Objective:To compare four postmastectomy radiotherapy plans with different arc angles for left-sided breast cancer prepared using deep inspiration breath hold (DIBH) technique, in order to explore the feasibility of selecting optimal arc angles based on the parameters of patients′ anatomical structures.Methods:A total of 51 patients who underwent postmastectomy radiotherapy for left-sided breast cancer using DIBH at the Second Affiliated Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangzhou Medical University were selected. Among these, 40 patients selected using simple random sampling were treated with four radiotherapy plans with different arc angles, labeled as SV120, SV100, SV80, and SV60, while the remaining 11 patients were treated with only the SV60 plans. The dose parameters of the target volumes (TVs) and organs at risk (the heart, lungs, and contralateral breast), as well as the beam-on times of individual arcs, in these plans were compared. The parameters of the anatomical structures (i.e., the heart, lung, and breast) of the 51 patients, including PHeart, PLungl, and PBreast, were extracted. Taking these parameters as independent variables and the quality of the SV60 plans as the dependent variable, fitting was conducted using P(SV60)—a multivariate logistic regression model—based on a training set (45 patients) and a testing set (six patients). The classification threshold of the plans was set at 0.5. Results:As the arc angle increased, the plans exhibited improved modulation capabilities for TVs and the left lung. However, the V5 of the right lung and the average beam-on time of a single arc also increased. The SV120 plans demonstrated significantly better V107% of planning target volume (PTV; 6.84%), homogeneity index (HI; 0.13), conformity index (CI; 0.81), and mean dose to the left lung (1 330.97 cGy) compared to the other three types of plans, with statistically significant differences ( W = 0-99, P < 0.001). The SV60 plans displayed lower mean doses to the contralateral breast (198.97 cGy) and the heart (440.35 cGy) and lower V5 of the right lung (0.27%) than the other three types of plans, with significant differences in V5 of the right lung and the mean dose to the contralateral breast ( W = 0-157, P < 0.001). In contrast, no significant difference was observed in these parameters (except for V5 of the right lung) among the other three types of plans. The four types of plans exhibited average beam-on times of individual arcs of 22.0, 19.1, 16.1, and 14.4 s, respectively, with statistically significant differences ( χ2= 93.0, P < 0.001). A multivariate logistic regression model revealed that PLungl, PHeart, and PBreast were negatively correlated with the quality of the SV60 plans ( t = -64.84, -28.20, -24.45, P<0.001). This model yielded an accuracy of 93.33% and a precision of 92.86% in the training set, while its accuracy and precision reached 100% in the testing set. Conclusions:For patients treated with postmastectomy radiotherapy for left-sided breast cancer using DIBH, it is feasible to select appropriate arc angles based on patients’ anatomical structures.

