Objective To explore the non-invasive diagnostic criteria of magnetocardiography (MCG) for coronary microvascular dysfunction (CMVD), and its value in dynamically assessing drug treatment for CMVD. Methods Patients who presented with chest tightness or chest pain at Zhongshan Hospital, Fudan University from September 2024 to March 2025 were consecutively enrolled, and all of whom had non-obstructive coronary arteries on angiography. Using the coronary angiography-derived index of microcirculatory resistance (caIMR) as the gold standard, patients were divided into a normal microcirculation group (caIMR≤40 U) and a CMVD group (caIMR＞40 U). MCG testing was performed using a domestic device (MD-U041001, Mind Medical). Patients in the CMVD group received adenosine treatment and underwent repeat MCG after medication. Differences in MCG parameters between the two groups were analyzed, and a diagnostic model was established. The value of the diagnostic model was analyzed using receiver operating characteristic (ROC) curves. Results A total of 311 patients were included, with 135 in the normal microcirculation group and 176 in the CMVD group. The CMVD group had a significantly higher proportion of males (61.9% vs 47.4%, P＝0.012), and lower high-density lipoprotein cholesterol (HDL-C) levels ([1.16±0.31] mmol/L vs [1.24±0.29] mmol/L, P＝0.029) than the normal group. Eleven MCG parameters showed significant differences between the two groups (P＜0.05), among which increased values of mfm_QR_epav, mfm_RS_epmse, space_zeroRTrot, as well as decreased value of mfm_QR_v1 were independent predictors of CMVD. The diagnostic model based on these 11 MCG parameters yielded an area under the curve (AUC) of 0.688 (95%CI 0.629-0.747). The integrated diagnostic model combining clinical risk factors (male, smoking history, HDL-C) with MCG parameters had an AUC of 0.701 (95%CI 0.643-0.759). After adenosine treatment, patients in the CMVD group showed significant decreases in mfm_QR_epav (P＝0.010), mfm_RS_sad (P＝0.013), and mfm_RS_epmse (P＝0.046). Conclusions The model based on MCG parameters demonstrates good diagnostic ability for CMVD; dynamic changes in MCG parameters following adenosine intervention may serve as potential objective indicators for evaluating microcirculatory treatment efficacy.

Objective:To analyze relevant factors influencing severe acute radiation enteritis (SARE) during total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC). To identify specific prediction indicators of the occurrence and progression of radiation enteritis by investigating the effect relationships between radiation enteritis and multidimensional factors.Methods:A total of 92 patients with rectal adenocarcinoma who received total neoadjuvant therapy at the First Affiliated Hospital of Soochow University from January 2020 to September 2023 were enrolled in this study. Their relevant information was collected, encompassing clinical nutritional indicators, dynamic changes in hematological parameters, systemic inflammatory indicators, and the occurrence of adverse reactions. Then, risk factors associated with radiation enteritis were determined using logistic regression analysis. Based on independent risk factors, a nomogram model for risk prediction was constructed.Results:Univariate analysis revealed significant correlations of the SARE occurrence with certain nutritional indicators, local tumor measurement data, and laboratory parameters. Multivariate regression analysis further identified the independent risk factors for SARE occurrence, including albumin reduction >26.5% before vs. after treatment ( OR = 5.010, 95% CI: 1.766-14.154, P = 0.010), rectual tenesmus rating of Grade 1-3 ( OR = 3.639, 95% CI: 1.425-9.300, P = 0.024), and elevated disease activity index (DAI) score ( OR ≈ 7.683 per 1-point increase, 95% CI: 1.105-53.410, P = 0.039). The prediction model constructed based on these factors demonstrated high prediction efficiency (AUC = 0.841; 95% CI: 0.749-0.934). Conclusions:The nomogram model constructed using albumin reduction, rectal tenesmus rating, and DAI score can provide accurate, simple, and low-cost risk prediction of radiation enteritis during TNT for LARC patients. This model facilitates the early clinical identification of high-risk patients, providing a basis for implementing personalized adjustments to radiotherapy regimens and enhancing nutritional interventions.

