Objective To investigate the effect of different strand lengths of 125I seeds with the same activity on the dose of different reference points around the seeds.Methods The scanned images were transferred to the three-dimensional treatment planning system(3D-TPS)according to DICOM format.The target volume was delineated at 5 mm and 10 mm above and below the center of the phantom,and a 0.8 mCi seeds strand was simulated.The 1-20 seeds were arranged with an equal spacing of 5 mm(5 mm-100 mm).The 5 mm points above and below the center of the seeds strand were defined as point A and point A',and the 10 mm points above and below the center were defined as point B and point B'.5 mm above and below the edge of the seeds strand on the left side were defined as AL points and AL'points,and 5 mm above and below the edge of the seeds strand on the right side were defined as AR points and AR'points.Similarly,points 10 mm above the above mentioned positions were defined as BL points,BL'points,BR points,BR'points.The average dose symmetry points were measured at AL,AL',AR,and 5 mm,10 mm,15 mm and 20 mm inside AR' of the 45 mm-100 mm seeds strand.The dose at the center was compared with the dose at the end points.The dose at the center point A was compared with the average dose at the symmetry points of 5 mm,10 mm,15 mm and 20 mm inside of the end points AL,AL',AR and AR',and the dose at each point was curve fitting.The correlation between each point and seeds strands of different lengths was analyzed.Results There was a positive correlation between the dose and the length of each point.There was no statistically significant difference between the center point and the end point.There was a statistically significant difference in dosage at points 5 mm and 10 mm inside from point A,while there was no statistically significant difference in dosage at points 15 mm and 20 mm inside from point A.The dose of A,A',B and B' point increased steadily with the increase of seed chain length,and the fitting curves were obtained respectively:y=e(-0.620/x+5.28)(R2=0.992),y=e(-0.640/x+5.34)(R2=0.987),y=e(-0.82/x+4.80)(R2=0.984),y=e(-0.82/x+4.83)(R2=0.9g1).Conclusion The doses at points A,A',B,and B'are positively correlated with seeds strand length and have a high degree of stability.Point A can be used as a reference point for the target area dose of the seeds strand,and point B can be used as a reference point for the dose to critical organs.The dose at other positions is more variable and thus has a certain degree of uncertainty as a reference point for the seeds strand dose.

Objective To investigate the relationship between the absorbed dose and implantation duration at the target area and at the critical organ dose reference points in the application of radioactive 125I seed strands for the treatment of intraluminal tumors.Methods A self-developed 125I seed strand arc template with a 30-degree angle was used to place 10 seeds(each with activity of 1.0mCi)into the template.CT-based DICOM images were transferred to a treatment planning system(TPS)for dose calculation.Absorbed doses at multiple time points(from day 5 to day 90 with a 5-day interval)were measured at following four specific locations:point A'(5 mm inside the arc center),point A(5 mm outside the arc center),point B(10 mm outside the arc center),and point B'(10 mm inside the arc center).The TPS was first used to calculate the expected absorbed doses,followed by actual absorbed dose measurements over the 90-day period.The expected absorbed doses were calculated,and then the actual absorbed doses were calculated.The time-dose relationship of the above points was analyzed,and the curves and equations were obtained.Results The expected absorbed doses at points A',A,B,and B'were 221.36,196.39,115.78,and 136.32 Gy,respectively.The time(x)-dose(y)relationships of all the above points followed a quadratic function relationship in the form of y=c+bx-ax2.Within the time range of 5-90 days,the actual absorbed dose increased with the prolongation of time,and the increase speed showed a pattern of first fast and then slow.The increase in speed was fast within 20 days,than became stable between 20-75 days,and after 75 days the increase in speed became to slow down.Conclusion When using 125I seed strands to treat intraluminal tumors,the actual absorbed dose of the tumor needs to be accurately calculated based on the implantation duration.The actual absorbed dose initially accumulates rapidly and decreases significantly after 75 days.It is recommended to replace the 125I seed strand with a new one after implanting it for approximately 75 days.

