Objective To compare the dosimetric differences, plan complexity, verification pass rate, and execution efficiency of volumetric modulated arc therapy (VMAT) plans designed for post-mastectomy radiotherapy of breast cancer using Halcyon 2.0 and VitalBeam accelerators in flattening filter-free mode. Methods A retrospective analysis was conducted on imaging data from 87 female breast cancer patients aged 29 to 75 (49.9 ± 9.9) years who underwent modified radical mastectomy followed by radiotherapy. VMAT plans were designed using both VitalBeam and Halcyon accelerators in flattening filter-free mode. The dosimetric parameters, plan complexity, verification pass rate, and execution efficiency were compared between the plans designed for both accelerators, with a significance level of P<0.05. Results In terms of target volume parameters, Halcyon 2.0 plans demonstrated superior homogeneity index and conformity index. For organs at risk, the Halcyon 2.0 plans showed lower doses for the lungs (D_20% and D_mean) and heart (D_mean) compared to the VitalBeam plans (all P<0.05). Regarding plan complexity, Halcyon 2.0 plans exhibited better median average aperture area variation (0.35 ± 0.02), smaller aperture score, and larger median plan aperture area than VitalBeam plans (all P<0.05). However, VitalBeam plans had a superior median modulation complexity score (0.28 ± 0.01) compared to Halcyon 2.0 plans (P<0.05). Patient plans were assessed using the ArcCHECK phantom, revealing higher pass rates and significantly shorter execution time for Halcyon plans compared to VitalBeam plans (P<0.05). Conclusion Both Halcyon 2.0 and VitalBeam accelerators can provide high-quality VMAT plans for postoperative radiotherapy of breast cancer, with excellent verification pass rates ensuring treatment accuracy and efficacy. However, Halcyon 2.0 offers lower plan complexity, simplifies the treatment planning process, and reduces execution time, thereby achieving higher treatment efficiency and demonstrating greater advantages in clinical applications.

Objective:To investigate the predictive value of serum 25 hydroxyvitamin D3[25 (OH) D3], insulin-like growth factor 1 (IGF-1) and bone mineral density (BMD) in the occurrence of osteoporosis (OP) in postmenopausal women.Methods:A total of 87 postmenopausal women admitted to Shanxi Children’s Hospital from Jan. 2020 to Dec. 2023 were chosen and separated into OP group ( n=40) and non-OP group ( n=47) . The differences of clinical features, serum 25 (OH) D3, IGF-1 and BMD were compared, and the correlation analysis between serum 25 (OH) D3, IGF-1 and BMD (including L 1-4 BMD, femoral neck BMD and total hip BMD) was analyzed. Multivariate Logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the influencing factors of OP occurrence in postmenopausal women and the predictive value of serum 25 (OH) D3 and IGF-1 combined with BMD for OP occurrence. Results:Compared with non-OP group, there were no significant differences in age, body mass index (BMI) , menopause time, serum calcium, serum phosphorus, alanine aminotransferase (ALT) , or aspartate aminotransferase (AST) levels in OP group ( t=1.42, 1.03, 1.71, 0.93, 0.76, 0.43, 0.04; P=0.161, 0.306, 0.092, 0.354, 0.452, 0.670, 0.966) , but the proportion of diabetes mellitus significantly increased ( χ2=4.37, P=0.037) . Compared with non-OP group, the levels of serum 25 (OH) D3 and IGF-1 and the values of L1-4 BMD, femoral neck BMD and total hip BMD in OP group significantly decreased ( t=5.37, 4.83, 8.31, 2.01, 3.11; P<0.001, P<0.001, P<0.001, P=0.048, P=0.003) . Correlation analysis showed that serum 25 (OH) D3 and IGF-1 were significantly positively correlated with L 1-4 BMD, femoral neck BMD and total hip BMD ( r=0.37, 0.42, 0.29, 0.33, 0.28, 0.29; P<0.001, P<0.001, P=0.024, P=0.015, P=0.032, P=0.021) . Multivariate Logistic analysis showed that serum 25 (OH) D3, IGF-1 and L 1-4 BMD were independent influencing factors for OP occurrence in postmenopausal women ( P=0.007, 0.019, 0.001) ROC curve showed that the area under the curve (AUC) values of serum 25 (OH) D3, IGF-1, L 1-4 BMD and their combination in the prediction of the occurrence of OP in postmenopausal women were 0.764, 0.752, 0.957 and 0.985, respectively. Conclusion:Serum 25 (OH) D3, IGF-1 and L 1-4 BMD can be used as predictors of OP occurrence in postmenopausal women, and the combined value of the three is higher.

