Objective To investigate the relationship between different body position fixation tech-niques,umbilical plane volume change(ΔV),body weight change rate(ΔW%),and radiotherapy setup errors in cervical cancer patients,and to provide recommendations for determining the margin of planning target vol-ume(MPTV).Methods A retrospective analysis was performed on the clinical data of 57 cervical cancer pa-tients who underwent radiotherapy at this hospital from June 2022 to May 2023.Patients were divided into the observation group(fixed with body membrane+thermoplastic pad,n=24)and the control group(fixed with body membrane alone,n=33)based on different positioning fixation methods.They were also further strati-fied by median BMI into BMI≥23.82 kg/m2 and BMI<23.82 kg/m2 patients.Setup errors in the left-right(X),cranio-caudal(Y),and anterior-posterior(Z)directions were recorded.Meanwhile,the umbilical plane volume on the first CT positioning image and the patient's body weight before positioning were recorded,as well as umbilical plane volume of cone-beam CT(CBCT)verification images during weekly radiotherapy and body weight before scan,the ΔV and ΔW%were calculated.Setup errors were compared between two groups,and correlations between ΔV,ΔW%and setup errors were analyzed in all patients,in two groups(the obser-vation group and the control group)and in two BMI subgroups.MPTV values in X,Y,and Z directions were calculated,and receiver operating characteristic(ROC)curve determined the cut off values of ΔV and ΔW%when setup errors met the department's MPTV criteria.Results Compared with the control group,the ob-servation group showed significantly smaller setup errors in X,Y,and Z directions(P<0.05).Both ΔV and ΔW%were positively correlated with setup errors in X and Y direction in all patients,patients in the control group,and patients with BMI≥23.82 kg/m2(P<0.05).In the observation group,ΔW%was positively corre-lated with setup errors in Z direction in patients with BMI<23.82 kg/m2(P<0.05);In the control group,ΔV and ΔW%were positively correlated with setup errors in X and Y direction in patients with BMI≥23.82 kg/m2.ROC curve analysis showed that when setup errors in Y direction reached the department's MPTV criteria(8.41 mm),the cutoff values ΔV and ΔW%were 8.045 cm2 and 4.12%,respectively.Conclusion The body membrane+thermoplastic pad fixation technique reduces setup errors and mitigates the impact of ΔV and ΔW%on setup errors in X and Y directions.When ΔV or ΔW%exceeds the cutoff values,increasing CBCT verification frequency and re-fabricating the body membrane are recommended.

OBJECTIVES: Recent evidence suggests that the gut may be a primary site of metformin action. However, studies on the effects of metformin on gut microbiota remain limited, and its impact on gut microbial metabolites such as short-/medium-chain fatty acids is unclear. This study aims to investigate the effects of metformin on gut microbiota, short-/medium-chain fatty acids, and associated metabolic benefits in high-fat diet rats. METHODS: Twenty-four Sprague-Dawley rats were randomly divided into 3 groups: 1) Normal diet group (ND group), fed standard chow; 2) high-fat diet group (HFD group), fed a high-fat diet; 3) high-fat diet + metformin treatment group (HFD+Met group), fed a high-fat diet for 8 weeks, followed by daily intragastric administration of metformin solution (150 mg/kg body weight) starting in week 9. At the end of the experiment, all rats were sacrificed, and serum, liver, and colonic contents were collected for assessment of glucose and lipid metabolism, liver pathology, gut microbiota composition, and the concentrations of short-/medium-chain fatty acids. RESULTS: Metformin significantly improved HFD-induced glucose and lipid metabolic disorders and liver injury. Compared with the HFD group, the HFD+Met group showed reduced abundance of Blautia, Romboutsia, Bilophila, and Bacteroides, while Lactobacillus abundance significantly increased (all P<0.05). Colonic contents of butyric acid, 2-methyl butyric acid, valeric acid, octanoic acid, and lauric acid were significantly elevated (all P<0.05), whereas acetic acid, isoheptanoic acid, and nonanoic acid levels were significantly decreased (all P<0.05). Spearman correlation analysis revealed that Lactobacillus abundance was negatively correlated with body weight gain and insulin resistance, while butyrate and valerate levels were negatively correlated with insulin resistance and liver injury (all P<0.05). CONCLUSIONS Metformin significantly increases the abundance of beneficial bacteria such as Lactobacillus and promotes the production of short-/medium-chain fatty acids including butyric, valeric, and lauric acid in the colonic contents of HFD rats, suggesting that metformin may regulate host metabolism through modulation of the gut microbiota.
Animals ; Metformin/pharmacology* ; Rats, Sprague-Dawley ; Diet, High-Fat/adverse effects* ; Rats ; Gastrointestinal Microbiome/drug effects* ; Male ; Fatty Acids, Volatile/metabolism* ; Fatty Acids/metabolism*

