Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Objective:To explore the dosimetry optimization strategy based on filter thickness and shape selection for the bulb superficial X-ray radiotherapy unit.Methods:Monte Carlo code TOPAS was used to model tubular equipment, and the dose distribution from six X-ray energies (50-150 kV) and five conventional aluminum filters (0.5-3.0 mm) with different thickness were simulated in the water model. The percentage depth dose (PDD) curve along the central axis, the center-axis profile dose at different depths, and the lateral dose distribution were analyzed. The dose distribution of three different designs of aluminum filters (conventional cylindrical, conical and oblique cylindrical filters) was compared to evaluate the effect of dosimetric optimization of different filter shapes.Results:Under the same energy, increasing the thickness of the filter can optimize the superficial skin dose, and the optimization effect of depth dose uniformity can be increased by 26% at a depth of 5.5 mm at 70 kV energy. The raised, flat and inclined dose distribution modes can be achieved by using conventional cylindrical, conical and inclined aluminum filters.Conclusions:By selecting the appropriate X-ray energy and filter thickness, an ideal dose distribution matching the tumor depth can be achieved. The application of personalized filters is also of great significance for diverse target areas.

Aim To investigate the antidepressant mechanism of hyperforin via the utilization of single-cell sequencing technology.Methods C57BL/6 mice were randomly divided into the control group,depres-sion model group,and hyperforin intervention group.The chronic unpredictable mild stress(CUMS)model was induced and drug interventions were administered for 28 d.Behavioral experiments were conducted to as-sess depressive symptoms,and hippocampal tissue was collected for single-cell RNA sequencing.Key cell populations and differentially expressed genes across groups were identified,followed by PPI network,GO,and KEGG enrichment analysis.Results Behavioral experiments indicated that CUMS successfully induced depressive symptoms in mice,while hyperforin im-proved depressive behavior.In the depression model group,the proportion of brain perivascular macrophages(PVM)increased,and this proportion decreased after hyperforin intervention,approaching the level seen in the control group.The top 20 common differentially ex-pressed genes in the PVM subpopulation were Saa3,Hbb-bs and Ccl24.PPI network analysis identified core targets,including Ccl2,Dhx9,C3,Msr1,Cxcl2 and Cx3cr1.KEGG enrichment analysis revealed pathways related to chemokines,phagosome formation,and inosi-tol phosphate metabolism.Conclusion The antide-pressant mechanism of hyperforin may be related to the regulation of Ccl24 and its related chemokine signaling pathway by PVM.

Objective To investigate the biomechanical characteristics of Salto Talaris tibial components with different heights at the bone-prosthesis interface during different gait support phases after total ankle replacement.Methods An ankle joint model was reconstructed using a weight-bearing CT from a 61-year-old female patient with ankle arthritis,and Salto Talaris tibial components with different heights(5,7,9,11 mm)were modelled to simulate the loading of the tibial-prosthesis during four gait support phases,and to analyse the micromotion and stresses at the bone-prosthesis interface.Results The 11 mm and 9 mm models had a poorer prosthesis stability,with the peak micromotion exceeding 50 μm and the peak internal tibial stresses of 30.75 MPa and 29.86 MPa,respectively,which exceeded the yield stress of the cancellous bone.The tibial stresses of the 7 mm and 5 mm models were within reasonable ranges and the average peak micromotions were only 42.66 μm and 40.32 μm.In contrast,the initial stability of the 5 mm model prosthesis was the best.Conclusions For total ankle replacement with Salto prosthesis,the height of the tibial component should be chosen appropriately,and the optimal height was about 5 mm.Excessive flexion and extension activities of the ankle joint should be avoided to maintain the stability of the prosthesis after surgery.This study provides a theoretical basis for the improvement of the structural parameters of the Salto prosthesis,which is valuable for the selection of clinical surgical prostheses and helps to improve the results of total ankle replacement.

