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 prevalence of anemia and its influencing factors among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into improvements of nutrition and prevention of anemia among students. Methods: Grade 1 to 3 Kazakh ethnic students were sampled using a cluster sampling method from 7 primary schools in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region from April to June, 2022. Demographics and dietary behaviors were collected using questionnaire surveys, and the height and body weight were measured, while peripheral blood hemoglobin was detected. Factors affecting anemia were identified using a multivariable logistic regression model. Results: A total of 2 378 questionnaires were allocated, and 2 214 valid questionnaires were recovered, with an effective rate of 93.10%. The respondents included 1 123 men (50.72%) and 1 091 women (49.28%), and had a mean age of (8.12±1.41) years. The prevalence of anemia was 22.49%, and the detection rates of mild and moderate anemia were 15.31% and 7.18%, with no severe anemia detected. Multivariable logistic regression analysis identified frequency of eating eggs (0, OR=2.532, 95%CI: 2.114-3.015; 1 to 3 times/week, OR=1.926, 95%CI: 1.648-2.216), frequency of eating meat (1 to 3 times/week, OR=1.468, 95%CI: 1.256-1.689; 4 to 7 times/week, OR=2.212, 95%CI: 1.823-2.641), frequency of healthy check-up (0, OR=2.872, 95%CI: 2.523-3.231; 1 time/year, OR=1.826, 95%CI: 1.546-2.108), monthly mean household income (1 500 Yuan and lower per month, OR=1.324, 95%CI: 1.071-1.582; 1 501 to 3 000 Yuan per month, OR=1.124, 95%CI: 1.029-1.221) and caregiver (grandparents, OR=1.175, 95%CI: 1.038-1.324; others, OR=1.241, 95%CI: 1.032-1.466) as factors affecting anemia. Conclusions The prevalence of anemia is 22.49% among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, with mild anemia as the predominant type. Dietary behaviors, frequency of healthy check-up, economic status and caregiver may affect the development of anemia.

A 3D printing based wrist orthosis device was developed. After collecting the contour information of the carpal and metacarpophalangeal joints of the patients with a 3D scanner, the wrist orthotics were designed to meet the individual needs of the patients according to the relevant requirements of biomechanics. Choose TPU (thermoplastic polyurethanes) materials for preparation of 3D printing. It can functionally assist the smart brace after stroke patients with hemiplegia early rehabilitation training, the use of orthoses carry MPU6050 inertial sensor, magnetometer, time module device such as a sensor and monitor its movements and record the training time, ensure safe efficient rehabilitation training, help patients return to a normal life as soon as possible.
Humans ; Orthotic Devices ; Printing, Three-Dimensional ; Stroke ; Wrist ; Wrist Joint

Objective To investigate the clinical significance of combined heart and lung ultrasound in patients with severe left heart failure and pulmonary hypertension. Methods From March 2016 to June 2017, 75 patients with grade Ⅲ and Ⅳ heart failure and dyspnea were enrolled in Qingdao Municipal Hospital Affiliated to Qingdao University. Thirty-three patients had normal pulmonary artery pressure (normal pulmonary arterial pressure group), 25 patients had mild pulmonary hypertension (mild pulmonary hypertension group), and 17 patients had moderate to severe pulmonary hypertension (moderate to severe pulmonary hypertension group). The patient′s plasma B-type natriuretic peptide (BNP) was measured. Left ventricular diameter (LVD), right ventricular diameter (RVD), and left ventricular ejection fraction (LVEF) were measured by echocardiography. The patient′s lungs were observed by lung ultrasonography, and its number was recorded. One-way analysis of variance was used to compare the differences of LVD, RVD, and LVEF in three groups of patients with severe left heart failure. Further comparison between groups was performed using LSD-t test. Kruskal-wallis H test was used to compare the plasma BNP concentration and B-line number in three groups of patients with severe left heart failure. The Mann-Whitney U test was used to further compare the groups. The receiver operating characteristic (ROC) curve of pulmonary hypertension diagnosed by plasma BNP concentration and B line number in patients with severe left heart failure were drwan. Results The concentrations of BNP in patients with normal pulmonary arterial pressure, mild pulmonary hypertension, and moderate to severe pulmonary hypertension were 890 (614, 1516), 1460 (1245, 1950), and 2660 (1670, 3279) ng/L, respectively. The number of B line was 12 (9, 16), 17 (14, 18), 26 (20, 28), and the RVD was (22.1±1.7), (24.9±2.0), (26.3±2.8) mm, respectively. The number of B-line and RVD in the moderate-severe pulmonary hypertension group were both lager than those in the mild pulmonary hypertension group, and the number of B-line and RVD in the mild pulmonary hypertension group were both lager than those in the normal pulmonary artery pressure group. There was significant difference between any two groups (BNP concentration: U=210.500, P < 0.05; U=47.000, 73.000, both P < 0.001;B line number:U=189.000,P < 0.05;U=38.5000,64.000,both P < 0.001;RVD:t=0.553, 0.623, both P<0.001; t=0.656, P<0.05). There was no significant difference in LVD and LVEF between the three groups of patients. The ROC curve showed that the optimal threshold for the diagnosis of pulmonary hypertension in patients with severe left heart failure with BNP concentration was 1225 ng/L. The sensitivity was 85.7%,the specificity was 69.7%,the area under the curve was 0.814,and the 95% CI was 0.717 to 0.911. The optimal threshold for diagnosis of pulmonary hypertension in patients with severe left heart failure was B line number 14, the sensitivity was 88.1%, specificity was 66.7%, the area under the curve was 0.836, and 95%CI was 0.747 to 0.925.Conclusion Patients with severe left heart failure at different pulmonary artery pressure levels have different B-line findings, and the number of B-line increases with the severity of pulmonary hypertension, which warrants further study and application.