Objective:To compare four postmastectomy radiotherapy plans with different arc angles for left-sided breast cancer prepared using deep inspiration breath hold (DIBH) technique, in order to explore the feasibility of selecting optimal arc angles based on the parameters of patients′ anatomical structures.Methods:A total of 51 patients who underwent postmastectomy radiotherapy for left-sided breast cancer using DIBH at the Second Affiliated Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangzhou Medical University were selected. Among these, 40 patients selected using simple random sampling were treated with four radiotherapy plans with different arc angles, labeled as SV120, SV100, SV80, and SV60, while the remaining 11 patients were treated with only the SV60 plans. The dose parameters of the target volumes (TVs) and organs at risk (the heart, lungs, and contralateral breast), as well as the beam-on times of individual arcs, in these plans were compared. The parameters of the anatomical structures (i.e., the heart, lung, and breast) of the 51 patients, including PHeart, PLungl, and PBreast, were extracted. Taking these parameters as independent variables and the quality of the SV60 plans as the dependent variable, fitting was conducted using P(SV60)—a multivariate logistic regression model—based on a training set (45 patients) and a testing set (six patients). The classification threshold of the plans was set at 0.5. Results:As the arc angle increased, the plans exhibited improved modulation capabilities for TVs and the left lung. However, the V5 of the right lung and the average beam-on time of a single arc also increased. The SV120 plans demonstrated significantly better V107% of planning target volume (PTV; 6.84%), homogeneity index (HI; 0.13), conformity index (CI; 0.81), and mean dose to the left lung (1 330.97 cGy) compared to the other three types of plans, with statistically significant differences ( W = 0-99, P < 0.001). The SV60 plans displayed lower mean doses to the contralateral breast (198.97 cGy) and the heart (440.35 cGy) and lower V5 of the right lung (0.27%) than the other three types of plans, with significant differences in V5 of the right lung and the mean dose to the contralateral breast ( W = 0-157, P < 0.001). In contrast, no significant difference was observed in these parameters (except for V5 of the right lung) among the other three types of plans. The four types of plans exhibited average beam-on times of individual arcs of 22.0, 19.1, 16.1, and 14.4 s, respectively, with statistically significant differences ( χ2= 93.0, P < 0.001). A multivariate logistic regression model revealed that PLungl, PHeart, and PBreast were negatively correlated with the quality of the SV60 plans ( t = -64.84, -28.20, -24.45, P<0.001). This model yielded an accuracy of 93.33% and a precision of 92.86% in the training set, while its accuracy and precision reached 100% in the testing set. Conclusions:For patients treated with postmastectomy radiotherapy for left-sided breast cancer using DIBH, it is feasible to select appropriate arc angles based on patients’ anatomical structures.

Objective:To construct bacterial cytoplasmic membrane nanovesicles(BMV)with overexpressing programmed death 1(PD-1),denoted as BMV-PD-1 and evaluate the targeting efficacy of BMV-PD-1 towards transplanted lung tumor tissues in mice.Methods:The fusion plasmid ClyA-PD-1-EGFP fused by PD-1 and Cytolysin A(ClyA)was transferred into Escherichia coli BL21-Codonplus through plasmid transformation.Laser confocal microscopy,SDS-PAGE,and WB were used to detect the expression of the fusion protein ClyA-PD-1-EGFP.Bacterial membranes were extracted and processed with an extruder to generate BMV-PD-1.TEM and NTA were utilized to assess the morphology,size distribution,and zeta potential of BMV-PD-1,while WB was used to verify the presence of PD-1 protein.Laser confocal imaging was conducted to monitor the uptake of BMV-PD-1 by Lewis lung cancer cells.A C57BL/6J mouse subcutaneous transplant tumor model of LLC lung cancer cells was constructed,and the tumor targeting of BMV-PD-1 was evaluated by small animal imaging system.Results:Laser confocal microscopy images demonstrated that the plasmid ClyA-PD-1-EGFP was transferred into BL21-Codonplus and successfully expressed into protein.SDS-PAGE results suggested that ClyA-PD-1-EGFP was overexpressed in BL21-Codonplus.WB analysis indicated that PD-1 was expressed in bacteria and highly expressed in BMV-PD-1(P<0.001).NTA and TEM analyses revealed that BMV-PD-1 were spherical vesicles with a diameter of(145±14)nm and a negative surface charge.Laser confocal imaging showed that the high expression of PD-1 significantly increased the uptake of BMV-PD-1 by lung cancer cells(P<0.01).In vivo imaging of small animals further confirmed that the high expression of PD-1 can effectively improve cancer targeting of BMV-PD-1(P<0.01).Conclusion:In this study,bacterial plasma membrane nanovesicles BMV-PD-1 with high PD-1 expression are successfully constructed,and it is found that PD-1 overexpression markedly improve the mouse lung cancer xenograft tissue targeting specificity of BMV-PD-1,laying the groundwork for further development of BMV-PD-1 as a carrier for targeted drug delivery systems in tumors.

Child safety seats have been proven to be one of the most effective tools for protecting child passengers. However, the widespread phenomenon of safety seats being "unavailable," "owned but not used," or "used incorrectly" is prevalent globally. This paper aims to summarize the obstacles to the use of child safety seats from four aspects: Individual, society, environment and policy, in order to provide a basis for follow-up comprehensive intervention to ensure the safety of children.

