Objective To investigate the current distribution of radiotherapy resources in Gansu Province, evaluate the equity of resource allocation, and provide a scientific basis for optimizing regional resource allocation. Methods A questionnaire survey was carried out to assess radiotherapy resources in medical institutions across Gansu Province, China. The equity of radiotherapy resource distribution and associated disparities were assessed using the Gini coefficient, Lorenz curve, and Theil index. Results A total of 23 medical institutions in Gansu Province provided radiotherapy services, comprising 39 radiotherapy devices and 438 professionals, of whom medical physicists accounted for 16.9%. The radiotherapy frequency was 0.47 cases per thousand population. The Gini coefficients for radiotherapy resource distribution ranged from 0.38 to 0.56 by population and from 0.52 to 0.70 by geography. The Theil index for radiotherapy resources ranged from 1.36 to 3.67. Conclusion Radiotherapy resources in Gansu Province were insufficient, and the capacity of radiotherapy service was suboptimal. The equity of radiotherapy resource allocation by geography was worse than that by population. Therefore, it is imperative to address the shortage of radiotherapy resources, strengthen the professional workforce, enhance the capacity radiotherapy service and resource utilization, optimize resource allocation, and promote regional equity in radiotherapy provision in Gansu Province.

Objective: To investigate the effect of specific deletion of SET-domain-containing 2 (Setd2) in dental germ mesenchymal cells on early tooth development and provide a research basis for exploring the etiology of dental developmental disorders. Methods: This study was approved by the Animal Care and Ethical Committee of Wuhan University. Wnt1Cre mice with a C57BL/6J background were crossed with Setd2flox/flox mice to generate the Setd2 knockout experimental group (Wnt1Cre; Setd2flox/flox) and the control group (Setd2flox/flox). Tail tissues of mouse embryos were collected at embryonic day (E) 13.5, E15.5, and E18.5 for polymerase chain reaction (PCR)-based genotyping, and embryonic heads were collected for paraffin sectioning to observe the development of the first mandibular molar germs. Immunohistochemical (IHC) staining was performed to verify the specific knockout of Setd2 in dental germ mesenchymal cells; hematoxylin and eosin (HE) staining and subrenal culture were used to evaluate the effect of Setd2 knockout in dental germ mesenchymal cells on tooth development; Ki67 staining and a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay were employed to evaluate the effects of specific Setd2 knockout on the proliferation and apoptosis of dental germ mesenchymal cells; immunofluorescence (IF) staining was conducted to observe the impact of Setd2 knockout on the trimethylation of lysine 36 on histone 3 (H3K36me3). Results: PCR-based genotyping showed that the experimental group presented a single band (266 bp) for the Setd2flox/flox homozygote and a characteristic band for Wnt1Cre, while the control group only showed a single band (266 bp) for the Setd2flox/flox homozygote. IHC staining confirmed the successful knockout of Setd2 in dental germ mesenchymal cells of the experimental group; HE staining and subrenal culture demonstrated that specific knockout of Setd2 in the experimental group led to reduced size of tooth germs and increased condensation of mesenchymal cells at E15.5 and E18.5 (E15.5, P < 0.05; E18.5, P < 0.01); Ki67 staining showed no statistically significant effect on the proportion of division of dental germ mesenchymal cells between the experimental and control groups at E13.5 and E15.5 (E13.5, P = 0.694; E15.5, P = 0.503); the TUNEL assay demonstrated increased apoptosis of dental germ mesenchymal cells in the experimental group at both E13.5 and E15.5 (P < 0.001); IF staining revealed the absence of H3K36me3 modification in the dental germ mesenchymal cells of the experimental group across E13.5, E15.5, and E18.5 (P < 0.000 1). Conclusion Specific knockout of Setd2 in dental germ mesenchymal cells leads to increased cell apoptosis by impairing H3K36me3 modification, resulting in early developmental defects in mouse teeth characterized by reduced tooth germ volume.

