[Objective]To explore the effect of Xuefu Zhuyu Decoction on pulmonary vascular remodeling in hypoxic pulmonary hypertension(HPH)through regulating long non-coding RNA metastasis-related lung adenocarcinoma transcript 1(lncRNA MALAT1),and further verify the specific molecular mechanism.[Methods]The HPH model of rat was established by using a low-pressure hypoxia method,and intragastric administration of Xuefu Zhuyu Decoction was performed at doses of 4.5 g/(kg·d)and 8.75 g/(kg·d).The model construction was evaluated by rat right ventricular systolic pressure and Fulton index,and then the pulmonary artery vascular remodeling was observed by hematoxylin-eosin(HE)staining and immunohistochemistry.The drug-containing serum of rats was prepared,and pulmonary artery smooth muscle cells(PASMCs)of rat were extracted.The cell model was then established under hypoxic conditions.PASMCs activity and migration capacity were detected by cell counting kit-8(CCK-8)and Transwell respectively.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of lncRNA MALAT1 and serine/arginine-rich splicing factor 1(SRSF1).Western blot was employed to analyze the expression of related proteins in cells and tissues.[Results]Compared with model group,the right ventricular systolic blood pressure and ventricular hypertrophy in Xuefu Zhuyu Decoction group were significantly relieved(P＜0.05),and the remodeling of pulmonary artery was alleviated.lncRNA MALAT1 was significantly overexpressed in the pulmonary artery tissues of rats in model group,and the downstream SRSF1/mammalian target of rapamycin complex 1(mTORC1)/eukaryotic translation initiation factor 4E-binding protein 1(4E-BP1)signaling axis was significantly activated.Compared with model group,the expressions of lncRNA MALAT1 and SRSF1/mTORC1/4E-BP1 signaling axis-related proteins in the pulmonary artery tissues of rats in Xuefu Zhuyu Decoction administrated group were significantly decreased(P＜0.05).In vitro,PASMCs treated with drug-containing serum of Xuefu Zhuyu Decoction exhibited significantly reduced proliferation(P＜0.05)and migration abilities,decreasing expression of lncRNA MALAT1(P＜0.05).Meanwhile,the expression of SRSF1/mTORC1/4E-BP1 signaling axis-related proteins was significantly decreased(P＜0.05).Furthermore,through the transfection with overexpression plasmids of lncRNA MALAT1 or SRSF1,the expression of lncRNA MALAT1 was increased(P＜0.05),the cell proliferation(P＜0.05)and migration abilities were recovered,and the expression of SRSF1/mTORC1/4E-BP1 signal axis-related proteins was increased(P＜0.05),indicating that the above inhibitory effects were significantly reversed.[Conclusion]Xuefu Zhuyu Decoction can alleviate HPH vascular remodeling by down-regulating lncRNA MALAT1 expression,and regulating SRSF1/mTORC1/4E-BP1 signaling axis.

Dental impressions contaminated by Candida albicans(C.albicans)and Streptococcus mutan(S.mutans)were used to com-pare the disinfection effects of the 2 disinfection reagents.Digital technology was used to compare the effect on accuracy of the 2 reagents.After rinsing the dental impressions with 100 mg/L slightly acidic hypochlorite water(SSHW)for 2 min,the killing log values for C.albicans and S.mutan were 3.44 and 5.26,and the bactericidal rates(％)99.96 and 100,respectively,and the root mean square(RMS)of deviation before and after disinfection was(21.40±2.88)μm.After immersing the dental impressions with 0.525％sodium hypochlorite for 10 minutes,the killing log values for C.albicans and S.mutan were 5.18 and 5.26,the bactericidal rates(％)was 100％for both.The RMS of deviation before and after disinfection was(28.50±4.25)μm.The SAHW rinsing method has good disinfec-tion effect,and has less influence on the accuracy of dental impressions.