Objective:To compare the correlation and consistency of central corneal thickness (CCT) measured by four different instruments, specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT.Methods:A diagnostic test study was performed.A total of 50 right eyes of 50 consecutive outpatients who planned to undergo corneal refractive surgery at Hanyang Aier Eye Hospital from January to May 2022 were included.CCT was measured with the specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT, respectively.The differences of CCT measurements by the four instruments were compared.The correlation and consistency between the CCT values was analyzed by Pearson linear analysis and Bland-Altman test, respectively.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Hanyang Aier Eye Hospital (No.HYEYE20221229JM).Written informed consent was obtained from each subject.Results:The mean CCT values measured by SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT were (522.68±30.08), (544.06±32.85), (541.00±31.75) and (528.86±31.60)μm, respectively, with a statistically significant overall difference ( F=5.09, P=0.002).CCT measurements obtained with SP-1P were lower than those obtained with IOLMaster 700 and Pentacam HR, while the IOLMaster 700 measurements were higher than those of RTVue XR-OCT, showing statistically significant differences (all at P<0.05).Pearson correlation analysis revealed significant positive correlations of CCT measurements between SP-1P and IOLMaster 700, SP-1P and Pentacam HR, SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR, IOLMaster 700 and RTVue XR-OCT, Pentacam HR and RTVue XR-OCT ( r=0.988, 0.980, 0.988, 0.981, 0.982, 0.973; all at P<0.01).Bland-Altman consistency analysis showed that the 95% limits of agreement (95% LoA) for CCT measurements between SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR were -16.46-6.14 and -10.56-14.48 μm, respectively, with 3(6%) and 2(4%) data points outside the 95% LoA, respectively.The mean difference lines for the CCT measurements were close to 0, indicating good consistency and clinically acceptable differences without statistical significance. Conclusions:CCT values measured with specular microscope SP-1P and RTVue XR-OCT, as well as those measured with IOLMaster and Pentacam HR, are relatively close in patients with low to moderate myopia, show good consistency and can therefore be considered interchangeable.

Objective To investigate the changes of microarchitecture and gene expression of subchondral bone in the initial stage of traumatic arthritis ,to explore the characteristics of subchondral bone remodeling and its role in the articular cartilage de‐generation .Methods The medial meniscal tear (MMT) was performed on the right knees of 13 SD rats to simulate the traumatic osteoarthritis ,while sham operation on the control group .Three weeks later ,all the rats were executed and dissected ,with proximal tibiae being kept and distributed into the two groups ,10 respectively .Micro‐computed tomography (micro‐CT) was adopted to re‐construct and analyze the subchondral bone .After being fixed by 4% paraformaldehyde ,all the samples were decalcified until six weeks passed ,followed by paraffin‐sectioning ,safranin O and fast green staining ,and examining and photographing under an ordina‐ry optical microscope .The RNA of another 3 SD rats′subchondral bone was extracted ,and a real‐time PCR test was carried out to illuminate the expression variation of bone‐formation marker genes (ALP ,RUNX2 ,and OCN) ,and bone‐resorption marker genes (TRAP ,CTSK and MMP9) ,between the two groups .Results Three weeks after MMT surgery ,subchondral bone disorders were observed among the experimental samples through micro‐CT scanning .There was lesser BV/TV ,Conn .D and Tb .Th(P<0 .05) and more Tb .Sp(P<0 .05) in the experimental group compared with the control group .In the pathological section ,arthritic degen‐eration was not spotted in both groups ,but trabeculae of the experimental group were found to be sparse .Compared with control group ,the level of mRNA expression of the bone‐formation marker genes of the experimental group was decreased(P<0 .05) ,while bone‐resorption related genes increased(P<0 .05) .Conclusion The model of initial traumatic osteoarthritis induced by MMT in rats′knees showed an active bone remodeling ,more bone absorbing than bone formation ,lowered bone volume ,and microarchitec‐ture changing of the subchondral bone .