Objective:To conduct a scoping review on the current status, assessment tools and influencing factors of malnutrition in elderly stroke patients, so as to provide new ideas for the development of individualized nutritional intervention programs.Methods:Studies related to malnutrition in elderly stroke patients were searched in China National Knowledge Infrastructure, VIP, WanFang Data, China Biology Medicine disc, PubMed, Web of Science, Embase and Clinical Trial Registration Center. The search period was from the establishment of the database to January 2024. Two researchers independently screened the literature, extracted information based on inclusion and exclusion criteria, and finally categorized and reported the findings.Results:A total of 33 papers were included. In elderly stroke patients, the prevalence of malnutrition varied between studies. There was a wide range of tools to assess the nutritional status of patients, but there was an overall lack of multidimensional and specific tools. Commonly used was the Short-form Mini-nutritional Assessment. Factors influencing malnutrition in patients included general demographic, disease-related and lifestyle factors, physiologic and biochemical indicators, functional correlates, nutrient literacy-related factors, psychological and supportive factors.Conclusions:Malnutrition in elderly stroke patients is influenced by a variety of factors and seriously affects patient prognosis. Standardized assessment tools should be adopted to detect timely and accurately, take targeted measures for each factor, and carry out personalized intervention programs to promote benign changes in the nutritional status of elderly stroke patients.

Objective:To conduct a scoping review on the current status, assessment tools and influencing factors of malnutrition in elderly stroke patients, so as to provide new ideas for the development of individualized nutritional intervention programs.Methods:Studies related to malnutrition in elderly stroke patients were searched in China National Knowledge Infrastructure, VIP, WanFang Data, China Biology Medicine disc, PubMed, Web of Science, Embase and Clinical Trial Registration Center. The search period was from the establishment of the database to January 2024. Two researchers independently screened the literature, extracted information based on inclusion and exclusion criteria, and finally categorized and reported the findings.Results:A total of 33 papers were included. In elderly stroke patients, the prevalence of malnutrition varied between studies. There was a wide range of tools to assess the nutritional status of patients, but there was an overall lack of multidimensional and specific tools. Commonly used was the Short-form Mini-nutritional Assessment. Factors influencing malnutrition in patients included general demographic, disease-related and lifestyle factors, physiologic and biochemical indicators, functional correlates, nutrient literacy-related factors, psychological and supportive factors.Conclusions:Malnutrition in elderly stroke patients is influenced by a variety of factors and seriously affects patient prognosis. Standardized assessment tools should be adopted to detect timely and accurately, take targeted measures for each factor, and carry out personalized intervention programs to promote benign changes in the nutritional status of elderly stroke patients.