Background Cold exposure alters thermoregulation and influences metabolic, neuromuscular, and cardiovascular responses. Endurance performance tends to decline in extremely cold environments, yet the evidence has not been systematically mapped. Objective To summarize available evidence on the effects of cold environments on endurance exercise performance and physiological responses, and to provide insights for training practice and future research. Methods The review was conducted in accordance with PRISMA-ScR guidelines. Databases including PubMed, Embase, EBSCOhost, Web of Science, Cochrane, and CNKI were searched. Risk of bias was assessed using the RoB 2.0 tool. Study characteristics, environmental parameters, interventions, outcomes, and main findings were extracted. Evidence maps and matrices were used to describe research coverage and the direction of findings via qualitative synthesis. Results Ten randomized controlled trials or randomized crossover trials involving running, cycling, and cross-country skiing were included. Performance decrements were more often reported in extreme cold, while findings in cool conditions were mixed: maximal oxygen uptake was generally unchanged, but sustained endurance or maximal work capacity was more affected at lower temperatures. Some studies reported elevated heart rate and/or perceived exertion. RoB 2.0 assessment results showed that the overall risk of bias was low. Due to limited evidence and heterogeneity, results were synthesized descriptively without a meta-analysis. Conclusion Extreme cold is more likely to impair endurance performance, whereas findings in cool conditions are inconsistent. Maximal oxygen uptake is generally maintained, but sustained endurance appears more vulnerable, often accompanied by increased heart rate or perceived exertion. Further evidence is needed due to limited sample size and differences in environment and tasks.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:To investigate the causal effects of plasma lipidomics on pancreatitis using Mendelian ran-domization(MR)and evaluate the roles of intra-pancreatic fat deposition(IPFD)and gallstone disease in this relation-ship.Methods:A bidirectional MR analysis was conducted,with 179 plasma lipids as exposures and acute pancreati-tis(AP)and chronic pancreatitis(CP)as outcomes.Data were sourced from genome-wide association studies(GWAS),the UK Biobank,and the FinnGen project.Two-step Mendelian randomization(TSMR)and multivariable Mendelian ran-domization(MVMR)analyses were applied to assess the mediating roles of IPFD and gallstone disease in the associa-tion between plasma lipids and pancreatitis.Results:MR analysis identified two sterols negatively associated with AP(P＜0.05)and seven sterols negatively associated with CP(P＜0.05).One phospholipid showed a positive association with CP(P＜0.05).IPFD was positively associated with both AP and CP.Gallstone disease was confirmed as a risk fac-tor for AP.However,TSMR analysis indicated that neither IPFD nor gallstone disease mediated the relationship be-tween plasma lipids and pancreatitis.Conclusion:The causal relationship exists among plasma lipomics and AP/CP,also between IPFD,cholelithiasis and pancreatitis.These findings highlight novel risk factors and potential biomarkers to support early diagnosis and intervention for pancreatitis.

