Objective To evaluate the dosimetric effect of three-dimensional(3D)printed headrests made of different materials in radiotherapy for head and neck tumor,and to evaluate whether the existence of customized 3D-printed headrest can be neglected during planning phase by comparing differences in target area doses,homogeneity index(HI),conformity index(CI),monitor units(MU),and organ-at-risk(OAR)dose.Methods Ten patients with head and neck tumors,including 5 cases with nasopharyngeal carcinoma and 5 with other head and neck tumors,were enrolled.The headrest contours were outlined using Monaco treatment planning system,and with the same calculation parameters,treatment plans were generated for scenarios without a headrest,with a standard headrest,and with 3D-printed headrests made of 10%filled polylactic acid and thermoplastic polyurethane.The target area doses,OAR dose,MU,and other results were recorded and subjected to statistical analysis.Results No significant differences were observed among the 4 groups(ignoring headrest,standard headrest,3D-printed headrests with 10%filled polylactic acid and thermoplastic polyurethane)in parameters such as D95,D5,Dmean,HI,CI,MU,and OAR dose(the maximum dose to the spinal cord)(P>0.05).Considering the presence of the headrest,significant differences were found in CI for nasopharyngeal carcinoma and other head and neck tumors(P<0.05).Conclusion During the planning phase,the existence of customized 3D-printed headrest can be ignored,but it should be noted that the presence of a headrest may reduce the MU in radiotherapy plans.When considering the headrest,the average CI of patients with other head and neck tumors is significantly higher than that with nasopharyngeal carcinoma.

Objective To explore the effect of occupational skills relearning programme on hemiplegic arm motor function and ac-tivities of daily living(ADL)in stroke patients. Methods From February,2022 to August,2023,74 stroke patients in Guangdong Work Injury Rehabilitation Hospital were enrolled and randomly divided into control group(n=37)and experimental group(n=37).The control group received conventional rehabilitation training,and the experimental group received additional occupational skills relearning programme,for three weeks.They were assessed with Fugl-Meyer Assessment-Upper Extremi-ties(FMA-UE),Functional Test for the Hemiplegic Upper Extremity-Hong Kong(FTHUE-HK),Motor Activity Log(MAL)-amount of use(AOU)and MAL-quality of movement(QOM),modified Barthel Index(MBI),and Stroke Impact Scale(SIS)-Hand and SIS-ADL before and after treatment. Results The scores in all assessments improved significantly in both groups(|t|>3.597,P<0.05)after treatment,while the scores of FMA-UE,FTHUE-HK,MAL-AOU,MAL-QOM were higher in the experimental group than in the control group(|t|>2.352,P<0.05). Conclusion Occupational skills relearning programme could promote the recovery of hemiplegic arm motor and activity,and facilitate the use of the hemiplegic arm in daily life in stroke patients.

OBJECTIVE To ascertain the substance benchmarks of the classic prescription Huangqi Guizhi Wuwu Decoction(HGWD),examine the quantitative value transfer throughout the entire process of HGWD,from herb pieces to decoction,concentrated solution and finally freeze-dried powder,and provide a valuable reference for the preparation method and scientific evaluation of bench-mark samples of classic prescriptions containing volatile substances.METHODS According to the Key information table of Ancient Classic Prescriptions(25 prescriptions)released by China,15 batches of HGWD were prepared.The multi-index content determination and characteristic chromatogram analysis methods were established,and the characteristic peak attribution and similarity evaluation were carried out.The multi-index contents of HGWD and its freeze-dried powder were investigated and compared,and the quantitative value transfer in the preparation process of decoction-concentrated solution-freeze-dried powder was analyzed.The physical form of the benchmark samples were scientifically and reasonably determined,and the content and transfer rate range of each component in the HGWD benchmark samples were determined,and the HGWD substance benchmarks were established.RESULTS The contents of cinnamaldehyde and cinnamyl alcohol in HGWD decreased significantly during the concentration and drying process,and the other in-dex components could be transferred more completely between the decoction,concentrated solution and freeze-dried powder.The simi-larity of the characteristic chromatograms of 15 batches of HGWD benchmark samples were all over 0.9,and 8 characteristic peaks were identified,which were from Paeoniae γadix Alba,Cinnamomi γamulus and Ginger.The paste-forming rate ranged from 8.0%to 11.0%.The content of Astragaloside Ⅳ was 0.04%-0.07%and the transfer rate was 9.0%-18.0%.The content of paeoniflorin was 1.5%-3.0%and the transfer rate was 33.0%-62.0%.The content of cinnamyl alcohol was 0.02%-0.04%,and the transfer rate was 25.0%-47.0%.The content of cinnamic aldehyde was 0.02%-0.05%and the transfer rate was 0.7%-1.5%.The content of cinnamic acid was 0.03%-0.06%and the transfer rate was 17.5%-34.0%.The content of 6-gingerol was 0.04%-0.08%and the transfer rate was 7.0%-14.0%.CONCLUSION The physical form of the decoction as the HGWD benchmark sample is deter-mined,which provides reference for the scientific selection of the physical form of the benchmark sample of classic prescriptions contai-ning volatile substances.The quality indexes of HGWD substance benchmarks are established,and the quantitative value transfer is an-alyzed,which provides the basis for the development of the classic prescription compound preparation.

