Objective:To explore the feasibility and advantages of applying visualized thermosensitive color-changing bolus in postmastectomy radiotherapy (PMRT) for breast cancer.Methods:Forty patients with breast cancer treated with PMRT in the Second Affiliated Hospital of Soochow University from June 2023 to June 2024 were prospectively selected. They were randomly divided into test and control groups (also referred to as groups A and B, respectively), with 20 patients in each group. Group A, underwent two CT scans: the first scan without bolus (image A1) and the second scan with visualized thermosensitive color-changing bolus (image A2). They were treated with visualized thermosensitive color-changing bolus. Group B also underwent two CT scans: the first scan without bolus (image B1) and the second scan with conventional commercial bolus (image B2), and then were treated with conventional commercial bolus. In the radiotherapy planning, images A1 and A2 were designed as A1-Plan and A2-Plan, and A3-Plan was created by transferring the A1-Plan onto image A2. Images B1 and B2 were designed as B1-Plan and B2-Plan, and B3-Plan was created by transferring the B1-Plan onto image B2. The radiation fields and target optimization functions were identical. The dosimetric differences and skin toxicity reactions between different plans were compared.Results:In Group A, A1-Plan and A2-Plan manifested no statistically significant differences ( P > 0.05) in the doses to organs at risk (OARs), including the ipsilateral lung ( V5 Gy, V10 Gy, V20 Gy), heart ( Dmean), contralateral breast ( Dmean), and skin ( Dmax and Dmean), target homogeneity index (HI), conformity index (CI), prescription dose volume ( V50 Gy), depth of maximum dose ( Dmax), and monitor unit (MU). In Group B, B3-Plan compared to B1-Plan showed reduced V50 Gy (89.9% vs. 95%), HI (0.153 vs. 0.136), and CI (0.817 vs. 0.810), while the two plans displayed no statistically significant differences in doses to OARs. In contrast, A3-Plan and B3-Plan exhibited statistically significant differences ( t = 2.78, 2.29, -0.47, 0.51, 3.13, P < 0.05) in V50 Gy (94.05% vs. 89.90%), Dmax (5 665.4 cGy vs. 5 632.7 cGy), HI (0.148 vs. 0.163), CI (0.83 vs. 0.82), and skin Dmean (5 153.6 cGy vs. 5 048.2 cGy). Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus yielded a significantly reduced air cavity volume (3 833 mm 3vs. 21 498 mm 3,t = -9.65, P < 0.05). Both groups experienced only grade I skin toxicity reactions. Conclusions:Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus shows a more effective dosimetric distribution in terms of target coverage, HI, and CI, a higher fit to the skin, highly visualized air cavity, and higher positional repeatability in fractionated radiotherapy, demonstrating high practicality and safety.

Voice biomarkers， as an emerging smart medical technology， are now being used in applications such as assisting in the diagnosis and treatment of diseases， facilitating accurate and personalized medical services for patients. However， it also raises many ethical issues， including informed consent， privacy protection， accuracy and reliability， data security， legal risks， and other issues. This paper systematically sorted out the ethical issues in the applications of voice biomarkers in the medical field， summarized these issues， such as informed consent， privacy protection， accuracy and reliability， data security， and legal risks， as well as explored the corresponding coping strategies. These countermeasures encompassed utilizing new media platforms to raise public awareness of voice biomarkers， strengthening supervision and management to promote the privacy protection of voice biomarkers， reducing algorithm biases to promote the general benefits of voice biomarkers to the public， establishing multidisciplinary teams to protect the data security of voice biomarkers， and encouraging medical professionals and researchers to participate in policy research， with a view to providing references for promoting and regulating the applications of voice biomarkers in the medical field.