Objective:To analyze relevant factors influencing severe acute radiation enteritis (SARE) during total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC). To identify specific prediction indicators of the occurrence and progression of radiation enteritis by investigating the effect relationships between radiation enteritis and multidimensional factors.Methods:A total of 92 patients with rectal adenocarcinoma who received total neoadjuvant therapy at the First Affiliated Hospital of Soochow University from January 2020 to September 2023 were enrolled in this study. Their relevant information was collected, encompassing clinical nutritional indicators, dynamic changes in hematological parameters, systemic inflammatory indicators, and the occurrence of adverse reactions. Then, risk factors associated with radiation enteritis were determined using logistic regression analysis. Based on independent risk factors, a nomogram model for risk prediction was constructed.Results:Univariate analysis revealed significant correlations of the SARE occurrence with certain nutritional indicators, local tumor measurement data, and laboratory parameters. Multivariate regression analysis further identified the independent risk factors for SARE occurrence, including albumin reduction >26.5% before vs. after treatment ( OR = 5.010, 95% CI: 1.766-14.154, P = 0.010), rectual tenesmus rating of Grade 1-3 ( OR = 3.639, 95% CI: 1.425-9.300, P = 0.024), and elevated disease activity index (DAI) score ( OR ≈ 7.683 per 1-point increase, 95% CI: 1.105-53.410, P = 0.039). The prediction model constructed based on these factors demonstrated high prediction efficiency (AUC = 0.841; 95% CI: 0.749-0.934). Conclusions:The nomogram model constructed using albumin reduction, rectal tenesmus rating, and DAI score can provide accurate, simple, and low-cost risk prediction of radiation enteritis during TNT for LARC patients. This model facilitates the early clinical identification of high-risk patients, providing a basis for implementing personalized adjustments to radiotherapy regimens and enhancing nutritional interventions.

Objective:To evaluate the effect of hyperthermia on radiation pneumonitis (RP) in elderly patients with esophageal cancer undergoing intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 177 elderly esophageal cancer patients (aged ≥60 years) receiving IMRT in the First Affiliated Hospital of Soochow University and Yixing Cancer Hospital from August 1, 2017 to February 6, 2023 were retrospectively analyzed. Patients were divided into the hyperthermia and non-hyperthermia groups based on whether they received hyperthermia treatment. Patients in two groups received IMRT with 6 MV X-rays. Patients in the hyperthermia group underwent high-frequency hyperthermia within 1 h before radiation using the external thermotherapy device HG-2000Ⅲ (heating temperature: 41-43 ℃ for 40 min, twice a week). After adjusting for confounding factors between two groups using propensity score matching (PSM), the short-term effective rates between two groups were compared using Chi-square test. Univariate analysis and logistic multivariate analysis were employed to compare the incidence of RP between two groups. Results:After applying PSM, 42 pairs were successfully matched, and the baseline data and radiotherapy parameters showed no statistically significant differences between two groups (all P>0.05). The objective response rate (ORR) in the hyperthermia group was significantly higher than that in the non-hyperthermia group (83.3% vs. 64.3%, P=0.047). Univariate analysis revealed that the incidence of RP and symptomatic RP (≥ grade 2) in the hyperthermia group was significantly lower than that in the non-hyperthermia group (61.9% vs. 85.7%, P=0.013; 21.4% vs. 47.6%, P=0.012). Logistic multivariate analysis indicated that hyperthermia was an independent protective factor for symptomatic RP ( P=0.011). Conclusions:The incidence and severity of RP in elderly esophageal cancer patients receiving IMRT can be reduced by hyperthermia. Hyperthermia, as a clinically beneficial green treatment, improves efficacy and reduces toxicity for patients with esophageal cancer.

The promise of regeneration therapy for restoration of damaged myocardium after cardiac ischemic injury relies on targeted delivery of proliferative molecules into cardiomyocytes whose healing benefits are still limited owing to severe immune microenvironment due to local high concentration of proinflammatory cytokines. Optimal therapeutic strategies are therefore in urgent need to both modulate local immunity and deliver proliferative molecules. Here, we addressed this unmet need by developing neutrophil-mimic nanoparticles NM@miR, fabricated by coating hybrid neutrophil membranes with artificial lipids onto mesoporous silica nanoparticles (MSNs) loaded with microRNA-10b. The hybrid membrane could endow nanoparticles with strong capacity to migrate into inflammatory sites and neutralize proinflammatory cytokines and increase the delivery efficiency of microRNA-10b into adult mammalian cardiomyocytes (CMs) by fusing with cell membranes and leading to the release of MSNs-miR into cytosol. Upon NM@miR administration, this nanoparticle could home to the injured myocardium, restore the local immunity, and efficiently deliver microRNA-10b to cardiomyocytes, which could reduce the activation of Hippo-YAP pathway mediated by excessive cytokines and exert the best proliferative effect of miR-10b. This combination therapy could finally improve cardiac function and mitigate ventricular remodeling. Consequently, this work offers a combination strategy of immunity modulation and proliferative molecule delivery to boost cardiac regeneration after injury.