Objective:This study aimed to analyze the genomic characteristics of Varicella-Zoster Virus (VZV) strains circulating in Jilin province from 2010 to 2023.Methods:Vesicle fluid from 78 sporadic cases with VZV infection were collected in Jilin province from 2010 to 2023, after detecting by Real-time PCR, 26 specimens (CT<25) were detected by PCR. Open reading frame 22(ORF22), ORF38 and ORF62 were amplified and analyzed. Genotyping was confirmed by SNPs ORF22 (37902, 38019, 38055, 38081 and 38177) and ORF38 (69424). Vaccine strains were indentified from wild-type strains according to ORF38 (69349) and ORF62 (106262, 107252, and 108111). Sequences were analyzed by homologous comparison and phylogenetic analysis.Results:The comparison with Dumas sequence revealed that SNPs (37902, 38055, 38081 and 38177) in ORF22 and ORF38 (69424) have mutations similar to the pOka strain, which belong to clade 2. Compared to the Dumas and Baike strains, all 26 samples were wild-type strains. JL2016-4 strain changes from threonine to asparaginyl at position 38059, JL2021-4 strain changes from arginine to proline at position 37933, from aspartic acid to tyrosine at position 37935, and from aspartic acid at base 38031 to tyrosine. JL2023-1 strain changes from arginine to leucine at position 37933.Conclusions:VZV has been prevalent for 14 years in Jilin province. The main epidemic strains belong to the clade 2. We should strengthen the monitoring of VZV outbreaks and raise the coverage rate of VZV vaccination.

Objective:To explore the regulatory effects and mechanism of melatonin on the proliferation and osteogenic differentiation of human dental pulp stem cells(hDPSCs).Methods:hDPSCs were cultured in vitro.The cells in the blank control groups were rou-tinely cultured,while the cells in the experimental groups were cultured with osteogenic induction medium(OIM)and OIM with me-latonin at 5,1,10,25,50,100,500 and 1 000 μmol/L respectively.The effect of melatonin on the proliferation of hDPSCs was ob-served by CCK-8 assay.Alkaline phosphatase(ALP)test,RT-qPCR and Western blot were used to analyze the expression of osteo-genic related genes and proteins.The expression level of the proteins related to classical Wnt pathway was detected.Results:Melato-nin at 100 and 250 μmol/L promoted the proliferation of hDPSCs,at 100 μmol/L increased the expression levels of osteogenesis-related mRNA and proteins in hDPSCs,up-regulated β-catenin and down-regulated GSK-3β expression.Conclusion:Melatonin at specific concentrations can promote the proliferation of hDPSCs and has the potential to regulate Wnt/β-catenin signal pathway to pro-mote osteogenic differentiation of hDPSCs.

Lymphoplasmapheresis(LPE) is a combination of plasma exchange and lymphocyte separation technology. It can not only remove autoimmune antibodies, but also remove the immune active cells producing these antibodies. At the same time, it can inhibit cellular and humoral immune responses, and improve the efficiency and reliability of treatment. This technology is safe, reliable, and easy to operate. In recent years, it has been widely used in the treatment of various autoimmune diseases and the suppression of immune rejection after organ transplantation, especially in the treatment of critically ill patients. This paper summarizes the clinical application status of LPE in immune-related diseases at home and abroad, analyzes the problems existing in the clinical promotion of LPE, and makes a prospect of its application value.

After ischemic stroke, the key to reduce the mortality and disability rate is to restore the blood supply of brain tissue as soon as possible. However, the cerebral ischemia-reperfusion injury (CIRI) caused by blood flow restoration is also an important cause of brain tissue structural damage and dysfunction. Studies in recent years have shown that the activation of mitophagy at CIRI stage can reduce the volume of cerebral infarction and protect neurons from CIRI, while excessive or insufficient mitophagy can aggravate CIRI. This suggests that inducing moderate mitophagy may be a potential therapeutic target for neuroprotection after stroke. However, the neuroprotective mechanism of mitophagy has not yet been fully elucidated. This article reviews the neuroprotective mechanism and potential application of mitophagy in stroke, and discusses some problems of mitophagy as a therapeutic target for stroke.

