Objective:To investigate whether ultra-high dose rate (FLASH) irradiation can reduce radiation-induced intestinal injuries of mice compared to conventional dose rate (CONV) irradiation.Methods:Both FLASH and CONV irradiation were delivered with electron beam, with dose rates of 750 Gy/s and 0.5G y/s, respectively. A total of 105 mice were randomly divided into groups using a simple randomization method. Twenty-one mice were selected for weight observation, 7 mice in each group. After 9 Gy FLASH and CONV irradiation on the abdomen, the weight changes of mice were measured every other day, and compared among three groups. Twenty-four mice were selected for pathological examination including 5 mice in the control group. Three-and-a-half-day days after 12 Gy FLASH ( n=10) and CONV irradiation ( n=9) on the abdomen, the intestines of the mice were taken. Pathological sections were stained with hematoxylin-eosin (HE) to compare the number and percentage of regenerated crypts of the small intestine between two groups. After 12 Gy FLASH ( n=10) and CONV irradiation ( n=10) on the abdomen, the survival of 20 mice was observed. After FLASH using 4.5 Gy×2 times ( n=10) and CONV irradiation at 9 Gy×1 time ( n=10) on the abdomen, the weight changes were observed. After FLASH using 6 Gy×2 times ( n=10) and CONV irradiation at 12 Gy×1 time ( n=10) on the abdomen, the survival of mice was observed. The time interval between two irradiation was 1 min. EBT3 film was employed to monitor the actual exposure dose of the mice. The variables conforming to normal distribution were expressed by Mean±SD. Inter group comparison was performed by independent t-test. The survival of mice among different groups was compared by log-rank test. Results:After 9 Gy of abdominal irradiation, the mean weight of mice in the FLASH group was significantly higher than that in the CONV group. The weight of mice in the FLASH and CONV groups was (19.8±0.8) g and (18.0±1.8)g ( P=0.036) at 7 days after irradiation, (22.0±1.0)g and (21.2±0.5)g ( P=0.075) at 15 days after irradiation, and (24.2±1.4)g and (22.0±1.2)g ( P=0.012) at 25 days after irradiation, respectively. After 12 Gy irradiation, the mean survival of mice in FLASH and CONV groups was 4 days and 4.7 days ( P=0.029). After 12 Gy total abdominal irradiation, the mean number of intestinal regenerative crypts in the FLASH and CONV groups was 2.9/mm and 1.2/mm ( P=0.041), and the percentage of intestinal regenerative crypts was 34.1% and 14.1%, respectively. The survival of mice irradiated by FLASH using 6 Gy×2 times was longer compared with that of mice after CONV irradiation at 12 Gy×1 time. The weight of mice after 4.5 Gy×2 times irradiation was higher than that of mice after CONV irradiation at 9 Gy×1 time. Conclusion:Weight, survival and the number of intestinal regenerative crypts in the FLASH group are higher than those in the CONV group after irradiation, indicating that radiation-induced intestinal injury caused by FLASH irradiation is slighter than that of CONV irradiation.

Objective:To explore the application of flash glucose monitoring (FGM) system in patients with type 2 diabetes and its impact on patients, and to provide reference for improving blood glucose management in patients with type 2 diabetes.Methods:Qualitative research method was adopted. Purposive sampling was used to select patients with type 2 diabetes who received FGM in Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital from December 2023 to February 2024 as interview subjects. Semi-structured interview method was conducted for one-to-one in-depth interview, and thematic analysis was used to sort out and analyze data, identify and refine themes.Results:A total of 15 interviewees were included, including 7 males and 8 females, aged (61.27 ± 14.07) years. The interview results were summarized into five themes: behavioral changes of wearing FGM system (including changes of patients′blood glucose monitoring, diet, exercise and medication behaviors); FGM system improves the convenience and comfort of blood glucose monitoring; FGM system can effectively improve patients′sense of security; the advice of medical staff affects the willingness of patients to wear FGM system; price factors affect patients′willingness to wear FGM systems on a regular basis.Conclusions:The FGM system plays an important role in the management of patients with type 2 diabetes, improving patients′self-management behavior and blood glucose monitoring experience, and improving patients′sense of security. Medical personnel play an important role in the decision-making of patient disease management. However, price is an important factor restricting patients to wear regularly, and efforts should be made to improve the popularity of FGM system.

ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections. MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections. ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P₂₅， P₇₅： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections. ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.

Alzheimer's disease (AD) is a common and highly disabling irreversible degenerative disease of the central nervous system, with characteristics as progressive cognitive impairment, memory loss, and behavioral disturbances. Cognitive impairment in AD, being closely associated with amyloid beta-protein (Aβ) deposition, Tau hyperphosphorylation and neuroinflammation, affects the quality of life of patients. Currently, the exact cause of AD remains unclear, and effective treatment options still lacks. In recent years, stem cell-derived exosomes have garnered widespread attention due to their unique biological properties and crucial role in intercellular communication. These exosomes can carry various bioactive molecules, such as proteins, lipids, and RNA, playing significant roles in central nervous system degenerative diseases. Therefore, this article primarily describes the biogenesis, biological characteristics, and advantages of stem cell-derived exosomes, and summarizes their current applications and future prospects in cognitive impairment in AD, aiming to provide new insights for AD treatment.