Aim To investigate the antidepressant mechanism of hyperforin via the utilization of single-cell sequencing technology.Methods C57BL/6 mice were randomly divided into the control group,depres-sion model group,and hyperforin intervention group.The chronic unpredictable mild stress(CUMS)model was induced and drug interventions were administered for 28 d.Behavioral experiments were conducted to as-sess depressive symptoms,and hippocampal tissue was collected for single-cell RNA sequencing.Key cell populations and differentially expressed genes across groups were identified,followed by PPI network,GO,and KEGG enrichment analysis.Results Behavioral experiments indicated that CUMS successfully induced depressive symptoms in mice,while hyperforin im-proved depressive behavior.In the depression model group,the proportion of brain perivascular macrophages(PVM)increased,and this proportion decreased after hyperforin intervention,approaching the level seen in the control group.The top 20 common differentially ex-pressed genes in the PVM subpopulation were Saa3,Hbb-bs and Ccl24.PPI network analysis identified core targets,including Ccl2,Dhx9,C3,Msr1,Cxcl2 and Cx3cr1.KEGG enrichment analysis revealed pathways related to chemokines,phagosome formation,and inosi-tol phosphate metabolism.Conclusion The antide-pressant mechanism of hyperforin may be related to the regulation of Ccl24 and its related chemokine signaling pathway by PVM.

Objective To investigate the biomechanical characteristics of Salto Talaris tibial components with different heights at the bone-prosthesis interface during different gait support phases after total ankle replacement.Methods An ankle joint model was reconstructed using a weight-bearing CT from a 61-year-old female patient with ankle arthritis,and Salto Talaris tibial components with different heights(5,7,9,11 mm)were modelled to simulate the loading of the tibial-prosthesis during four gait support phases,and to analyse the micromotion and stresses at the bone-prosthesis interface.Results The 11 mm and 9 mm models had a poorer prosthesis stability,with the peak micromotion exceeding 50 μm and the peak internal tibial stresses of 30.75 MPa and 29.86 MPa,respectively,which exceeded the yield stress of the cancellous bone.The tibial stresses of the 7 mm and 5 mm models were within reasonable ranges and the average peak micromotions were only 42.66 μm and 40.32 μm.In contrast,the initial stability of the 5 mm model prosthesis was the best.Conclusions For total ankle replacement with Salto prosthesis,the height of the tibial component should be chosen appropriately,and the optimal height was about 5 mm.Excessive flexion and extension activities of the ankle joint should be avoided to maintain the stability of the prosthesis after surgery.This study provides a theoretical basis for the improvement of the structural parameters of the Salto prosthesis,which is valuable for the selection of clinical surgical prostheses and helps to improve the results of total ankle replacement.

Objective:To understand the awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention and related factors in primary and secondary school teachers.Methods:Cross-sectional study design and stratified random sampling method were used to select 5 teachers from each of 51 primary schools and 40 middle schools in a district of Beijing from April 17 to 21, 2024. A questionnaire survey was conducted in the selected teachers with an estimated sample size of 1 040. The survey collected the information about their demographic characteristics, awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention. Multivariate logistic regression model was used to analyze the factors related to influenza vaccination status and intention.Results:In the 975 primary and secondary school teachers, the awareness of susceptibility and severity of influenza and the benefits of influenza vaccination were high. In terms of safety of influenza vaccine, 48.00% (468/975) of the teachers believed that adverse reaction would occur after the vaccination. Influenza like illness occurred in 41.13% (401/975) of the teachers during 2023-2024, and in these teachers, 40.15% (161/401) asked for leave from work due to illness, 40.90% (164/401) sought medical care and 32.93% (54/164) were influenza virus positive. In the 975 teachers, 13.95% (136/975) were vaccinated against influenza during 2023-2024 and 34.46% (336/975) were willing to be vaccinated against influenza during 2024-2025. Multivariate logistic regression analysis showed that being teacher in charge of a class (a OR=1.58, 95% CI: 1.06-2.35), believing that influenza vaccination could effectively prevent influenza (a OR=1.99, 95% CI: 1.05-3.80), believing that teachers' vaccination could improve students' willingness to be vaccinated (a OR=1.98, 95% CI: 1.12-3.50) were the positive factors for teachers' vaccination, and worrying about adverse reactions after the vaccination (a OR=0.52, 95% CI: 0.34-0.80) was the negative factor. Doctors' recommendation (a OR=2.62, 95% CI: 1.41-4.86) and free influenza vaccination (a OR=10.26, 95% CI: 5.17-20.39) were positively correlated with teachers' intention to influenza vaccination. Conclusions:Primary and secondary school teachers in a district of Beijing had high awareness of influenza and influenza vaccine, but their awareness of influenza vaccine safety should be improved. The incidence of influenza-related infection was high in the primary and secondary school teachers. The influenza vaccination rate was low and the willingness to receive influenza vaccination in following year was not strong. For the better prevention and control of influenza in schools, it is necessary to strengthen the health education in primary and secondary school teachers to improve their awareness of influenza vaccine safety and vaccination rate.