Dental impressions contaminated by Candida albicans(C.albicans)and Streptococcus mutan(S.mutans)were used to com-pare the disinfection effects of the 2 disinfection reagents.Digital technology was used to compare the effect on accuracy of the 2 reagents.After rinsing the dental impressions with 100 mg/L slightly acidic hypochlorite water(SSHW)for 2 min,the killing log values for C.albicans and S.mutan were 3.44 and 5.26,and the bactericidal rates(％)99.96 and 100,respectively,and the root mean square(RMS)of deviation before and after disinfection was(21.40±2.88)μm.After immersing the dental impressions with 0.525％sodium hypochlorite for 10 minutes,the killing log values for C.albicans and S.mutan were 5.18 and 5.26,the bactericidal rates(％)was 100％for both.The RMS of deviation before and after disinfection was(28.50±4.25)μm.The SAHW rinsing method has good disinfec-tion effect,and has less influence on the accuracy of dental impressions.

[Objective]To explore the effect of Xuefu Zhuyu Decoction on pulmonary vascular remodeling in hypoxic pulmonary hypertension(HPH)through regulating long non-coding RNA metastasis-related lung adenocarcinoma transcript 1(lncRNA MALAT1),and further verify the specific molecular mechanism.[Methods]The HPH model of rat was established by using a low-pressure hypoxia method,and intragastric administration of Xuefu Zhuyu Decoction was performed at doses of 4.5 g/(kg·d)and 8.75 g/(kg·d).The model construction was evaluated by rat right ventricular systolic pressure and Fulton index,and then the pulmonary artery vascular remodeling was observed by hematoxylin-eosin(HE)staining and immunohistochemistry.The drug-containing serum of rats was prepared,and pulmonary artery smooth muscle cells(PASMCs)of rat were extracted.The cell model was then established under hypoxic conditions.PASMCs activity and migration capacity were detected by cell counting kit-8(CCK-8)and Transwell respectively.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of lncRNA MALAT1 and serine/arginine-rich splicing factor 1(SRSF1).Western blot was employed to analyze the expression of related proteins in cells and tissues.[Results]Compared with model group,the right ventricular systolic blood pressure and ventricular hypertrophy in Xuefu Zhuyu Decoction group were significantly relieved(P＜0.05),and the remodeling of pulmonary artery was alleviated.lncRNA MALAT1 was significantly overexpressed in the pulmonary artery tissues of rats in model group,and the downstream SRSF1/mammalian target of rapamycin complex 1(mTORC1)/eukaryotic translation initiation factor 4E-binding protein 1(4E-BP1)signaling axis was significantly activated.Compared with model group,the expressions of lncRNA MALAT1 and SRSF1/mTORC1/4E-BP1 signaling axis-related proteins in the pulmonary artery tissues of rats in Xuefu Zhuyu Decoction administrated group were significantly decreased(P＜0.05).In vitro,PASMCs treated with drug-containing serum of Xuefu Zhuyu Decoction exhibited significantly reduced proliferation(P＜0.05)and migration abilities,decreasing expression of lncRNA MALAT1(P＜0.05).Meanwhile,the expression of SRSF1/mTORC1/4E-BP1 signaling axis-related proteins was significantly decreased(P＜0.05).Furthermore,through the transfection with overexpression plasmids of lncRNA MALAT1 or SRSF1,the expression of lncRNA MALAT1 was increased(P＜0.05),the cell proliferation(P＜0.05)and migration abilities were recovered,and the expression of SRSF1/mTORC1/4E-BP1 signal axis-related proteins was increased(P＜0.05),indicating that the above inhibitory effects were significantly reversed.[Conclusion]Xuefu Zhuyu Decoction can alleviate HPH vascular remodeling by down-regulating lncRNA MALAT1 expression,and regulating SRSF1/mTORC1/4E-BP1 signaling axis.