Objective To establish a detection system of ultra high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for everolimus concentration in whole blood of liver transplant recipients. Methods The proteins of samples were precipitated with methanol and zinc sulfate, and everolimus-D4 was used as the internal standard. Phenomenex Kinetex PFP column was used. The mobile phase A was water (containing 2 mmol/Lammonium formate and 0.1% formic acid), and the mobile phase B was methanol (containing 2 mmol/L ammonium formate and 0.1% formic acid). The gradient elution was performed with the flow rate of 1 mL/min, the column temperature of 50 ℃ and the injection volume of 1 μL. The multi-reaction monitoring mode was used to quantitatively analyze with electrospray positive ionization. The UPLC-MS/MS detection system required only 100 μL of whole blood, and could achieve a sufficient lower limit of quantification without complicated sample preparation. The total running time was within 4.5 min. Linear regression (1/x²) analysis was performed using peak area of everolimus / peak area of everolimus-D4 (y) and concentration of everolimus/concentration of everolimus-D4 (x) to calculate the calibration function and analyze its accuracy and linear relationship. UPLC-MS/MS was used to detect the trough blood concentration of everolimus in blood samples of 5 recipients after liver transplantation. Results The accuracy of quality control was within 15%, and the linear relationship of everolimus was good in the blood concentration range of 1-100 ng /mL(R² > 0.990). Trough blood concentration of everolimus measured in blood samples of 5 liver transplant recipients ranged from 3.77 to 9.27 ng/mL. Conclusions The detection system of UPLC-MS/MS in this study is suitable for monitoring the concentration of everolimus in whole blood of liver transplant recipients because of its high accuracy, simple sample processing method and short detection time.

Objective:To analyze the effect of the multipoint tiny incision with continuous buried suture method in double eyelidplasty for patients with mild or moderate dermatolysis.Methods:Totally, 1 161 patients from May 2008 to February 2019 underwent the double-eyelid surgical procedure with the multipoint tiny incision with continuous buried suture method. 1 148 patients were female and 13 patients were male, ranging from 25 to 50 years old. All the patients had normal single-eyelid or inborn narrow double-eyelid without blepharoptosis and they were performed double eyelidplasty for the first time. During the operation, moderate orbicularis oculi muscle and orbital septum fat were cut down from the four or five tiny incisions which were all 2 mm long. Skin levator fixation was performed through continuous buring suture between subcutaneous and the levator aponeurosis. Postoperative follow-up time points were 3 months, 1 year and 5 years.Results:There were 10 patients that showed slight asymmetry, 8 patients' eyes showed shallow creases and 5 patients' double eyelids narrowed. These 23 patients were operated for the second time. Besides that, all the creases were symmetry, parallel and natural. Notched scars did not occur, and patients' satisfaction was achieved in the rest of the cases.Conclusions:Our double eyelid procedure creates natural and beautiful double eyelids without depressed scars. The blepharoplasty of multipoint tiny incision with continuous buried suture method can produce a desired aesthetic effect and it lasts for a long time.

Objective: To investigate the effect of perioperative fluid therapy on early postoperative pulmonary complication (PPC) after orthotopic liver transplantation (OLT). Methods: The clinical data of 132 patients who underwent OLT in the First Affiliated Hospital of Xi′an Jiaotong University from April 2016 to December 2017 were analyzed retrospectively. These patients included 96 males and 36 females, aged (47.3±9.6) years (range: 24-69 years). Based on the clinical manifestations, laboratory and imaging findings of patients in ICU and PPC occurrence within 7 days after OLT surgery, the patients were divided into 2 groups: non-PPC group and PPC group. Univariate and multivariate logistic regression analyses were used to evaluate the association between perioperative variables and PPC. The Kaplan-Meier method was used to estimate cumulative survival of recipients with or without PPC within 2-years. Results: During the follow-up, 11 patients (8.3%) died and 72 patients (54.5%) developed PPC after operation. There were 34 cases, 6 cases, 3 cases, 4 cases, 15 cases, 6 cases and 4 cases of only pleural effusion, only pulmonary edema, only pneumonia, pleural effusion with pneumonia, pleural effusion with pulmonary edema, pleural effusion with atelectasis, and pleural effusion with pneumonia and pneumonia in PPC, respectively. Univariate analysis showed that the preoperative factors (model for end-stage liver disease score), the intra-operative factors (duration of surgery, total infusion volume, total blood products) and the postoperative cumulative fluid balance within the first 24 h, 48 h, and 72 h were the prognosis factors of PPC (P<0.05). At least two out of the first three postoperative days with a fluid balance of ≤-500 ml was a protective factor. Using multivariate analysis by Logistic regression, only the red blood units >10 U (OR=3.55, 95% CI: 1.35-9.26, P=0.010) and the cumulative fluid intake >12 L (OR=2.98, 95% CI: 1.14-7.80, P=0.026) within the first 72 h after operation were independent prognosis factors of PPC after OLT. Kaplan-Meier analysis showed that the cumulative survival rate was lower in PPC group than that in non-PPC group (χ²=6.590, P=0.01). Conclusion Massive red blood cell transfusion and the cumulative fluid volume >12 L during perioperative 72 hours are independent prognosis factors of PPC after OLT.