Objective:To explore the mechanism by which atractylodin regulates the ROS (reactive oxygen species) /AKT signaling pathway to induce apoptosis and cell cycle arrest in endometrial cancer cells, and to provide theoretical support for its potential application in the treatment of endometrial cancer.Methods:Endometrial cancer cell lines (Ishikawa and HEC-1A) were selected as experimental models. Cells were treated with different concentrations (1, 5, 10, 20 μM) of atractylodin. Cell proliferation was assessed by CCK-8 assay, apoptosis was analyzed by flow cytometry (FCM), and protein expression levels of AKT, p-AKT, Bcl-2, Caspase-3, and other AKT signaling pathway-related proteins were detected by Western blot. ROS levels were measured by flow cytometry.Results:Atractylodin treatment significantly inhibited the proliferation of endometrial cancer cells. Flow cytometry analysis revealed a marked increase in the apoptotic cell population. Western blot results showed that atractylodin treatment significantly decreased p-AKT expression, reduced Bcl-2 protein levels, and increased Caspase-3 expression. ROS level analysis showed that atractylodin treatment significantly elevated intracellular ROS generation, suggesting that atractylodin might induce AKT pathway inhibition through ROS, leading to cell cycle arrest and apoptosis.Conclusions:Atractylodin regulates the ROS/AKT signaling pathway to induce apoptosis and cell cycle arrest in endometrial cancer cells, exhibiting potential anti-endometrial cancer effects. This study provides new theoretical evidence for the application of atractylodin in the treatment of endometrial cancer and reveals its underlying mechanisms.

A method for simultaneous determination of 21 kinds of Aconitum alkaloids(ATS)in biological specimens and infused liquor using ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)was developed.The biological samples were pretreated with methanol-acetonitrile(1∶2,V/V)for protein precipitation,while infused liquors were diluted 100-fold with acetonitrile,followed by centrifugation,and filtration by a 0.22-μm membrane.Chromatographic separation was carried out on an EC-C18 column using gradient elution with the mixture of 10 mmol/L ammonium acetate and 0.2%formic acid as mobile phase A and acetonitrile as mobile phase B.With this method,all the analytes were separated within 9.5 min.The samples were detected in positive ESI mode with dynamic multiple reaction monitoring(MRM)and quantified via external standard calibration.The results showed that the concentrations of the analytes in the range of 2-1000 ng/mL had excellent linearity(R2>0.9992)with the peak area.The developed method was successfully used for detection of 21 kinds of aconitum alkaloids,with limits of detection of 0.5-2 ng/mL,quantification limits of 2-6 ng/mL,intra/inter-day precision≤6.0%,spiked recoveries of 89.4%-100.9%,extraction recoveries of 74.2%-104.4%,and matrix effects ranging from-11.1%to 9.2%in blood/urine.The method was applied to detection of 12 samples from 4 fatal aconite poisoning cases,and all 21 kinds of ATS with total alkaloid concentrations of 0.04-4.18 μg/mL in blood and 154.96-422.83 μg/mL in medicinal liquors were detected.Tissue distribution revealed that the order of concentrations from highest to lowest is as follows:urine(157.22 μg/mL)>gastric contents(51.37 μg/mL)>kidney(21.6 μg/g)>whole blood(4.18 μg/mL)>liver(0.03 μg/g).This method showed many advantages such as simple pretreatment,low detection limits,accurate quantification,broad analyte coverage,and superior anti-interference capability in complex matrices,proving ideal for forensic and toxicological analysis of aconitum alkaloids.

Objective To evaluate the quality of propranolol hydrochloride tablets based on national drug sampling,to analyze existing quality issues and improve their quality standards,to provide references and suggestions for the production,quality control,and supervision of this product.Methods A comprehensive evaluation of 178 batches of sampled products was conducted using legal standards combined with exploratory research,including key quality indicators such as related substances,dissolution,content uniformity,content determination,in vitro dissolution profiles,and genotoxic impurity N-nitrosoproranolol.The quality of domestic propranolol hydrochloride tablets and the controllability of the current quality standards for product quality were assessed.Results According to the legal standard methods,the qualification rate of 178 batches of sampled products was 100%.Exploratory research revealed that the impurity levels of samples from six manufacturing enterprises were far below the limit requirements;however,differences existed in genotoxic impurity N-nitrosoproranolol and other aspects.Conclusions The overall quality of propranolol hydrochloride tablets is good,but the current standards need further improvement.It is recommended to add/revise the detection methods for related substances,content,and content uniformity,strictly control N-nitrosoproranolol,and urge enterprises to pay attention to the quality of excipients and the control of the preparation production process.