Objective:To explore the clinical application value of preoperative colonoscopic marking by Nd-Fe-B magnet ring to assist laparoscopy.Methods:A total of 51 patients with colorectal tumor who underwent radical laparoscopy from January 2020 to October 2021 at the Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital were recruited. The patients were marked by Nd-Fe-B magnet ring under endoscopy one day before the operation, another magnet ring was sent into the abdominal cavity during the radical laparoscopy through cannula. The two magnet rings were attracted and clung to each other to orient the lesions. The basic information of patients, location of preoperative marks under endoscopy and laparoscopy conditions were recorded.Results:All 51 Nd-Fe-B magnet rings were successfully located to the position of colorectal tumor and fixed. According to the location of the lesions, there were 15 cases of transverse colon, 12 cases of descending colon, 19 cases of sigmoid colon, and 5 cases of upper rectal segment. According to the lesion type, there were 21 cases of colon cancer, 25 cases of polyp carcinomatosis, and 5 cases of laterally spreading tumors with partial carcinomatosis. There were 5 cases with positive margins after endoscopic mucosal resection and 1 case with positive margin after endoscopic submucosal dissection. All lesions were accurately located during the operation. The marking time was 4.1±1.2 min (3-6 min) before the operation and the localization time was 1.5±1.1 min (0.9-5.3 min) during the operation. All magnet rings were removed from the body by laparoscope. The mean distances between the tumor and the cutting edge of the proximal and distal intestinal segments were 5.5 cm and 6.3 cm, respectively. No complications such as colon mucosal injury, bleeding, intestinal perforation or local inflammatory reactions occurred.Conclusion:Nd-Fe-B magnet ring tracer technique for laparoscopic orientation is simple, fast, accurate and safe with no need for additional equipment or apparatus, which is worthy of clinical application.

Dandy-Walker syndrome is one of the posterior fossa malformations, which is easily confused with arachnoid cyst or cerebellar dysplasia in clinical practice, leading to misdiagnosis. Dandy-Walker syndrome is easy to be combined with hydrocephalus, resulting in increased intracranial pressure, increased head circumference, growth retardation, spastic hemiplegia and other manifestations, and can also be accompanied by other nervous system malformations. On February 27, 2021, a child with Dandy-Walker syndrome with growth retardation as the primary manifestation was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. After multiple surgical treatment, the child's hydrocephalus was significantly improved. Through the analysis of the clinical data of the child's operation and the treatment of complications, it is helpful to improve the clinicians' understanding of the surgical treatment of the disease.

Objective:To investigate the changes of serum Golgi protein 73 (GP73) expression and its clinical significance in breast cancer patients before and after radiotherapy.Methods:A total of 135 patients with primary breast cancer who were diagnosed and treated in Qingdao Hospital Affiliated to Shandong First Medical University Hospital from Aug. 2016 to Dec. 2017 were selected and received standard radiotherapy after surgery. Enzyme-linked immunosorbent assay (ELISA) was used to determine the content of GP73 in the serum of patients before and after radiotherapy, and the differences in the expression levels of GP73 before and after radiotherapy in patients with different molecular phenotypes, tumor stages, and pathological types were compared. Association between the expression of serum GP73 and clinical outcome before and after radiotherapy was analyzed.Results:The expression of GP73 in breast cancer patients was (117.69±33.57) mg/L before radiotherapy and (101.88±30.92) mg/L after radiotherapy, and the difference was statistically significant ( t=4.025, P<0.001) . Different molecular phenotypes were stratified and found that the expression of serum GP73 in patients with luminal A, luminal B, HER-2 overexpression, and triple negative after radiotherapy decreased compared with those before radiotherapy, but only the HER-2 overexpression type had statistically significant difference between before and after radiotherapy ( P<0.05) . Stratification according to different tumor stages showed that the expression of serum GP73 in patients with stage I, II, III and IV after radiotherapy was lower than that before radiotherapy, but only the patients with stage II, stage III, and stage IV were compared before and after radiotherapy, and the difference was statistically significant ( P<0.05) . Stratification according to different pathological types showed that the expression of serum GP73 in patients with invasive ductal carcinoma before and after radiotherapy was significantly lower in patients with invasive lobular carcinoma ( P<0.05) . In addition, the 1-year survival rate of the descending group was significantly higher than that of the ascending group, while the local recurrence rate and the occurrence of distant metastasis were significantly lower than those of the ascending group, and the difference was statistically significant ( P<0.05) . Conclusions:The expression level of serum GP73 in breast cancer patients after radiotherapy is significantly higher than that before radiotherapy, and it has a certain relationship with molecular phenotype, tumor stage, and pathological type. At the same time, the increase in serum GP73 expression after radiotherapy may be detrimental to the clinical outcome of patients.