Objective To evaluate efficacy of thymopentin combined with ceftriaxone on patients with early syphilis serum fixation.Methods A total of 108 patients with early syphilis serum fixation were chosen and divided into observation group and control group by the number of tables (54 cases in each group).The control group were underwent conventional sodium penicillin with benzathine with nursing treatment,the observation group were treated with ceftriaxone thymopentin combined with nursing treatment,changes in the relevant indicators before and after treat-ment were observed.Results After treatment,IL -2,IL -10 and other indicators in the observation group were improved compared to the control group[IL -2:the control group before treatment (20.8 ±4.9)μg/L,after treatment (42.7 ±7.3)μg/L;the observation group before treatment(19.8 ±5.1)μg/L,after treatment (54.6 ±8.3)μg/L;IL -10:the control group before treatment (76.3 ±16.1)μg/L,after treatment (51.3 ±5.4)μg/L;the observation group before treatment(78.3 ±4.1)μg/L,after treatment(23.8 ±5.1)μg/L],the differences of the two groups after treatment were statistically significant (t =3.923,8.832,all P <0.05);after treatment,the RPR negative rates of the observation group at 3,6,12 months after treatment(72.2%,85.2%,96.3%)was significantly higher than those of the control group(53.7%,57.4%,63.0%),the differences were statistically significant (χ2 =4.932,11.372, 22.842,all P <0.05);the efficacy of the observation group at 3,6,12 months after treatment(75.9%,79.6%, 75.9%)were significantly better than those of the control group (72.2%,64.8%,57.4%),the differences were statistically significant (χ2 =5.232,6.183,all P <0.05 ).Conclusion Thymopentin combined with ceftriaxone treatment of early syphilis can significantly improve its fixed immunological parameters,which coordinated with nursing measures can strengthen patient care awareness,then the efficacy will be better,so it is worthy of clinical further promotion.

Objective To evaluate efficacy and safety of Iodine-125 seeds used in brachytherapy for cholangiocarcinoma.Methods A total of 65 cases of cholangiocarcinoma patients were diagnosed and treated with ERCP.The Iodine-125 seeds were implanted into bile duct cavity by self-made carrier (applicator) in various ways, and Iodine-125 seeds were replaced to improve the local irradiation dose.Follow-up was regularly made through endoscopy and ultrasonography to evaluate feasibility, efficacy and complications.Results Self-expanding metal stents, single or double plastic stents were successfully placed in 65 patients.At first , single row of Iodine-125 seeds were inserted to 59 patients, double row Iodine-125 were inserted to 6 patients , and the average activity of the first irradiation was 5.775 mCi.Iodine-125 were replaced in 4 patients after three months, in 41 patients after six months, in 5 patients after one year.The total dose was up to 14 mCi.In the follow-up of 6-35 months, the longest survival time was 35 months in two patients, where the Iodine-125 seeds were replaced 3 times as a whole and there was no serious complications.Conclusion Iodine-125 brachytherapy on cholangiocarcinoma by ERCP, where biliary stents and Iodine-125 seeds can be replaced at any time , is convenient, less invasive and can obviously prolong survival time.

Objective To explore the application value of the guide-wire for selective biliary cannulation of proximal biliary obstruction.Methods A total of 344 patients with proximal biliary obstruction were treated by endosocopic retrograde cholangio-pancreatography.Various guide-wire skills,were applied to pass through the stricture of bile duct,so as to reach the target bile duct,and analyzed for their therapeutic effects.Results Selective biliary cannulation of proximal biliary obstruction was completed in 336 patients,after successful cholangiography for therapeutic operation.The overall success rate was 97.67％.There was no procedure-related complications,such as hemobilia or perforation.Conclusion The guide-wire for selective biliary cannulation of proximal biliary obstruction not only improves the success rate of therapeutic endoscopy but also reduces the procedure time and the incidence of complications.