Objective To investigate the nutritional quality characteristics of vitamin D3-fortified yogurt and explore its improving effect on vitamin D metabolism in the body under simulated weightlessness,thereby providing a theoretical basis for the development of functional foods.Methods Using reconstituted milk as the matrix and Vitamin D3(VD3)microcapsule powder as the fortifier,VD3-fortified yogurt was prepared.A systematic study was conducted to investigate the effects of different gradients(1.25 μg/100 mL,2.50 μg/100 mL,3.75 μg/100 mL,5.00 μg/100 mL,6.25 μg/100 mL)of VD3 microcapsule addition on its quality characteristics(titratable acidity,solid content,water-holding capacity,syneresis).In vivo assessments were conducted using a Sprague-Dawley(SD)rat tail-suspension model to simulate weightlessness.Levels in serum 25(OH)D3,1,25-(OH)2D3,calcium(Ca),and phosphorus(P)were detected using the enzyme-linked immunosorbent assay(ELISA)to evaluate its metabolic capacity.Results During fermentation(3 h),titratable acidity of VD?-fortified yogurt initially increased,then decreased,and eventually stabilized with rising microcapsule dosage,while total solid content remained consistent.WHC exhibited an initial increase followed by a decline,whereas syneresis showed an inverse trend.At an optimal dosage of 3.75 μg/100 mL,the yogurt displayed a dense and uniform network structure,characterized by non-Newtonian fluid behavior with shear-thinning properties.This formulation demonstrated robust structural stability under high-frequency mechanical stress,alongside desirable textural,flavor,and sensory attributes.Animal experiments revealed that the serum concentrations of 25(OH)D3,1,25-(OH)2D3,calcium,and phosphorus in the vitamin D?-fortified yogurt intervention group were significantly higher than those in the tail-suspended control group(P<0.05).Conclusion VD? microencapsulation technology effectively preserves and enhances the nutritional quality characteristics of yogurt and mitigates vitamin D metabolic dysregulation under simulated weightlessness.

Objective:To explore the feasibility and advantages of applying visualized thermosensitive color-changing bolus in postmastectomy radiotherapy (PMRT) for breast cancer.Methods:Forty patients with breast cancer treated with PMRT in the Second Affiliated Hospital of Soochow University from June 2023 to June 2024 were prospectively selected. They were randomly divided into test and control groups (also referred to as groups A and B, respectively), with 20 patients in each group. Group A, underwent two CT scans: the first scan without bolus (image A1) and the second scan with visualized thermosensitive color-changing bolus (image A2). They were treated with visualized thermosensitive color-changing bolus. Group B also underwent two CT scans: the first scan without bolus (image B1) and the second scan with conventional commercial bolus (image B2), and then were treated with conventional commercial bolus. In the radiotherapy planning, images A1 and A2 were designed as A1-Plan and A2-Plan, and A3-Plan was created by transferring the A1-Plan onto image A2. Images B1 and B2 were designed as B1-Plan and B2-Plan, and B3-Plan was created by transferring the B1-Plan onto image B2. The radiation fields and target optimization functions were identical. The dosimetric differences and skin toxicity reactions between different plans were compared.Results:In Group A, A1-Plan and A2-Plan manifested no statistically significant differences ( P > 0.05) in the doses to organs at risk (OARs), including the ipsilateral lung ( V5 Gy, V10 Gy, V20 Gy), heart ( Dmean), contralateral breast ( Dmean), and skin ( Dmax and Dmean), target homogeneity index (HI), conformity index (CI), prescription dose volume ( V50 Gy), depth of maximum dose ( Dmax), and monitor unit (MU). In Group B, B3-Plan compared to B1-Plan showed reduced V50 Gy (89.9% vs. 95%), HI (0.153 vs. 0.136), and CI (0.817 vs. 0.810), while the two plans displayed no statistically significant differences in doses to OARs. In contrast, A3-Plan and B3-Plan exhibited statistically significant differences ( t = 2.78, 2.29, -0.47, 0.51, 3.13, P < 0.05) in V50 Gy (94.05% vs. 89.90%), Dmax (5 665.4 cGy vs. 5 632.7 cGy), HI (0.148 vs. 0.163), CI (0.83 vs. 0.82), and skin Dmean (5 153.6 cGy vs. 5 048.2 cGy). Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus yielded a significantly reduced air cavity volume (3 833 mm 3vs. 21 498 mm 3,t = -9.65, P < 0.05). Both groups experienced only grade I skin toxicity reactions. Conclusions:Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus shows a more effective dosimetric distribution in terms of target coverage, HI, and CI, a higher fit to the skin, highly visualized air cavity, and higher positional repeatability in fractionated radiotherapy, demonstrating high practicality and safety.

Background::Pathological scars are a disorder that can lead to various cosmetic, psychological, and functional problems, and no effective assessment methods are currently available. Assessment and treatment of pathological scars are based on cutaneous manifestations. A two-photon microscope (TPM) with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo. This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients. Methods::Fifteen patients with pathological scars and three healthy controls were recruited. Imaging was performed using a portable handheld TPM. Five indexes were extracted from two dimensional (2D) and three dimensional (3D) perspectives, including collagen depth, dermo-epidermal junction (DEJ) contour ratio, thickness, orientation, and occupation (proportion of collagen fibers in the field of view) of collagen. Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images. We assessed index differences between scar and normal skin and changes before and after treatment.Results::Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers. Five indexes were employed to distinguish between normal skin and scar tissue. Statistically significant differences were found in average depth ( t = 9.917, P <0.001), thickness ( t = 4.037, P <0.001), occupation ( t= 2.169, P <0.050), orientation of collagen ( t = 3.669, P <0.001), and the DEJ contour ratio ( t = 5.105, P <0.001). Conclusions::Use of portable handheld TPM can distinguish collagen from skin tissues; thus, it is more suitable for scar imaging than reflectance confocal microscopy. Thus, a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.