Transmission X-ray tubes are relatively new devices characterized by portability,suitability for miniaturization,and low requirements for shielding,making them ideal radiation sources for kilovoltage X-ray therapy.However,their application in radiotherapy remains underexplored.An electron target model of a transmission X-ray tube is developed using the Monte Carlo toolkit TOPAS 3.8.1.The study investigates the effect of tungsten target thickness on X-ray output efficiency,finding that a tube voltage of 50 kV and a tungsten thickness of 1.4 μm yields the highest emission efficiency.Based on the energy spectrum at this optimal efficiency,polynomial fitting approach is applied to determine the corresponding aluminum filter thickness for mean energies ranging from 20 keV to 35 keV,achieving a mean fitting error of 0.91%.Next,the study simulates dose deposition in a water phantom for spectra with different mean energies and various source-to-surface distances,and plots percent-depth-dose curves,relative normalized dose-depth curves,and relative normalized dose histograms under each treatment condition.Finally,the simulated results are compared with experimental data from the intraoperative radiotherapy system Intrabeam and the superficial X-ray therapy unit SRT-100,obtaining average relative errors of 3.71%and 4.38%,respectively.These findings provide a theoretical foundation for further optimization of transmission X-ray tubes in kilovoltage radiotherapy.

Objective:To explore the dosimetry optimization strategy based on filter thickness and shape selection for the bulb superficial X-ray radiotherapy unit.Methods:Monte Carlo code TOPAS was used to model tubular equipment, and the dose distribution from six X-ray energies (50-150 kV) and five conventional aluminum filters (0.5-3.0 mm) with different thickness were simulated in the water model. The percentage depth dose (PDD) curve along the central axis, the center-axis profile dose at different depths, and the lateral dose distribution were analyzed. The dose distribution of three different designs of aluminum filters (conventional cylindrical, conical and oblique cylindrical filters) was compared to evaluate the effect of dosimetric optimization of different filter shapes.Results:Under the same energy, increasing the thickness of the filter can optimize the superficial skin dose, and the optimization effect of depth dose uniformity can be increased by 26% at a depth of 5.5 mm at 70 kV energy. The raised, flat and inclined dose distribution modes can be achieved by using conventional cylindrical, conical and inclined aluminum filters.Conclusions:By selecting the appropriate X-ray energy and filter thickness, an ideal dose distribution matching the tumor depth can be achieved. The application of personalized filters is also of great significance for diverse target areas.

Aim To investigate the effects of endur-ance exercise(EE)on rats following cerebral ischemi-a/reperfusion injury(CI/RI)and to explore its rela-tionship with the Mas signaling pathway.Methods Seventy-two adult male SD rats were randomly divided into four groups(n=18 each):sham group,model group,EE group(group E),and A779 pretreatment group(group A).The CI/RI model was established u-sing middle cerebral artery occlusion method Rats in both group E and group A underwent regular running for four weeks before model preparation,while rats in group A were injected with A779 30 minutes before model preparation.The cognitive function of rats was evaluated using the Neurological Disability Score(NDS)and Morris water maze test.After intravenous injection of Evans blue(EB)for one hour,the rats were euthanized,and brain tissues were collected to measure the infarction volume,EB content,ROS con-tent,and the percentage of apoptotic neurons of the hippocampal CA1 region.The protein expression relat-ed to the Mas pathway was detected by Western blot.Results Compared with the model group,the learning and memory ability as well as the neurological function in group E exhibited a significant improvement(P＜0.05).Both the cerebral infarction volume and the ap-optotic neuron percentage in the ischemic hippocampal CA1 region showed a significant reduction in group E(P＜0.05).The ROS content along with the EB con-tent in the brain tissue significantly decreased in group E(P＜0.05).Furthermore,the expressions of Mas/PKA/CREB/UCP2 pathway related proteins were sig-nificantly enhanced in group E(P＜0.05).However,the Mas receptor antagonist A779 significantly inhibited these neurological effects(P＜0.05).Conclusion EE may inhibit oxidative stress and alleviate CI/RI in rats by activating the Mas/PKA/CREB/UCP2 signaling pathway.