Objective To evaluate the molluscicidal effect of spraying different formulations of niclosamide ethanolamine salt with drones against Oncomelania hupensis in ditches. Methods A semi-dry and semi-wet ditch with O. hupensis snails was selected in the second branch field of Jiangbei Farm, Jiangling County, Hubei Province in May 2023, and divided into 4 experimental areas, named groups A1, A2, B1 and B2. Environmental cleaning was performed in groups A1 and B2, and was not conducted in groups A2 or B2. Then, 50% wettable powder of niclosamide ethanolamine salt was sprayed with drones at an effective dose of 2 g/m² in groups A1 and A2, and 5% niclosamide ethanolamine salt granule was sprayed with drones at an effective dose of 2 g/m² in groups B1 and B2. O. hupensis snails were surveyed using the systematic sampling method 1, 3, 5, 7, 14 days after spraying, and the natural mortality and corrected mortality of O. hupensis snails were calculated. Results The occurrence of frames with living snails, mean density of living snails and natural mortality of snails were 97.50% (117/120), 6.30 snails/0.1 m² and 1.18% (9/765) in the test ditch before spraying, respectively. There were significant differences in the mortality of snails among four groups 1, 3, 5, 7 and 14 days after spraying niclosamide formulations with drones (χ² = 17.230, 51.707, 65.184, 204.050 and 34.435, all P values < 0.01). The overall mortality rates of snails were 94.51% (1 051/1 112), 79.44% (908/1 143), 96.54% (977/1 012) and 88.55% (1 021/1 153) in groups A1, A2, B1 and B2 (χ² = 207.773, P < 0.05), respectively. In addition, there was no significant difference in the overall snail mortality between groups A1 and B1 (P > 0.05), and the snail mortality in groups A1 and B1 were both statistically different from that in groups A2 and B2 (all P values < 0.05). Conclusion Both 50% wettlable powder of niclosamide ethanolamine salt and 5% niclosamide ethanolamine salt granule sprayed with drones are active against O. hupensis snails in ditches, and environmental cleaning may improve the molluscicidal effect.

Objective:To compare the dosimetric differences between active breathing coordinator (ABC) and Catalyst for respiratory gating after breast conserving surgery for left breast cancer.Methods:Data of 48 female patients with left breast cancer after breast conserving surgery admitted to the Radiotherapy Department of Shenzhen People′s Hospital from November 2020 to August 2021 were retrospectively selected. They were randomized to receive dynamic intensity modulated radiotherapy (IMRT) plans with ABC or Catalyst. The dosimetric differences in targets and organs at risk between the two groups were analyzed.Results:Comparison of the two respiratory gating IMRT plans revealed no statistically significant differences ( P > 0.05) in D90%, D98%, Dmax, Dmean, conformity index (CI), homogeneity index (HI), and monitor unit parameters in the target volume, (i.e., chest wall), as well as the ipsilateral lung and heart under the deep inhalation breath hold (DIBH) mode. The Dmean, Dmax, and D2% of the left anterior descending coronary artery (LAD) in the Catalyst group were better than those in the ABC group [(1 047.72 ± 1 401.84) vs. (454.48 ± 206.26), (1 619.28 ± 809.05) vs.(1 068.53 ± 419.63), (1 405.85 ± 798.30) vs. (1 016.54 ± 592.00) cGy], with statistically significant differences ( t= -2.07, -3.18, -2.07, P<0.05). Conclusions:Both ABC and Catalyst respiratory gating systems meet the requirements for clinical treatment, with the latter more effective in reducing the exposure dose of LAD.