Objective:To explore the mechanism by which atractylodin regulates the ROS (reactive oxygen species) /AKT signaling pathway to induce apoptosis and cell cycle arrest in endometrial cancer cells, and to provide theoretical support for its potential application in the treatment of endometrial cancer.Methods:Endometrial cancer cell lines (Ishikawa and HEC-1A) were selected as experimental models. Cells were treated with different concentrations (1, 5, 10, 20 μM) of atractylodin. Cell proliferation was assessed by CCK-8 assay, apoptosis was analyzed by flow cytometry (FCM), and protein expression levels of AKT, p-AKT, Bcl-2, Caspase-3, and other AKT signaling pathway-related proteins were detected by Western blot. ROS levels were measured by flow cytometry.Results:Atractylodin treatment significantly inhibited the proliferation of endometrial cancer cells. Flow cytometry analysis revealed a marked increase in the apoptotic cell population. Western blot results showed that atractylodin treatment significantly decreased p-AKT expression, reduced Bcl-2 protein levels, and increased Caspase-3 expression. ROS level analysis showed that atractylodin treatment significantly elevated intracellular ROS generation, suggesting that atractylodin might induce AKT pathway inhibition through ROS, leading to cell cycle arrest and apoptosis.Conclusions:Atractylodin regulates the ROS/AKT signaling pathway to induce apoptosis and cell cycle arrest in endometrial cancer cells, exhibiting potential anti-endometrial cancer effects. This study provides new theoretical evidence for the application of atractylodin in the treatment of endometrial cancer and reveals its underlying mechanisms.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective To evaluate the quality of propranolol hydrochloride tablets based on national drug sampling,to analyze existing quality issues and improve their quality standards,to provide references and suggestions for the production,quality control,and supervision of this product.Methods A comprehensive evaluation of 178 batches of sampled products was conducted using legal standards combined with exploratory research,including key quality indicators such as related substances,dissolution,content uniformity,content determination,in vitro dissolution profiles,and genotoxic impurity N-nitrosoproranolol.The quality of domestic propranolol hydrochloride tablets and the controllability of the current quality standards for product quality were assessed.Results According to the legal standard methods,the qualification rate of 178 batches of sampled products was 100%.Exploratory research revealed that the impurity levels of samples from six manufacturing enterprises were far below the limit requirements;however,differences existed in genotoxic impurity N-nitrosoproranolol and other aspects.Conclusions The overall quality of propranolol hydrochloride tablets is good,but the current standards need further improvement.It is recommended to add/revise the detection methods for related substances,content,and content uniformity,strictly control N-nitrosoproranolol,and urge enterprises to pay attention to the quality of excipients and the control of the preparation production process.

Objective:To investigate the predictive value of serum 25 hydroxyvitamin D3[25 (OH) D3], insulin-like growth factor 1 (IGF-1) and bone mineral density (BMD) in the occurrence of osteoporosis (OP) in postmenopausal women.Methods:A total of 87 postmenopausal women admitted to Shanxi Children’s Hospital from Jan. 2020 to Dec. 2023 were chosen and separated into OP group ( n=40) and non-OP group ( n=47) . The differences of clinical features, serum 25 (OH) D3, IGF-1 and BMD were compared, and the correlation analysis between serum 25 (OH) D3, IGF-1 and BMD (including L 1-4 BMD, femoral neck BMD and total hip BMD) was analyzed. Multivariate Logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the influencing factors of OP occurrence in postmenopausal women and the predictive value of serum 25 (OH) D3 and IGF-1 combined with BMD for OP occurrence. Results:Compared with non-OP group, there were no significant differences in age, body mass index (BMI) , menopause time, serum calcium, serum phosphorus, alanine aminotransferase (ALT) , or aspartate aminotransferase (AST) levels in OP group ( t=1.42, 1.03, 1.71, 0.93, 0.76, 0.43, 0.04; P=0.161, 0.306, 0.092, 0.354, 0.452, 0.670, 0.966) , but the proportion of diabetes mellitus significantly increased ( χ2=4.37, P=0.037) . Compared with non-OP group, the levels of serum 25 (OH) D3 and IGF-1 and the values of L1-4 BMD, femoral neck BMD and total hip BMD in OP group significantly decreased ( t=5.37, 4.83, 8.31, 2.01, 3.11; P<0.001, P<0.001, P<0.001, P=0.048, P=0.003) . Correlation analysis showed that serum 25 (OH) D3 and IGF-1 were significantly positively correlated with L 1-4 BMD, femoral neck BMD and total hip BMD ( r=0.37, 0.42, 0.29, 0.33, 0.28, 0.29; P<0.001, P<0.001, P=0.024, P=0.015, P=0.032, P=0.021) . Multivariate Logistic analysis showed that serum 25 (OH) D3, IGF-1 and L 1-4 BMD were independent influencing factors for OP occurrence in postmenopausal women ( P=0.007, 0.019, 0.001) ROC curve showed that the area under the curve (AUC) values of serum 25 (OH) D3, IGF-1, L 1-4 BMD and their combination in the prediction of the occurrence of OP in postmenopausal women were 0.764, 0.752, 0.957 and 0.985, respectively. Conclusion:Serum 25 (OH) D3, IGF-1 and L 1-4 BMD can be used as predictors of OP occurrence in postmenopausal women, and the combined value of the three is higher.

Depression is a psychological disorder that imposes a tremendous social burden, with a high prevalence in China. In recent years, the number of diagnosed cases of depression in China has steadily increased, yet the recognition rate of the disease remains low. Depression demostrates a clear familial aggregation pattern. To improve its recognition, numberous studies have utilized the polygenic risk score for major depressive disorder (MDD-PRS) as a potential genetic marker to identify high-risk populations. This article reviews the latest progress and research on the use of MDD-PRS in depression, aiming to clarify its capacity to capture genetic variations associated with depression, its interaction with environmental factors, and their relationship to the onset of the disorder. Additionally, this review evaluates the predictive performance of existing risk models for depression and proposes potential directions for future research.