Objective To investigate the impact of different 125I seeds strand radian on the dose of different reference points around the seeds.Methods CT scan of self-developed radioactive particle radiation dose measurement phantom was performed,the scanned images were transferred to the three-dimensional treatment planning system(TPS).The target area at the middle level of the model was drawn.The target volume was delineated at 5 mm and 10 mm above and below the center of the phantom.125I seeds strand plans were designed with different radians,with a total length of 8 cm,seed spacing of 0 cm,activity of 0.8 mCi,and a total of 16 particles,with radians ranging from 30°to 170°,increasing by 10° increment.The point 5 mm vertically away from the center of the seeds strand towards the center was named A',and the point away from the center was named A.The point 10 mm vertically away from the center of the seeds strand towards the center was named B',and the point away from the center was named B.The doses at different radians were recorded,and the actual absorbed dose at 1-2 months after operation was calculated based on the particle activity decay formula.Results The doses at points A'and A were(218.3±23.1)and(201.5±16.0)Gy respectively(P=0.001).The actual absorbed doses at 1 month after operation were(65.5±6.9)and(60.5±4.8)Gy respectively(P=0.001),and the actual absorbed doses at 2 months after operation were(109.2±11.5)Gy and(100±7.9)Gy respectively(P=0.001).The doses at points B'and B were(95.9±11.0)Gy and(81.7±4.9)Gy respectively(P＜0.001),and the actual absorbed doses at 1 month after operation were(28.8±3.3)Gy and(24.5±1.5)Gy respectively(P＜0.001).The actual absorbed doses at 2 month after operation were(48.0±5.5)Gy and(41.0±2.4)Gy respectively(P＜0.001).The doses at points A'and A gradually decreased with the increase of the radians,reaching the minimum value at 100 degrees,and then increased gradually,showing a cubic function change.The actual absorbed dose showed the same trend.The doses at points B'and B increased gradually with the increase of the radians,showing a cubic function change.Conclusion At different radians,the point doses and absorbed doses on the centrifugal side of the seeds strand are both less than those on the centripetal side.There is a cubic function relationship between the dose at the reference points and the radian of the seeds strand.

BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
Humans ; Lung Neoplasms/genetics* ; Adenocarcinoma of Lung/genetics* ; China ; Prognosis ; Transcription Factors

Objective:To investigate the epidemiological characteristics of pneumonia and the related factors of the length of hospitalization of pneumonia in the elderly aged 60 years and older in Ningbo in 2019.Methods:Data on hospitalized cases of pneumonia in the elderly aged 60 years and older in Ningbo in 2019 were collected through the regional health information platform, and the population data of Ningbo in 2019 were obtained through the Zhejiang Provincial Bureau of Statistics. A descriptive epidemiological analysis was conducted on hospitalized cases of pneumonia in the elderly population, and factors related to the length of hospitalization were explored.Results:A total of 15 956 hospitalized cases of pneumonia aged 60 years and older were reported in Ningbo in 2019, and the incidence of pneumonia requiring hospitalization was 1.02% (15 956/1 571 431). The incidence was 1.13% (8 613/760 357) in males and 0.83% (6 759/811 074) in females, and the ratio of male to female cases was 1.27∶1. The highest incidence was found in the ≥80 age group (2.52%), and the lowest incidence was found in the 60-69 age group (0.58%). March, February, and January were the peak period of pneumonia hospitalization. The main types of pneumonia diagnosed were not specified (65.12%), followed by bacterial pneumonia (34.60%). The M( Q1, Q3) of hospitalized patients with pneumonia was 9 (7, 13) days. The results of multivariate logistic regression analysis showed that gender (female: OR=0.911, 95% CI: 0.849-0.978) and older age (70-79 years old: OR=1.211, 95% CI: 1.111-1.321; ≥80 years old group: OR=1.486, 95% CI: 1.365-1.617), settlement method (self-payment: OR=0.567, 95% CI: 0.464-0.691), higher level of hospitals (Grade Ⅱ: OR=1.902,95% CI:1.723-2.100; Grade Ⅲ: OR=1.546,95% CI:1.407-1.698) were associated with the length of hospitalization for pneumonia in people aged 60 years and older in Ningbo. Conclusions:Hospitalization with pneumonia in people aged 60 years and older was high in winter and spring, men and older adults were in high-risk groups in Ningbo in 2019. Gender, age, billing method, and level of hospitals may be related factors to the length of hospitalization for pneumonia.

Drowning is a common and serious injury worldwide, especially for children and young people. Drowning occurs frequently, resulting in heavy health and economic burdens to society. This paper summarizes the progress in the research of the epidemiology of drowning both at home and abroad, including the epidemiological characteristics, risk factors and intervention measures. Through analysis on existing research literature, it is found that there are large differences in the incidence characteristics of drowning in different regions. Men and children are at high risk for drowning. Age, being man, rural environment, lack of supervision, alcohol consumption, and underlying diseases are risk factors for drowning. It is suggested to pay more attention to the problem of drowning, improve people's awareness of drowning, take appropriate intervention measures and strengthen multi-sectoral collaboration to prevent and control the incidence of drowning.