Objective:To explore the different types and characteristics of rehabilitation exercise compliance of patients with first stroke at 2 weeks of onset, and analyze its influencing factors, so as to provide reference for the formulation of targeted health education.Methods:A cross-sectional investigation was conducted in Neurology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June, 2021. 276 patients with first-episode stroke were investigated by the Questionnaire of Exercise Adherence at 2 weeks of the onset. The potential profile analysis was conducted to explore characteristics classification of the rehabilitation exercise compliance. And the chi-square test was used to compare demographic differences among different categories and ordered multi classification Logistic regression was used to explore the influencing factors of rehabilitation exercise compliance.Results:The patients were divided into 109 cases with high rehabilitation exercise compliance (39.5%), 114 cases with moderate rehabilitation exercise compliance (41.3%), and 53 cases with low rehabilitation exercise compliance (19.2%). There were statistically significant differences in education level, consciousness level at admission, complications and limb muscle strength among the three types of patients ( χ2 values were 6.17-31.50, all P<0.05). Ordered multi classification Logistic regression showed that the patient′s education level, the patient′s consciousness level at admission, whether there were complications and limb muscle strength would affect the rehabilitation exercise compliance of stroke patients ( P<0.05). Conclusions:There are three potential categories of rehabilitation exercise compliance in patients with first stroke. Patients with illiteracy, drowsiness, complications and poor limb muscle strength have poor rehabilitation exercise compliance.

Objective To effectively use the clinical data generated in daily operation and to realize information networking based on the existing resources of radiotherapy department. To improve quality management efficiency in radiotherapy process. Methods The radiotherapy process and required documents were analyzed. The reporting tool Microsoft Report Builder, which is based on SQL database, was applied to design the patient documents by extracting and analyzing a large number of data generated by Aria, the existing network of our radiotherapy department. PDCA Tools was used to analyze the weak links in the process. Reports with quantitative indices have been designed according to corresponding countermeasures, so as to improve quality control level of the process. Results More than one thousand patients were treated in our department since 2020. All patient documents of radiotherapy can be archived and inquired online after registration only once. 13 daily statistical reports, 5 quarters and 3 annual reports were scheduled according to practical demands. The waiting time before radiotherapy was shortened from 16.2 days to 14.8 days after operating the reporting system 3 months later. The staff could master the treatment progress of patients easily and patients who interrupted the treatment were found in time. Conclusion The reporting tools can realize patient information extraction and networked management effectively in radiotherapy process. Staff efficiency of personnel work and communication was improved. The resource allocation was optimized according to the report data in real time, improving the efficiency and quality of radiotherapy. This method is generally applicable and practical to radiotherapy department.

Objective:To study the effects of hyperbaric oxygen (HBO) therapy on immune function and quality of life in patients with breast cancer undergoing radiochemotherapy.Methods:A total of 100 breast cancer patients admitted in the Department of General Surgery of Fujian Provincial Hospital South Branch from the February of 2015 to the February of 2018 were selected as the study objects, and were divided into observation group and control group according to the random number table method, with 50 cases in each group. Patients in the control group were treated with chemoradiotherapy and other routine clinical symptomatic treatments. Patients in the observation group were treated with HBO therapy on the basis of the treatments of the control group. One week after treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs were all evaluated and recorded. After 5 courses of treatment, the changes of WBC, PLT, hemoglobin content, and serum immune function indexes, CD4 + , CD8 + , and CD4 + /CD8 + of both the two groups before and after treatment were detected and compared. Results:After 5 courses of treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs of the observation group were significantly lower than those of the control group (χ 2=8.073, P<0.01). WBC and PLT counts, hemoglobin content in the observation group were significantly higher than those in the control group( P<0.05). Compared with the control group, CD4 + , CD8 + and CD4 + /CD8 + were significantly increased in the observation group ( P<0.05). Conclusion:HBO therapy can improve the immune function indexes of breast cancer patients after radiochemotherapy and increase PLT, WBC count, and hemoglobin content, so as to significantly reduce the incidence of postoperative complications, which is worthy of popularization and application in clinic.