Objective To describe the clinical features of patients with primary sclerosing cholangitis(PSC)in China based on a nationwide multicenter patient cohort,and to investigate the risk factors for prognosis.Methods A retrospective cohort study was conducted among the patients with a confirmed diagnosis of PSC based on the electronic medical record system of seven grade A tertiary hospitals across the country,and related data were extracted.The Mann-Whitney U test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to estimate liver transplant-free survival,and the log-rank test was used for comparison of survival rate between PSC patients with different features.The Cox regression model was used to identify independent risk factors for the prognosis of PSC patients and the interactions between key factors.Results A total of 107 patients were enrolled,among whom 55.6%(55/99)had large-duct PSC and 29.0%(31/107)had comorbidity with inflammatory bowel disease(IBD).The positivity rate of anti-neutrophil cytoplasmic antibody(ANCA)was 32.9%(24/73),and 50.0%(40/80)of the patients had an increase in IgG/IgM.The median symptom-to-diagnosis interval was 1 year(<1-4.0),and 38.3%(41/107)of the patients had progressed to decompensated cirrhosis at the time of diagnosis.The median liver transplant-free survival time was 114 months(95%confidence interval[CI]:62-166),with a 5-year survival rate of 65.7%.The multivariate analysis showed that an increase in total bile acid(TBA)(hazard ratio[HR]=1.006,95%CI:1.002-1.010,P=0.001)and a prolonged symptom-to-diagnosis interval(HR=1.252,95%CI:1.059-1.480,P=0.009)were independent risk factors for prognosis.The interaction analysis showed that compared with the female patients with TBA<50 μmol/L,both male and female patients with TBA≥50 μmol/L had a significant increase in the risk of liver transplantation or death(male:HR=16.563,95%CI:2.103-130.449,P<0.001;female:HR=17.009,95%CI:2.113-136.934,P<0.001),and compared with the patients with an age of<45 years and a TBA level of<50 μmol/L,the patients with an age of≥45 years and a TBA level of≥50 μmol/L had a significant increase in the risk of liver transplantation or death(HR=10.729,95%CI:1.325-86.859,P=0.026).Compared with the female patients with an symptom-to-diagnosis interval of≤2 years,the male patients with a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.825,95%CI:1.725-13.644,P=0.003),and compared with the patients with an age of<45 years and a symptom-to-diagnosis interval of≤2 years,the patients with an age of<45 years and a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.983,95%CI:1.366-18.173,P=0.015).Conclusion Compared with the reports from Western countries,large-duct PSC is also the main type of PSC in China,but with a relatively low proportion,and there is also a relatively low proportion of patients with IBD or positive ANCA.An increase in TBA and a prolonged symptom-to-diagnosis interval are independent risk factors for prognosis,with significant interactions with age and sex.This suggests that early screening and intervention should be enhanced to improve prognosis.

Objective:To search, evaluate, and summarize the best evidence regarding discharge preparation services for adult patients with bronchial asthma, providing references for clinical practice and guideline development.Methods:A computer search was conducted in BMJ Best Practice, UpToDate, PubMed, Australia Joanna Briggs Institute Evidence-based Healthcare Center Database, Cochrane Library, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine disc, as well as relevant guideline and professional websites. The search period covered from the establishment of the databases to June 30, 2024. Two researchers independently conducted quality assessments of the included literature, evidence extraction, and synthesis.Results:A total of 14 articles were included, comprising five guidelines, four expert consensus, and five systematic reviews. Twenty-three pieces of evidence were summarized across six aspects: discharge preparation objectives, discharge preparation principles, health guidance during hospitalization, pre-discharge preparation, discharge instructions, and post-discharge follow-up.Conclusions:The best evidence for discharge preparation services for adult patients with bronchial asthma summarized in this study can be applied by clinical healthcare providers in China, considering the specific clinical context, to help adult patients with bronchial asthma manage their condition.

Objective:To explore the feasibility of the new auxiliary analysis software in chromosomal aberration analysis of radiation workers during occupational health examinations.Methods:Health examination data of 2 469 radiation workers in Henan province were collected. Manual analysis of chromosomal aberrations in peripheral blood lymphocytes was conducted using the new auxiliary software and the Ikaros software. Then, the chromosomal aberrations detected using both software tools were compared.Results:The new auxiliary software yielded a lower chromosomal aberration rate among radiation workers compared with the Ikaros software [(0.314 ± 0.014)% vs. (0.391 ± 0.022)%, χ2 = 9.24, P = 0.002]. Notably, the new auxiliary software yielded a significantly lower rate of acentric fragments (ace) [(0.136 ± 0.009)% vs. (0.209 ± 0.020)%, χ2= 17.76, P < 0.001]. However, no statistically significant differences were observed between the result of the two software tools in the rates of dicentrics plus rings (dic + r) and translocations ( P > 0.05). According to the GBZ/T 248-2014 standard, the differences in abnormality rates of chromosomal aberrations between the two groups had no statistically significance ( P > 0.05), with both groups showing an abnormality rate of 0 for ace. Furthermore, the new auxiliary software could double the detection efficiency. Among pre-service radiation workers of various occupations, the differences in the chromosomal aberrations detected using the two software tools exhibited statistical significance ( χ2 = 10.26, P = 0.001). In contrast, the differences in the chromosomal aberrations among in-service and post-service radiation workers had no statistically different significance ( P>0.05). The Poisson regression analysis result demonstrated that the rate of chromosomal aberrations excluding ace was affected by age ( z = 2.73, P = 0.006), while gender, analysis method, service status, and occupation had no impact. Conclusions:The two software tools yielded largely consistent result in detecting chromosomal aberrations induced by exposure to ionizing radiation. Notably, the new auxiliary software can significantly improve detection efficiency, indicating the feasibility of applying it to chromosomal aberration analysis among radiation workers.