Objective:To explore the coexisting gene mutations of FLT3-ITD mutation and its association with partial clinical parameters in acute myeloid leukemia (AML).Methods:The clinical data of 236 newly diagnosed AML outpatients and hospitalized patients of Changzhou No.2 People's Hospital and the Second People's Hospital of Wuxi between December 2012 and August 2019 were retrospectively analyzed. Genome DNA-polymerase chain reaction (PCR) combined with Sanger sequencing was used to detect FLT3-ITD mutations, and 51 tumor target gene mutations in patients with FLT3-ITD mutations were detected by using high-throughput DNA sequencing combined with Sanger sequencing.Results:Among 236 AML patients, FLT3-ITD mutations were found in 71 cases (30.1%). About 97.2% (69/71) patients with FLT3-ITD mutations were accompanied by additional mutations, of which 19 patients harbored double coexisting genes mutations, 24 patients harbored 3 coexisting genes mutations and 26 patients harbored ≥ 4 coexisting genes mutations. The most common coexisting genes mutations were NPM1 (55 cases, 77.5%), followed by DNMT3A (36 cases, 50.7%), TET2 (9 cases, 12.7%), CEBPA (5 cases, 7.0%), IDH1 (4 cases, 5.6%) and NRAS (4 cases, 5.6%). In FLT3-ITD mutation group, the hemoglobin level of patients with DNMT3A mutation type was lower than that of those with DNMT3A wild type ( t = -2.37, P = 0.020); the hemoglobin level of patients with NPM1 mutation type was higher than that of those with NPM1 wild type ( t = 2.04, P = 0.045). The platelet in patients with 3 mutations and ≥ 4 mutations was higher than that in those with double mutations ( χ2 = 7.72, P = 0.021). After chemotherapy in 71 patients, the curative effect of 66 cases was evaluable, and the white blood count of 18 patients who did not reach complete remission was higher than that of 48 patients who reached complete remission ( Z = -2.74, P = 0.006). Conclusions:Most FLT3-ITD mutated patients with AML commonly show coexisting gene mutations, and the mutation types of coexisting genes are correlated with the clinical features of patients.

BACKGROUND: Systemic lupus erythematosus (SLE) is a complex autoimmune disease, and the mechanism of SLE is yet to be fully elucidated. The aim of this study was to explore the role of two-pore segment channel 2 (TPCN2) in SLE pathogenesis. METHODS: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression of TPCN2 in SLE. We performed a loss-of-function assay by lentiviral construct in Jurkat and THP-1 cell. Knockdown of TPCN2 were confirmed at the RNA level by qRT-PCR and protein level by Western blotting. Cell Count Kit-8 and flow cytometry were used to analyze the cell proliferation, apoptosis, and cell cycle of TPCN2-deficient cells. In addition, gene expression profile of TPCN2-deficient cells was analyzed by RNA sequencing (RNA-seq). RESULTS: TPCN2 knockdown with short hairpin RNA (shRNA)-mediated lentiviruses inhibited cell proliferation, and induced apoptosis and cell-cycle arrest of G2/M phase in both Jurkat and THP-1 cells. We analyzed the transcriptome of knockdown-TPCN2-Jurkat cells, and screened the differential genes, which were enriched for the G2/M checkpoint, complement, and interleukin-6-Janus kinase-signal transducer and activator of transcription pathways, as well as changes in levels of forkhead box O, phosphatidylinositol 3-kinase/protein kinase B/mechanistic target of rapamycin, and T cell receptor pathways; moreover, TPCN2 significantly influenced cellular processes and biological regulation. CONCLUSION TPCN2 might be a potential protective factor against SLE.
Apoptosis/genetics* ; Cell Division ; Humans ; Jurkat Cells ; Lupus Erythematosus, Systemic/genetics* ; RNA, Small Interfering/genetics*