Objective:To understand the pathogens and molecular-epidemiologic characteristics of viral meningo-encephalitis in Zhejiang province during 2002 to 2018.Methods:All the samples were collected from suspected patients admitted to the hospitals under the monitoring program. Of the total samples, 2 173 were cerebrospinal fluids while the other 455 were stool specimens. Cerebrospinal fluid (CSF) samples were subject to real-time qPCR for the detection of Human enterovirus (HEV), Mumps virus (MuV), Herpes simplex virus (HSV), Cytomegalovirus (CMV) and Japanese encephalitis virus (JEV). Stool sample were subject to real-time qPCR for HEV. ELISA was used to detect the IgM antibodies in CSF, in the 5 kinds of virus mentioned above. VP1 genes from all RNA-positive specimen were amplified, sequenced, for typing and for evolution analysis.Results:871 (40.1 %) of the 2 173 samples were detected as HEV nucleic acid positive during 2002 to 2018. 654 (38.1 %) of the 1 718 CSF sample were HEV nucleic acid positive while 217 (47.7 %) of the 455 stool sample were HEV nucleic acid positive. Among the total positive nucleic acid sample, 670 of them were VP1 sequence positive, including 5 HEV-A and 665 HEV-B. There were 23 HEV serotypes, including Coxsackievirus (CV) CVA4, CVA6, CVA9, CVA10, CVB1-5, Echovirus (EchoV; E) E3, E4, E6,E7, E9, E11, E14, E16, E18, E21, E25, E30, E33 and EV-71. The top three serotypes went to E30, E6 and CVB5. These three serotypes presented enhanced viral activity in every several years. 795 CSF samples were detected as virus nucleic acid positive, including 374 HEV, 6 MuV, 5 HSV and 5 CMV, from 2012 to 2015 and in 2018. 5 kinds of IgM antibodies were detected simultaneously in 368 CSF samples, including 2 HEV positive, 6 JEV positive and 1 MuV positive for 5 viruses, respectively. Except for EV-71, there were 517 EchoV and 152 CV viruses presented, with the ratio of 3.4∶1. These two kinds of viruses alternately changed for each predominant epidemic strains in every 3-5 years. Based on VP1, results from the phylogenetic tree showed that HEV from Zhejiang province clustered into HEV-A and HEV-B clades respectively. E30 developed both h and i sub-genotypes. Conclusions:HEV-B seemed the main pathogen for viral meningo-encephalitis in Zhejiang province. Ratio of positive detection on EchoV was significantly higher than that on CV. These two kinds of virus alternately presented changing tendency in every several years. Predominant epidemic strains E30, CVB5 and E6 were presenting enhanced viral activity, also in every several years. High correlation was found in both HEV viral activity from the surveillance sites and in time line of the viral meningo-encephalitis outbreaks.

Objective:To study the effects of hyperbaric oxygen (HBO) therapy on immune function and quality of life in patients with breast cancer undergoing radiochemotherapy.Methods:A total of 100 breast cancer patients admitted in the Department of General Surgery of Fujian Provincial Hospital South Branch from the February of 2015 to the February of 2018 were selected as the study objects, and were divided into observation group and control group according to the random number table method, with 50 cases in each group. Patients in the control group were treated with chemoradiotherapy and other routine clinical symptomatic treatments. Patients in the observation group were treated with HBO therapy on the basis of the treatments of the control group. One week after treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs were all evaluated and recorded. After 5 courses of treatment, the changes of WBC, PLT, hemoglobin content, and serum immune function indexes, CD4 + , CD8 + , and CD4 + /CD8 + of both the two groups before and after treatment were detected and compared. Results:After 5 courses of treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs of the observation group were significantly lower than those of the control group (χ 2=8.073, P<0.01). WBC and PLT counts, hemoglobin content in the observation group were significantly higher than those in the control group( P<0.05). Compared with the control group, CD4 + , CD8 + and CD4 + /CD8 + were significantly increased in the observation group ( P<0.05). Conclusion:HBO therapy can improve the immune function indexes of breast cancer patients after radiochemotherapy and increase PLT, WBC count, and hemoglobin content, so as to significantly reduce the incidence of postoperative complications, which is worthy of popularization and application in clinic.