Objective:To understand intensive care unit(ICU)doctors'opinions and suggestions on implementing palliative care,and provides a reference basis for the implementation of palliative care in Chinese ICU.Methods:A purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors.Colaizzi's phenomenological analysis method was utilized to code,classify,interpret,and comprehensively analyze the interview data.Results:A total of 4 themes and 18 sub-themes was extracted,including cognitive biases toward palliative care,the belief that implementing palliative care in the ICU has significant humanistic implications(palliative care practice is the most perfect embodiment of medical humanities,palliative care in the ICU can alleviate patient pain and reduce invasive operations,palliative care can achieve comfortable care for ICU patients,palliative care focuses on maintaining the dignity of ICU patients,palliative care can pay attention to the inner voice of ICU patients,and implementing palliative care will help to more effectively allocate resources),difficulties faced by ICU in carrying out palliative care(lack of clarity in relevant policies at the legal level,closed management environment in the ICU,insufficient manpower in the ICU and lack of palliative care professional team,inadequate understanding of ICU patients'families,lack of death education,not included in medical insurance payments,and lack of communication skills of young doctors),strategies to promote the development of palliative care in the ICU(ICU palliative care can be piloted first,the development of ICU palliative care screening tools will help with the development of palliative care,the palliative environment and the handling of death procedures can be further optimized,and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care).Conclusions:The integration of palliative care and ICU in China is still blank.The significance of implementing palliative care in ICU should be emphasized,ICU doctors'knowledge and skills of palliative care should be improved from multiple perspectives,patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients'families,and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.

Objective To establish a novel clinical application process of the optical surface monitoring system(OSMS)guided volumetric modulated arc therapy(VMAT)for total body irradiation(TBI),and to assess the accuracy and effectiveness of OSMS in inter-fractional auxiliary positioning before radiotherapy and real-time monitoring of intra-fractional motion during radiotherapy.Methods A retrospective analysis was conducted on 15 leukemia patients who underwent OSMS-guided VMAT-TBI before hematopoietic stem cell transplantation.CT simulation positioning was performed,and the whole-body image data which were collected in head-first supine position(HFS)and feet-first supine position(FFS)were transmitted to the treatment planning system for image registration,multicenter VMAT planning and dose verification.The prescription dose was 800 cGy in 4 fractions twice daily.OSMS was used to assist positioning before delivery,and CBCT was used for position verification.During treatment,OSMS was used for monitoring.The intra-fractional error monitored by OSMS in real time was obtained by analyzing the offline log files.Results The mean dose and coverage of the target area in HFS plan were(905.4±19.0)cGy and 93.0%±2.8%.The mean doses to lung and kidney were(603.7±55.7)cGy and(600.4±49.6)cGy,respectively,and the maximum dose to the lens was(393.9±58.9)cGy.The mean dose and coverage of the target area in FFS plan were(888.5±58.9)cGy and 94.0%±3.2%;and the maximum dose at the junction was(1148.9±72.9)cGy.Fractional treatment delivery time was(75.1±15.1)min.OSMS-assisted positioning was carried out before delivery,and the total deviations of CBCT three-dimensional vector in translational and rotation directions were(2.71±1.96)mm and 0.91°±0.90°,respectively.The three-dimensional vector deviation of the intra-fractional motion amplitude in translational direction monitored by OSMS during the treatment was(1.95±1.88)mm,of which the deviation within 1 mm accounted for 57.5%,79.7%and 62.1%in longitudinal,lateral and vertical directions,respectively.The three-dimensional vector deviation in rotation direction was 0.76°±0.72°,of which the deviation within 1°accounted for 93.1%,85.7%and 94.3%in rotation,pitch and roll directions,respectively.Conclusion VMAT simplifies TBI process,while improving target coverage and organs-at-risk sparing.The use of OSMS can reduce positioning errors,especially rotation errors.In order to ensure the accurate implementation of TBI and the safety of patients,it is necessary to use OSMS for auxiliary positioning and intra-fractional position monitoring.