Objective:To investigate radionuclide deposition in the systems related to the primary loop during the overhaul and refueling at a nuclear power plant.Methods:The radionuclides deposited in the main piping system, the primary loop coolant purification system, the volume and boron control system, the waste heat export system, and the inner wall of pipe in boron-containing water system were measured by using the low and medium radiation field high-purity germanium (HPGe) in-situ γ source term measurement system, the strong radiation field cadmium zinc telluride (CZT) in- situ γ source term measurement system, and the portable radiation monitoring instrument Radiagem-2000. Results:The result had shown that the major radionuclides deposited in the systems related to primary loop were mainly 58Co, 60Co, 95Nb, 95Zr, 51Cr, 124Sb, 54Mn, 110Ag *, 59Fe, and those with higher deposition were 60Co, 58Co, 124Sb, 95Zr. Of them, the largest deposition was 60Co up to 21 200 Bq/cm 2 in extra strong pipe below the safety valve, 58Co up to 8 480 Bq/cm 2 in the pipeline of hot section in the state of full water in the main pipeline. 124Sb was 4 910 Bq/cm 2 in pipeline before the filter of the primary loop purification system and 4 680 Bq/cm 2 in the chemical capacity drainage pipeline, respectively, and 95 Zr was 2 500 Bq/cm 2 in the pipeline of hot section in the state of full water in the main pipeline. The radionuclides deposited, after the filter of the purification system, in the pipe upstream of the boron-containing pump were significantly lower than those in other systems. Conclusions:The types of radionuclides in the systems associated with primary loop at a nuclear power plant are basically identical, but their amount deposited varies greatly. Attention should be paid to the removal of radionuclides in primary loop through the filter of purification system.

Objective:To investigate the associations between small diffusion-weighted imaging (DWI) hyperintensities lesions and total cerebral small vessel disease (cSVD) burden and the influence on prognosis in patients with acute intracerebral hemorrhage (ICH).Methods:Consecutive patients with acute spontaneous ICH from January 2018 to June 2021 were recruited in the Stroke Center of Zhengzhou People′s Hospital. Magnetic resonance imaging was performed to quantify DWI hyperintensities lesions and cSVD imaging markers, including white matter hyperintensities, enlarged perivascular spaces, lacunes and cerebral microbleeds, which were calculated for the total cSVD burden (0-4 points). The prognosis was assessed with the modified Rankin Scale (mRS) at discharge and 90-day. Multivariable Logistic regression models were adopted to explore the associations between DWI lesions and total cSVD burden and clinical outcome.Results:Of 283 included patients, 59 (20.8%) had small DWI lesions, 32 (11.3%) had multiple lesions. They were mostly punctate, mainly located in the cortical and subcortical regions, and scattered in multiple vascular territories. With the increase of cSVD burden, the number of DWI lesions gradually increased. Spearman correlation analysis showed that the total cSVD burden was positively correlated with the number of DWI lesions ( r=0.21, P<0.001). In multivariable regression analyses, the total cSVD burden was independently associated with DWI lesions ( OR=1.63, 95% CI 1.23-2.15, P=0.001). The 90-day poor outcome (mRS scores≥4) in patients with DWI lesions was significantly higher than those without DWI lesions (39.3% vs 16.3%, χ 2=14.38, P<0.001), while there was no statistically significant difference in the poor outcome of discharge between the two groups (26.5% vs 17.7%, χ 2=3.06, P=0.080). With the increase in the number of DWI lesions, the 90-day poor outcome increased significantly (trend chi-squared test χ 2=11.50, P=0.001). Multivariable analyses showed that DWI lesions ( OR=4.39, 95% CI 1.92-10.03, P<0.001) and their number ( OR=1.42, 95% CI 1.06-1.90, P=0.018) were independently associated with the 90-day poor outcome. Conclusions:Higher total cSVD burden is an independent risk factor for small DWI lesions in patients with ICH. Small DWI lesions were independently associated with the 90-day poor outcome, but not with the discharge outcome.

Objective To understand the correlation between atmospheric particulate matter and confirmed cases of influenza in Pudong New Area, Shanghai, and to provide a basis for formulating relevant control measures. Methods The meteorological factors (average temperature, relative humidity, and atmospheric pressure), atmospheric pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃) and confirmed cases of influenza of different ages and genders from January 1, 2014 to December 31, 2018 were collected. Data was fitted to a generalized additive model of Poisson distribution to assess the correlation between atmospheric particulate matter (PM_2.5, PM₁₀) and the number of confirmed cases of influenza. Results There was a correlation between atmospheric particulate matter and the number of confirmed cases of influenza in Pudong New Area. For each increase of 10 μg/m³ in the concentration of the two types of particulate matter, the confirmed cases increased by 0.638% (95%CI: 0.413%~0.864%), and 0.520% (95%CI: 0.324%~0.715%), respectively, when the lag was 0-7d (lag07). People of different ages and genders were affected by atmospheric particulate matter differently. After incorporating the effects of SO₂, NO₂, CO, and O₃ in the multi-pollutant model, the effect of atmospheric particulate matter on the number of influenza cases had changed. Conclusion The increase of atmospheric particulate matter (PM_2.5, PM₁₀) concentration increased the number of confirmed cases of influenza in Pudong New Area.