Objective:By comparing the effects of installing 3d-printed bolus with or without positioning holes on the skin fit and patient dose distribution,the advantages and disadvantages of the two installation methods in the application of radiotherapy after radical breast cancer surgery were evaluated,and the reference was provided for clinical application.Methods:A total of 48 patients(34 patients with and 14 patients without positioning holes)who received radiotherapy for breast cancer in Suining Central Hospital from December 2022 to Au-gust 2024 were randomly selected.Three dimensional reconstruction of the air gap between the patient body surface and the 3d-printed bolus was conducted,and the tissue dose distribution of each case was analyzed.Comparative analysis was conducted using t-test to ana-lyze the differences of the skin fit and the key dosimetric indexes of target areas and organs at risk between the two bolus installation meth-ods.Results:The mean values of the maximum air gap height,air gap area and air gap volume of the group with positioning holes were lower than those of the group without positioning holes(P<0.05),and the skin fit showed better consistency.The target area conformity in-dex(CI),homogeneity index(HI),and affected lung radiation acceptance(V20,V5)of patients with positioning holes were better than those of patients without positioning holes(P<0.05).There was no significant difference in target area coverage of prescription dose,cardiac dose Dmean and spinal cord dose Dmax between two groups(P>0.05).Conclusions:The skin fit,dosimetric indexes of patient target area and or-gans at risk of 3d-printed bolus with positioning holes were superior to those without positioning holes,showing significant advantages in clinical applications.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:By comparing the effects of installing 3d-printed bolus with or without positioning holes on the skin fit and patient dose distribution,the advantages and disadvantages of the two installation methods in the application of radiotherapy after radical breast cancer surgery were evaluated,and the reference was provided for clinical application.Methods:A total of 48 patients(34 patients with and 14 patients without positioning holes)who received radiotherapy for breast cancer in Suining Central Hospital from December 2022 to Au-gust 2024 were randomly selected.Three dimensional reconstruction of the air gap between the patient body surface and the 3d-printed bolus was conducted,and the tissue dose distribution of each case was analyzed.Comparative analysis was conducted using t-test to ana-lyze the differences of the skin fit and the key dosimetric indexes of target areas and organs at risk between the two bolus installation meth-ods.Results:The mean values of the maximum air gap height,air gap area and air gap volume of the group with positioning holes were lower than those of the group without positioning holes(P<0.05),and the skin fit showed better consistency.The target area conformity in-dex(CI),homogeneity index(HI),and affected lung radiation acceptance(V20,V5)of patients with positioning holes were better than those of patients without positioning holes(P<0.05).There was no significant difference in target area coverage of prescription dose,cardiac dose Dmean and spinal cord dose Dmax between two groups(P>0.05).Conclusions:The skin fit,dosimetric indexes of patient target area and or-gans at risk of 3d-printed bolus with positioning holes were superior to those without positioning holes,showing significant advantages in clinical applications.

Objective: To analyze the strengths, weaknesses, opportunities and threats of the construction on intelligent vaccination clinics in Zhejiang Province, so as to provide countermeasures for promoting the construction of intelligent vaccination clinics in Zhejiang Province. Methods: By reviewing the annual reports of Zhejiang immunization planning, survey data from Zhejiang Centers for Disease Control and Prevention and Immunization Intelligent Service System, data of human resources of immunization planning, vaccine procurement, construction progress of intelligent vaccination clinics and vaccination were collected. The relevant literature was searched to gather information on the construction standards and norms of intelligent vaccination clinics. The analysis of the strengths, weaknesses, opportunities and threats (SWOT) of the construction of intelligent vaccination clinics was conducted, and corresponding countermeasures and suggestions were proposed. Results: The National Immunization Program reported vaccine rate in Zhejiang Province is more than 99%, and standardized vaccination clinics have been popularized throughout the province. The vaccination staff are professional, and a province-wide intelligent immunization service information system has been established, providing the resources and conditions for the construction of intelligent vaccination clinics. However, there are problems such as low data quality and matching efficiency in vaccination, insufficient data interoperability and sharing, unbalanced regional capabilities in intelligent transformation, and uneven distribution of talent and resources. It is crucial to seize the opportunities presented by the development of big data and artificial intelligence, rely on the regional development of the Internet and health industry, seize the opportunity of rapid growth in demand for intelligent vaccination services and high public acceptance, accelerate the construction of intelligent vaccination clinics, and establish intelligent vaccination service standards as soon as possible. Conclusion We should seize the opportunities presented by the digital reform and development, fully utilize the existing vaccination resources and strengths, address the shortcomings, and accelerate the construction of intelligent vaccination clinics in Zhejiang Province.