Objective:To investigate the protection of Active Breathing Coordinator(ABC)technique for heart and its substructures in radiotherapy for left breast cancer.Methods:A total of 50 patients with left breast cancer who underwent radiotherapy in our department were retrospectively selected,and treatment plans with intensity modulated radiotherapy(IMRT)were designed on the images of ABC combined with deep inspiration breath hold(ABC-DIBH)computed tomography(CT)and free-breathing(FB)CT,respectively.The dose parameters of the organ at risks(OARs)of heart and its substructures,including left ventricle(LV),left atrium(LA),right ventricle(RV),right atrium(RA),left main coronary artery(LMCA),left anterior descending coronary artery(LAD),left circumflex coronary artery(LCX)and right coronary artery(RCA),were compared between the two conditions.Results:Compared with FB,the dose of 2%volume(D2),the mean dose(Dmean),the percent volumes covered by different doses(V30,V20,V10,V5)decreased respectively 32.91%(absolute reduction of 1279.11 cGy),36.12%(195.94cGy),58.95%(2.8%),54.32%(3.58%),50.14%(5.56%)and 46.22%(9.67%)of heart under ABC-DIBH condition,and the differences were significant(t=10.28,12.81,9.16,10.28,12.82,12.24,P＜0.01),respectively.In addition,the Dmean values of LV,LA,RV,RA,LMCA,LAD,LCX and RCA decreased by 37.64%(absolute reduction was 285.92 cGy),15.38%(23.68 cGy),34.12%(118.93cGy),9.72%(12.52 cGy),22.17%(47.99 cGy),31.81%(820.63 cGy),16.51%(34.72 cGy)and 14.86%(34.11cGy)under ABC-DIBH condition,respectively,the differences were significant(t=9.50,3.71,6.20,8.65,3.18,10.92,4.26,6.71,P＜0.05).Conclusion:ABC technique can greatly reduce the received doses of heart and its substructures by extending the distance between the heart and the target region with DIBH,thus can form a very effective protection for the heart and its substructures.In addition,it can eliminate the dynamic variation of target location of breast cancer caused by respiratory,and avoid a series of problems,such as target missing,overexposure on normal tissue,and dose deviation.

Objective:To analyze the trend of disease burden of rheumatoid arthritis in China from 1990 to 2019, and to provide scientific basis for formulating targeted prevention and treatment strategies of rheumatoid arthritis.Methods:Based on data of the global burden of disease study 2019 (GBD 2019), according to the number of people with the disease, the prevalence, incidence, disability adjusted life year (DALY) and DALY rate of RA were used to describe the disease burden of RA in China and the world from 1990 to 2019. Joinpoint model was used to analyze the average annual percentage change (AAPC) of age-standardized prevalence rate, age-standardized incidence rate and age-standardized DALY rate of RA in China and the world from 1990 to 2019. The trend of disease burden of RA was analyzed.Results:In general, the standardized prevalence of RA in China and the world showed an upward trend from 1990 to 2019, and the age-standardized prevalence of RA in China increased by 0.18% per year on average ( t=7.34 , P=0.025). The global average annual increase was 0.27%, with a statistically significant difference ( t=6.64, P=0.013). From 1990 to 2019, the standardized incidence rate in China showed an average annual increase of 0.08%( t=7.54, P=0.032), while the standardized incidence rate in the world showed an average annual decrease of 0.37% ( t= -5.64, P=0.001). In 2019, the number of patients and prevalence of RA in China were 4.309.4 million and 302.98/100 000, respectively. The number of new cases and incidence of RA were 22.25 million and 15.64/100 000, respectively. Compared with 1990, in 2019, the number of patients and prevalence rate increased by 114.17% and 78.23%, the number of new cases and incidence rate increased by 77.90% and 48.05%, and DALY rate increased by 109.05% and 73.97%, respectively. From 1990 to 2019, the prevalence rate, incidence rate and DALY rate of women were higher than those of men. Both the prevalence rate and DALY rate showed an increasing trend with age, with the highest in the age group of 75 years old and above. Conclusion:From 1990 to 2019, the standardized incidence rate of RA in China has more increase than that in the world, and the overall incidence and prevalence of RA in China are on the rise. The prevalence, incidence and DALY of RA varies among different populations in China. Women and middle-aged and elderly people are at high risk.