep neural networks (DNNs), graph neural networks (GNNs), and attention-based architectures such as transformers have shown particular promise. GNNs, in particular, excel at modeling spatial and topological relationships in molecular structures, making them well-suited for protein modeling tasks. Furthermore, attention mechanisms enable models to dynamically weigh the contribution of specific residues or regions, capturing long-range interactions and allosteric effects. Nevertheless, several key challenges remain. These include the imbalance and scarcity of high-quality experimental datasets, particularly for rare or functionally significant mutations, which can lead to biased or overfitted models. Additionally, the inherently dynamic nature of proteins—their conformational flexibility and context-dependent behavior—is difficult to encode in static structural representations. Current models often rely on a single structure or average conformation, which may overlook important aspects of stability modulation. Efforts are ongoing to incorporate multi-conformational ensembles, molecular dynamics simulations, and physics-informed learning frameworks into predictive models. This paper presents a comprehensive review of the evolution of protein thermodynamic stability prediction techniques, with emphasis on the recent progress enabled by machine learning. It highlights representative datasets, modeling strategies, evaluation benchmarks, and the integration of structural and biochemical features. The aim is to provide researchers with a structured and up-to-date reference, guiding the development of more robust, generalizable, and interpretable models for predicting protein stability changes upon mutation. As the field moves forward, the synergy between data-driven AI methods and domain-specific biological knowledge will be key to unlocking deeper understanding and broader applications of protein engineering.

Objective: To investigate the epidemic situation of notifiable infectious diseases in Zhejiang Province in 2024, so as to summarize the epidemic characteristics. Methods: Data of notifiable infectious diseases cases in Zhejiang Province from January 1 to December 31, 2024 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The epidemiological characteristics were analyzed according to the classification and transmission routes using the descriptive epidemiological method. Results: A total of 32 types of notifiable infectious diseases with 1 858 695 cases and 392 deaths were reported in Zhejiang Province in 2024, with a reported incidence of 2 804.73/105 and a reported mortality of 0.591 5/100 000. A total of 238 infectious disease public health emergencies were reported, of which 218 (91.60%) occurred in schools and kindergartens. There were 22 types of class A and B notifiable infectious diseases reported, with incidence of 470.62/100 000 and mortality of 0.591 5/100 000. Totally 10 types of class C notifiable infectious diseases, with a reported incidence of 2 334.11/105, and no deaths were reported. Classified by transmission route, respiratory infectious diseases had the highest reported incidence of 2 423.87/100 000, among which influenza exhibited the highest reported incidence of 2 024.22/100 000. The reported incidence of intestinal infectious diseases was 312.94/105, among which the incidence of other infectious diarrhea and hand-foot-mouth disease (HFMD) were high, with reported incidences of 169.52/100 000 and 136.18/100 000, respectively. Blood-borne and sexually transmitted infectious diseases accounted for the largest number of reported deaths, among which AIDS had the highest mortality of 0.424 0/100 000. Natural and insect-borne infectious diseases exhibited a low reported incidence of 1.37/105. The reported incidence of dengue fever was 0.40/100 000, and 95.08% of the cases were imported. Conclusions The reported incidence of respiratory and intestinal infectious diseases and the reported mortality of AIDS were high in Zhejiang Province in 2024. It is recommended to strengthen the prevention and control of infectious diseases such as influenza, other infectious diarrhea, and HMFD in schools and kindergartens.

Objective:To investigate the application value and safety of donor renal biopsy during laparoscopic living donor nephrectomy.Methods:The clinical data of 45 pairs of living donor and recipients who underwent living kidney transplantation in Beijing Friendship Hospital, Capital Medical University from January 2023 to December 2023 were retrospectively analyzed. Remuzzi score was used to evaluate the renal biopsy pathology of the donor kidney. Recipients and donors were divided in different groups by donor age and Remuzzi score of the donor kidney biopsy. The clinical data, pathological data and renal function of the donors in different groups were compared. Shapiro-Wilk test was used to determine whether the data satisfied the normal distribution. The measurement data with normal distribution were expressed as mean±standard deviation ( ± s). The measurement data with non-normal distribution were expressed as median (interquartile range) [ M( Q1, Q3)], and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as the number of cases and percentage, and the Chi-square test or Fisher exact probability method was used for comparison between groups. Results:One recipient suffered from postoperative arteriovenous fistula, and the other living kidney transplant donors and recipients had no serious complications related to biopsy. Among the 45 cases of donor renal biopsy pathology, glomerular number was ≥20 in 36 cases (80.0%). There were 20 cases (44.4%, 20/45) in the high Remuzzi score group (≥4 points) and 25 cases (55.6%, 25/45) in the low Remuzzi score group (≤3 points). There were 17 cases (37.8%, 17/45) with IgA deposition and 1 case (2.2%, 1/45) with IgA nephropathy. There was no significant difference between the high Remuzzi score group and the low Remuzzi score group in terms of estimating glomerular filtration rate (eGFR) half year after surgery ( P> 0.05). 6 cases (13.3%, 6/45) in the elderly group (age ≥60 years) and 39 cases (86.7%, 39/45) in the young group (age< 60 years) had no significant difference in Remuzzi score, IgA deposition, IgA nephropathy, donor′s eGFR at discharge and recipient′s eGFR half a year after operation ( P> 0.05). Conclusions:Donor renal biopsy during laparoscopic living donor nephrectomy is a safe and effective way to evaluate donor kidney. The relationship between the results of abnormal donor kidney biopsy and the prognosis of donors and recipients is not clear, but the donors and recipients with abnormal donor kidney biopsy need to be followed up closely after operation.

Aim To investigate the effect of Tripterygi-um wilfordii polyglycosides(TWP)on renal protection and the expression of cannabinoid 2 receptor/NADPH oxidase4/NOD like receptor protoin3(CB2R/NOX4/NLRP3)in renal tissue of IgA nephropathy(IgAN)rats.Methods The IgAN rat model was replicated u-sing the"BSA+CCl4+LPS"combined method,and intervention with TWP was administered.A fully auto-mated biochemical analyzer was used to detect 24-hour urine protein quantification(24h-UTP),urine red blood cell count(URBC),serum albumin(ALB),ala-nine aminotransferase(ALT),serum creatinine(Scr),and blood urea nitrogen(BUN).The pathological changes in renal tissue were observed under light mi-croscopy,and IgA deposition in the mesangial area was observed using immunofluorescence.The protein ex-pressions of CB2R,NOX4 and NLRP3 in renal tissue were detected by Western blot.Results Compared with the model group,the pathological damage to the kidneys of rats in the TWP group was significantly re-duced,and the deposition of IgA electron dense materi-al was significantly reduced.The levels of ALB in rats treated with TWP increased,while the levels of 24h-UTP,URBC,ALT,Scr,and BUN all decreased.The expression of CB2R protein in renal tissue of rats trea-ted with TWP increased,while the expression of NOX4 and NLRP3 proteins was reduced.Conclusion TWP can effectively improve renal injury in IgAN rats,and its mechanism may be related to the regulation of the CB2R/NOX4/NLRP3 signaling pathway.