Primary familial brain calcification (PFBC) is an inherited neurodegenerative disorder mainly characterized by progressive calcium deposition bilaterally in the brain, accompanied by various symptoms, such as dystonia, ataxia, parkinsonism, dementia, depression, headaches, and epilepsy. Currently, the etiology of PFBC is largely unknown, and no specific prevention or treatment is available. During the past 10 years, six causative genes (SLC20A2, PDGFRB, PDGFB, XPR1, MYORG, and JAM2) have been identified in PFBC. In this review, considering mechanistic studies of these genes at the cellular level and in animals, we summarize the pathogenesis and potential preventive and therapeutic strategies for PFBC patients. Our systematic analysis suggests a classification for PFBC genetic etiology based on several characteristics, provides a summary of the known composition of brain calcification, and identifies some potential therapeutic targets for PFBC.
Animals ; Brain Diseases/therapy* ; Xenotropic and Polytropic Retrovirus Receptor ; Brain/pathology*

OBJECTIVE： To establish a method for the determination of related substances in rifabutin crude drug and capsules by HPLC. METHODS： HPLC method was adopted. The determination was performed on Agilent XDB-C8 column with mobile phase consisted of acetonitrile-0.1 mol/L potassium dihydrogen phosphate solution （pH 6.5±0.1） （50 ∶ 50， V/V） at the flow rate of 1.0 mL/min. The detection wavelength was set at 254 nm， the column temperature was 30 ℃， and sample size was 20 μL. The mobile phase was used as solvent to prepare the sample solution with a mass concentration of 1.0 mg/mL. The system suitability test was performed by using newly established method and current method （mass concentration of sample solution 0.5 mg/mL， C18 column） stated in quality standard of rifabutin crude drug and capsules. Related substance test was conducted for 6 batches of rifabutin crude drug and capsule （peak area normalization method）. RESULTS： The linear range of rifabutin was 0.8-16 μg/mL（r＝1.000 0）， RSDs of precision， reproducibility and stability tests （12 h） were all lower than 2.0％ （n＝6）； the limits of detection and quantification were 0.025 4， 0.085 2 μg/mL. In system suitability test， by using new method and current method， separation degree of rifabutin peak and pre-degradation product peak were 7.50 and 3.47. When 6 batches of samples were determined， the number of impurities detected by this method was 1-5 more than that by the current method， and the total amount of impurities was 0.19％-0.55％ higher. CONCLUSIONS： Established new method is well-separated and sensitive， and can be used for the determination of related substance in rifabutin crude drug and capsules， which helps the quality control of drugs.