The incidence rate of aortic dissection (AD) is low, but it is highly fatal in the acute phase. Miss diagnosis and misdiagnosis can occur occasionally, resulting the miss of the best intervention time. Research on the epidemiological characteristics and of AD and related risk factors can identify high-risk groups, make screening and diagnosis as soon as possible and effectively control the changeable risk factors to reduce the incidence of AD and improve the outcome of AD cases. This paper summarizes the progress in research of the epidemiological characteristics of AD and related risk factors in order to promote early prevention and diagnosis of AD, improve the AD case management and intervention level.

Objective:To investigate the immune reconstitution and its influencing factors in HIV/AIDS patients with antiretroviral therapy in Ningbo.Methods:The data were collected from HIV/AIDS patients of HIV/AIDS Comprehensive Response Information System in Ningbo during 2010-2020. The inclusion criteria of study subjects were HIV/AIDS patients aged 15 or above at initiation of antiretroviral therapy with duration of more than one year follow-up and baseline CD4 +T lymphocyte (CD4) counts completed. A retrospective cohort study was conducted to describe the epidemiological characteristics of the subjects, and univariate and multivariate Cox proportional risk regression models were used to analyze the influencing factors of immune reconstitution in HIV/AIDS patients. Results:A total of 3 851 HIV/AIDS patients were enrolled, in whom 3 185 were males (82.71%,3 185/3 851), 3 769 were in Han ethnic group (97.87%,3 769/3 851), and 1 333 had education level of junior high school (34.62%). Of the subjects, the age at initiation of antiretroviral therapy was (39.47±13.47) years. The median ( Q1, Q3) of follow-up time was 47 (25,77) months. The immune reconstitution after antiretroviral therapy accounted for 66.22% (2 550/3 851) in HIV/AIDS patients. Multivariate Cox proportional risk regression model results showed that, compared with HIV/AIDS patients receiving initial antiretroviral therapy at age ≥45 years, having baseline BMI <23.0 kg/m 2 and baseline CD4 counts <200 cells/μl, receiving initial antiretroviral therapy regimen of zidovudine+lamivudine+nevirapine (AZT+3TC+NVP), the immune reconstitution was more likely to occur in HIV/AIDS cases receiving initial antiretroviral therapy at age <30 years,having baseline BMI ≥23.0 kg/m 2 and baseline CD4 counts ≥200 cells/μl, receiving initial antiretroviral therapy regimen of AZT+3TC+efavirenz (EFV). Conclusions:Age at initial antiretroviral therapy, baseline BMI, baseline CD4 counts and initial regimens were the main factors affecting immune reconstitution. Therefore, it is necessary to start antiretroviral therapy as early as possible, conduct regular follow up and monitor CD4 levels, and pay attention to HIV/AIDS patients with older age and lower baseline BMI.

Chronic kidney disease (CKD) is characterized by long course, poor prognosis, multiple complications and high cost of treatment, thus it has become a major public health problem. Based on review of publications pertaining to the epidemiological study of CKD from February 2002 to March 2023, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of CKD. It is found that China has the largest number of adult patients with CKD in Asia, and the prevalence of CKD is higher among females and elderly people. The influencing factors for CKD include cardiovascular diseases, diabetes, hypertension and coronavirus disease 2019. Henceforth, it is of vital importance to emphasize three levels of prevention and optimize the CKD management, so as to support for prevention and control of CKD.

Pneumonia is a common lower respiratory tract infection, which causes a large disease and economic burden worldwide, and is an important public health problem to be solved urgently. Based on review of publications pertaining to the epidemiology of pneumonia from 2013 to 2023, this article summaries the epidemiological characteristics and main influencing factors of pneumonia. It is found that the epidemiological characteristics of pneumonia vary in different areas; men, the elderly and children are the high-risk groups of pneumonia incidence and mortality; and age, smoking, alcohol consumption, air pollution, comorbidity and vaccination are the main factors affecting the incidence and mortality of pneumonia. Strengthening health education, reducing exposure to risk factors and promoting vaccination are recommended to lower the morbidity and mortality of pneumonia in susceptible populations.