Objective:To evaluate the effect of long non-coding RNA (lncRNA) nuclear enriched abundant transcript 1 (NEAT1) on the radiosensitivity in breast cancer cells by regulating the miR-149-5p/ glutamic pyruvic transaminase 2 (GPT2) axis.Methods:Real-time reverse transcription PCR (RT-qPCR) was used to detect NEAT1, miR-149-5p and glutamic pyruvic transaminase 2 (GPT2) mRNA levels in human breast cells MCF-10A, and human breast cancer cells MCF-7, MDA-MB-231 and MDA-MB-468, respectively. MCF-7 cells were divided into 0, 2, 4, 6 and 8 Gy irradiation groups. MCF-7 cells were divided into NEAT1 knockdown (si-NEAT1) group and control (si-NC) group, NEAT1 knockdown +miR-149-5p knockdown (si-NEAT1+anti-miR-149-5p) group and control (si-NEAT1+anti-miR-NC) group, NEAT1 knockdown + GPT2 overexpression (si-NEAT1+GPT2) group and control (si-NEAT1+NC) group. On the basis of the above grouping, irradiate each group of cells with 4 Gy radiation for 2 h, denoted as IR+si-NEAT1, IR+si-NC, IR+si-NEAT1+anti-miR-149-5p, IR+si-NEAT1+anti-miR-NC, IR+si-NEAT1+GPT2, IR+si-NEAT1+NC groups. Subsequently, MCF-7 cells were irradiated at a dose of 4 Gy and divided into the IR+si-NEAT1, IR+si-NC, IR+si-NEAT1+anti-miR-149-5p, IR+si-NEAT1+anti-miR-NC, IR+si-NEAT1+GPT2 and IR+si-NEAT1+NC groups. RT-qPCR was used to detect NEAT1, miR-149-5p, GPT2 mRNA levels in cells. Colony formation assay was used to detect cell radiosensitivity. CCK-8 assay was adopted to detect cell proliferation ability. The binding sites of NEAT1 and miR-149-5p were predicted by StarBase database. The binding sites of miR-149-5p and GPT2 were predicted by Targetscan database, and validated by dual luciferase assay. Single factor ANOVA was used for inter-group comparisons. LSD- t test was used for pairwise comparison. Results:Compared with MCF-10A cells, NEAT1 and GPT2 mRNA levels in cell lines were up-regulated, whereas miR-149-5p level was down-regulated (all P<0.05). Compared with the 0 Gy dose group, NEAT1 and GPT2 mRNA levels were down-regulated, while miR-149-5p levels were up-regulated in the 2, 4, 6, and 8 Gy dose groups (all P<0.05). Knockdown of NEAT1 expression or radiation alone could enhance cell radiosensitivity, and reduce cell proliferation ability (all P<0.05). Simultaneous radiation treatment with knockdown of NEAT1 expression could strengthen the above effects upon cells (all P<0.05). Knockdown of miR-149-5p expression or overexpression of GPT2 could partially reverse the aforementioned effects of knockdown of NEAT1 expression (all P<0.05). Conclusion:Knockdown of NEAT1 expression enhances breast cancer cell radiosensitivity, and reduces cell proliferation ability by regulating the miR-149-5p/GPT2 signal axis.

With the development of clinical related disciplines, the update and establishment of relevant standards/guidelines at home and abroad, GBZ 185-2006 Diagnostic Criteria for Occupational Medicamentose-like Dermatitis due to Trichloroethylene (hereinafter referred to as “GBZ 185-2006”) was unable to meet clinical needs. Therefore, the GBZ 185-2006 was revised based on the principles of evidence-based medicine, in accordance with relevant laws/regulations and relevant standards/guidelines in combination with review of research data on occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) home and abroad, and the development of clinical practice and clinical related disciplines. The main modifications include: adding terms and definitions of OMDT, modifying the description of clinical manifestations of the diagnostic principles, adjusting the description of latency, deleting the diagnostic requirement of the incidence probability, adding the specific allergen patch test as the etiological diagnostic index, standardizing the application scope, operating procedure and precautions of the specific allergen patch test. In addition, the relevant content of “Basic Characteristics and Clinical Types of Skin Damage of Medicamentose-like Dermatitis due to Trichloroethylene” in Appendix A is improved, the treatment principles are revised, and the content of new progress in treatment, artificial liver application, are added. The revised GBZ 185-2024 Diagnostic Standard for Occupational Medicamentose-like Dermatitis due to Trichloroethylene is more scientific and practical, and can provide technical basis for the standardized diagnosis and treatment of OMDT in medical and health institutions.

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.