To establish a simple, quick and effective method to get a large amount of spider toxin JZTX-26 (35 aa) and JZTX-51 (27 aa) with 3 disulfide bonds each, the mature peptides coding gene fragments were constructed and fused with maltose-binding protein (MBP) tag in an Escherichia coli expression vector pMAL-p2x. The recombinant constructs pMAL-jz26 and pMAL-jz51 were transformed and cultured in E. coli TB1 and BL21 (DE3). After being induced by isopropyl-β-d-thiogalactoside (IPTG), the periplasmic proteins were purified by amylose affinity chromatography and analyzed by SDS-PAGE. The fusion proteins were digested with factor X, and purified by Sizes-Exclusion chromatography and Reversed Phase HPLC. Molecular weights of the purified peptides were obtained by using a MALDI-TOF-TOF mass spectrometer, which were consistent with the theoretical molecular weights. Five milligram of target protein could be purified from 1 L of culture medium. The results indicate that the peptides with three disulfide bonds can be expressed by using the prokaryotic expression system with MBP tag. Our findings suggest the possibility of genetic engineering to obtain large amount of spider peptide toxins.

Objective To investigate a new selection criteria for lower instrumentation vertebrae (LIV) in thoracolumbar adolescent idiopathic scoliosis (AIS).Methods Fifty-two cases of fusion thoracolumbar bend and more than 1.5 years follow up were included.The cases conformed to the AIS selection criteria,i.e.,the first vertebral body touched at the scoliosis distal end in the central sacral vertical line (CSVL) of erect orthotopic X-ray film served as the touch vertebrae (TV),moreover which should meet the following requirements:the Nash-Moe rotation ≤ degree Ⅱ;CSVL located between bilateral vertebral pedicle in the concave side Bending image;no kyphosis of thoracolumbar and lumbar segments existed;the patients with the distance 3-4 mm from CSVL to TV were also included into the study.The operation of each case was carried out by an experienced spine surgeon team.The internal fixation orthopedic fusion of total pedicle screws was adopted by posterior approach.The spine full length of the anterior-posterior and lateral X-ray film and left and right sides Bending images at clinostatism were taken before operation,instantly after operation and at final follow up.The Cobb angle of main bending,trunk shift (TS) at coronal plane,LIV tilting (LIVT) and LIV distal disc angulation (LIVA) were measured.The positions of TV and stable spine were observed,recorded and performed the statistical analysis.Results All cases were followed up for more than 18 months,with an average follow-up period of (23 ± 3) months.The main bending Cobb angles before operation,instantly after operation and at final follow up were (49.32±11.37)°,(9.08 ± 6.78)°and (10.65±6.68)°respectively,LIVT were (21.76±4.68)°,(5.17±4.09)° and (5.16±3.08)° respectively and LIVA were (7.19±5.16)°,(3.16±2.78)° and (4.17±3.28)° respectively;the above indicators had statistical differences between before operation with instantly after operation and at final follow up (P＜0.05).Twenty seven cases were preoperative trunk decompensation,and 5 cases were complicating trunk decompensation at final follow up,which were not increased compared with those before operation.Comparing TV as LIV with adopting stable vertebrae as LIV,the former could save (1.42 ±0.45) fusion segments.Conclusion Adopting the new criteria to conduct thoracolumbar AIS operation saves the fusion segments as compared with commonly used method in clinic.

Objective To understand the changes of positive rates of IHA detections of outpatients in schistosomiasis clinic. Results The data of IHA detections of outpatients in schistosomiasis clinic in Hubei Provincial Center for Disease Control and Prevention were collected and analyzed statistically from 2005 to 2014. Results A total of 7 113 outpatients were detected by IHA test,and 547 of them were positives with a positive rate of 7.69%. The positive rate of IHA test was on an upward slope be?fore 2008,and the rate reached 14.85% in 2008,which was significantly higher than that in 2005(5.81%)( χ2 = 47.40,P<0.01),then it was on a declined stage after 2008,and the positive rate decreased to 3.76 in 2014,which was significantly lower than that in 2008( χ2 = 12.29,P<0.01). The positive rate of outpatients in the 10~<30 years age group was higher than those in other age groups(all P < 0.012 5),and the male positives were more than the female ones. Conclusions The schisto?somiasis endemic situation has been significantly decreased in Hubei Province. The male and people in 10~<30 age group are the high risk groups,so the targeted health education should be strengthened.