Background::The dermoscopic features of rosacea have already been reported. However, the current findings are incomplete, and little is known about phymatous rosacea. Hence, this study aimed to summarize and compare the dermoscopic features and patterns of three rosacea subtypes (erythematotelangiectatic [ETR], papulopustular [PPR], and phymatous [PHR]) in the Chinese Han population and to evaluate whether these features differ with patients’ genders, ages, and durations.Methods::Dermoscopic images of 87 rosacea patients were collected in non-polarized and polarized dermoscopy contact modes at 20-fold magnification. Dermoscopic features, including vessels, scales, follicular findings, and other structures, were summarized and evaluated.Results::The reticular linear vessels and red diffuse structureless areas of ETR were distinctive. For PPR, red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules were typical dermoscopic criteria. The common dermoscopic features of PHR were: orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines. The following features statistically differed among the three rosacea subtypes: reticular linear vessels ( P < 0.001), unspecific linear vessels ( P= 0.005), linear vessels with branches ( P < 0.001), yellow scales ( P = 0.001), follicular plugs ( P < 0.001), perifollicular white color ( P < 0.001), red diffuse structureless areas ( P = 0.022), orange diffuse structureless areas ( P < 0.001), red focal structureless areas ( P = 0.002), orange focal structureless areas ( P = 0.003), white lines ( P < 0.001), follicular pustules ( P < 0.001), and black vellus hairs ( P < 0.001). Conclusions::The dermoscopic patterns of ETR are red diffuse structureless areas and reticular linear vessels. For PPR, the pattern comprehends combinations of red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules. Meanwhile, PHR is characterized by remarkable orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines.

OBJECTIVETodelineate the clinical and genetic features of a patient with myeloproliferative neoplasm (MPN) in association with PDGFRA and EVI1 genes rearrangements.

METHODSClinical data of the patient was collected. Conventional cytogenetics, fluorescence in situ hybridization (FISH) and nested PCR were carried out for the patient.

RESULTSThe patient has featured recurrent rash, joint pain, and intermittent fever. Laboratory tests showed hyperleukocytosis and marked eosinophilia. Physical examination revealed splenomegaly. His karyotype was 46,XY,t(3;5)(q26;q15)[6]/46,XY[10]. FISH assay showed that both PDGFRA and EVI1 genes were rearranged. Molecular studies of the mRNA suggested that there was a in-frame fusion between exon 12 of the PDGFRA gene and exon 9 of the FIP1L1 gene. Imatinib was initiated at a dosage of 200 mg, and after 10 months, the signal of the FIP1L1-PDGFRA fusion gene was undetectable in bone marrow sample. However, the expression of EVI1 mRNA was stable, with no significant difference found between the patient and 10 healthy controls.

CONCLUSIONMPN in association with PDGFRA and EVI1 genes rearrangements have unique clinical and genetic features. Genetic testing is helpful for early diagnosis. Imatinib may be effective for the treatment.

Antineoplastic Agents ; therapeutic use ; Base Sequence ; Chromosome Banding ; Chromosomes, Human, Pair 3 ; genetics ; Chromosomes, Human, Pair 5 ; genetics ; DNA-Binding Proteins ; genetics ; Gene Rearrangement ; Humans ; Imatinib Mesylate ; therapeutic use ; In Situ Hybridization, Fluorescence ; Karyotyping ; MDS1 and EVI1 Complex Locus Protein ; Male ; Myeloproliferative Disorders ; drug therapy ; genetics ; Proto-Oncogenes ; genetics ; Receptor, Platelet-Derived Growth Factor alpha ; genetics ; Transcription Factors ; genetics ; Translocation, Genetic ; Treatment Outcome ; Young Adult

OBJECTIVETo assess the correlation of cytogenetic changes with serum vascular endothelial growth factor (VEGF) and serum tartrate resistant acid phosphatase (TRacp-5b) levels among elderly patients with multiple myeloma (MM).

METHODSChromosomal changes were analyzed with a modified culturing method in the presence of IL-6. Serum levels of VEGF and TRacp-5b were determined with enzyme-linked immunosorbent assays (ELISA).

RESULTSAmong the 60 MM patients, chromosomal abnormalities were found in 27 cases, including 22 with numerical abnormalities and 15 with structural abnormalities. Many patients had both numerical and structural abnormalities. For 33 patients with a normal karyotype, the levels of VEGF and TRacp-5b were 117.35 ± 55.26 pg/mL and 4.15 ± 2.15 U/L, respectively, while for 27 patients with an abnormal karyotype, the levels of VEGF and TRacp-5b were 190.26 ± 85.74 pg/ml and 5.96 ± 2.24 U/L, respectively. The difference between the two groups was significant (P<0.05).

CONCLUSIONCompared with MM patients with a normal karyotype, the levels of VEGF and TRacp-5b are higher in those with cytogenetic abnormalities.

Aged ; Aged, 80 and over ; Chromosome Aberrations ; Cytogenetic Analysis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Male ; Multiple Myeloma ; blood ; diagnosis ; genetics ; Tartrate-Resistant Acid Phosphatase ; blood ; Vascular Endothelial Growth Factor A ; blood