Objective To explore the influence of nursing intervention on the pocket infection and other related problems following CRT-D therapy in chronic heart failure patients.Methods The causes of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy from March 2008 to March 2011 were reviewed,then analyzing and summarizing them to work out a detailed nursing interventions plan.During April 2011 to June 2013,nurses carried out the nursing intervention on patients who accepted CRT-D implantation.At last we compared the occurrence of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection during the period of 6 months after CRT-D therapy between the two groups.Results After the implementation of nursing interventions,the incidence of pocket infection and other related problems following CRT-D therapy in chronic heart failure patients reduced significantly.Conclusions The interventions such as rigorous preoperative skin preparation,eliminating the potential factors of infection,intraoperative strict aseptic operation,choosing the appropriate position of pocket,the implementation of interventions to prevent bleeding,meticulous and rigorous postoperative nursing,providing healthy knowledge sufciently and strengthening follow-up,finding problems and solving them timely can prevent the pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy effectively.

Objective To detect the Bag-1 and VEGF expressions in HCC tissues,cancerous liver tissues and normal liver tissues,and to explore their relationship with prognosis.Methods Immunohistochemical staining (SP method) was used to detect Bag-1 and VEGF in 60 cases of hepatocellular carcinoma specimens,next to the 30 cases of hepatocellular carcinoma in liver tissue,and 14 cases of normal liver tissue specimens,and their clinicopathological features were analyzed.Results Bag-l,VEGF expression rates were highest in HCC tissues [80.0 ％ (48/60),73.3 ％ (44/60)] and with adjacent tissues [46.7 ％ (14/30),43.3 ％ (13/30)],normal liver tissue [28.6 ％ (4/14),21.4 ％ (3/14)] expression rates had differences (P ＜ 0.05).Bag-1,VEGF expression had relationship with liver cancer staging,lymph node metastasis,tumor thrombosis formation,the correlation between the presence or absence of capsule formation (P ＜ 0.05),while had no relationship with the patient gender,age,tumor grade,tumor size,and alpha-fetoprotein (AFP) and other factors correlation (P ＞ 0.05).Bag-1 and VEGF expression in HCC specimens positive 40 cases,while negative eight cases,both in HCC tissues expression was positively correlated (P ＜ 0.05).Bag-1,VEGF positive expression in patients 1-year,2-year survival rates were less than negative patients,the survival time of patients with positive group was significantly lower than the negative patients (P ＜ 0.05).Conclusion Bag-1 and VEGF expressions are closely related with biological characteristics of liver cancer,and which is closely related to the prognosis of patients with hepatocellular.

Objectives:To observe growth suppressive effects of human wild type p53(wt p53) gene on human esophageal cancer cell line. Methods:Using the retroviral vector to introduce exogenous wt p53 gene into human esophageal cancer cell line ECA109,the gene expression and tumor inhibition were studied in vitro and in vivo . Results:The expression of p53 in transfected cell lines(ECA 109/p53 ) was increased.The growth rates and the ability to form colony in soft agar were greatly inhibited in ECA 109/p53 cells versus ECA109/neo and ECA109 cells.The G 0+G 1 ratio increased and S ratio decreased in cell cycle distribution,and apoptosis index significantly rose in the ECA109/p53 cells,which were confirmed by FCM analyzing.The tumorigen icity of ECA109/p53 cells in nude mice was obviously suppressed by exogenous p53. Conclusions:Exogenous wt p53 mediated by retroviral vector could inhibit the growth of human esophageal cancer cell.

Objective To investigate the protective effects of ethanol-extract of Halenia elliptica D. Don on chemical hepatic injury in mice. Methods Mouse models of chemical hepatic injury were induced by intraperitoneal injection of 0.12 %CCL4. Extract of Halenia elliptica D. Don by alcohol was administered,and serum ALT,AST activities and liver glycogen level were measured in mice. Results Compared with the models,the enzyme activities of ALT and AST were significantly reduced and the content of liver glycogen was significantly increased in the ethanol-ex tract of Halenia elliptica groups. Conclusion It is indicated that ethanol-extract of Halenia elliptica D. Don has an effect in protecting the liver.