Objective To explore the correlation between chronic diseases and the risk of benign prostatic hyperplasia(BPH)in middle-aged and older Chinese man.Methods Data from the 2013 China Health and Retirement Longitudinal Study(CHARLS)were used,including 4 509 male participants aged 45 years and older.Chronic diseases and BPH diagnoses were obtained through a questionnaire survey.Logistic regression analysis was performed to identify independent risk factors for BPH.Restricted cubic splines(RCS)were used to explore the nonlinear relationship between variables and BPH prevalence,while stratified analyses were conducted to assess the differential impact of chronic diseases on BPH prevalence in different subgroups.Results Compared to patients without BPH,those with BPH had a significantly higher prevalence of comorbid chronic diseases,including hypertension,diabetes,chronic respiratory diseases,chronic heart disease,stroke,chronic kidney disease,chronic digestive diseases,arthritis or rheumatism,depression,and memory-related disorders.Multivariable Logistic regression analysis indicated that factors such as the 10-item Center for Epidemiological Studies Depression Scale(CESD-10)scores(OR=1.043,95% CI:1.022-1.063,P<0.001),chronic respiratory disease(OR=1.518,95% CI:1.143-1.998,P=0.003),chronic heart disease(OR=1.515,95% CI:1.143-1.998,P=0.003),chronic kidney disease(OR=2.384,95% CI:1.799-3.137,P<0.001),and chronic digestive disease(OR=1.427,95% CI:1.129-1.796,P=0.003)were independently associated with the occurrence of BPH.RCS analysis demonstrated no non-linear association between age,BMI,and CESD-10 scores and BPH.Stratified analysis revealed that the influence of these chronic conditions on BPH remained constantly stable across different subgroups.Conclusion BPH is commonly comorbid with various chronic diseases.Future treatment strategies for BPH should consider the shared pathological mechanisms between BPH and these chronic conditions,with a focus on integrated interventions targeting common pathways.

Objective To explore the impacts of different surgical methods under hysteroscopy on the surgical time and endometrial thickness of patients with endometrial polyp(EP).Methods 180 patients with EP from April 2021 to April 2023 were regarded as the subjects.They were separated into group A,group B,and group C according to surgical methods,with 60 cases in each.Group A underwent hysteroscopic resection,group B underwent hysteroscopic cold knife surgery,and group C underwent hysteroscopic curettage surgery.The pictorial blood loss assessment chart(PBAC)score before and after treatment,endometrial lesion,intraoperative bleeding volume,hospitalization time,surgical time,hospitalization cost,clinical efficacy,complications,pregnancy rate and recurrence rate were compared.Results The intraoperative bleeding volume in group C was obviously less than that in group A and group B,hospitalization time,and surgical time were obviously shorter than those in group A and group B,and the hospitalization cost was obviously higher than that in group A and group B,the differences were statistically significant(P<0.05).The PBAC score in groups C was obviously less than that in group A and group B,the endometrial thickness was obviously smaller than that in group A and group B,the differences were statistically significant(P<0.05).The clinical efficacy of group A was obviously lower than that of group B and group C,the differences were statistically significant(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The complication rate in group C and group B were obviously less than that in group A(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The recurrence rate within 12 months in three groups was not statistically significant(P>0.05).The pregnancy rate in group C was obviously higher than that in group B and group A,and group B was higher than group A,the differences were statistically significant(P<0.05).Conclusion Hysteroscopic curettage is more effective in clearing lesions,shortening surgical time,reducing intraoperative bleeding,lowering endometrial thickness,and promoting menstrual recovery in patients compared to other hysteroscopic surgical methods,with high safety.