Objective: To evaluate the effectiveness of "Internet plus" continuous intervention on psychological status and nursing satisfaction of patients with depression after hospital discharge, so as to provide the reference for reducing the recurrence risk of patients with depression and improving the quality of life. Methods: From January to December 2024, patients with mild to moderate depression who were hospitalized in a tertiary grade-a mental health specialized hospital in Wenzhou City and met the discharge criteria were selected as the research objects. The patients were divided into the control group and the intervention group according to a ratio of 1∶1 by the random number table method. Hamilton Depression Scale, Hamilton Anxiety Scale, and Nursing Satisfaction Questionnaire were used to evaluate depressive symptoms, anxiety symptoms, and nursing satisfaction before and after intervention. Covariance analysis was used to compare the differences between the two groups before and after the intervention. Results: A total of 62 patients with mild to moderate depression were enrolled, with 31 patients in the intervention group and 31 patients in the control group. Before the intervention, there were no statistically significant differences in gender, age, course of disease, educational level, marital status, depression symptoms score, anxiety symptoms score, and nursing satisfaction score between the two groups (all P>0.05). After the intervention, the scores of depression and anxiety symptoms in the intervention group decreased by 8.87 and 5.01 points, respectively, compared with those before the intervention, and the scores of depression and anxiety symptoms in the control group decreased by 2.52 and 1.16 points, respectively (all P<0.05). After the intervention, the scores of depression and anxiety symptoms in the intervention group decreased more than those in the control group (both P<0.05). The nursing satisfaction score of the intervention group increased by 6.57 points on average compared with that before the intervention, and that of the control group increased by 4.23 points on average (both P<0.05). There was no statistically significant difference in the increase of nursing satisfaction scores between the two groups before and after intervention (P>0.05). Conclusion The "Internet plus" continuous intervention has a good effect on improving the depressive symptoms and anxiety symptoms of patients with depression after haspital discharge, which can consolidate the treatment effect and improve nursing satisfaction.

Cells and exosomes derived from them are extensively used as biological carrier systems. Cells demonstrate superior targeting specificity and prolonged circulation facilitated by their rich array of surface proteins, while exosomes, due to their small size, cross barriers and penetrate tumors efficiently. However, challenges remain, cells' large size restricts tissue penetration, and exosomes have limited targeting accuracy and short circulation times. To address these challenges, we developed a novel concept termed exosomal spheres. This approach involved incorporating platelet-derived exosomes shielded with phosphatidylserine (PS) and linked via pH-sensitive bonds for drug delivery applications. The study demonstrated that, compared with exosomes, the exosomal spheres improved blood circulation through the upregulation of CD47 expression and shielding of phosphatidylserine, thereby minimizing immune clearance. Moreover, the increased expression of P-selectin promoted adhesion to circulating tumor cells, thereby enhancing targeting efficiency. Upon reaching the tumor site, the hydrazone bonds of exosome spheres were protonated in the acidic tumor microenvironment, leading to disintegration into uniform-sized exosomes capable of deeper tumor penetration compared to platelets. These findings suggested that exosome spheres addressed the challenges and offered significant potential for efficient and precise drug delivery.

With the rapid advancement of vaccines, the research and application of vaccine adjuvants have garnered significant attention. Despite the development of numerous vaccine adjuvants, their applications in human vaccines remain limited due to either insufficient efficacy or severe side effects. Consequently, there is growing interest in developing bioactive compounds derived from traditional Chinese medicines (TCMs) as vaccine adjuvants, owing to their natural biocompatibility, diversity, and safety. Here, we systematically review the current application status and potential value of TCM-based bioactive compounds in vaccine adjuvants. Firstly, we elaborate on the types and characteristics of active ingredients, such as polysaccharides, saponins, flavonoids, acids, and alkaloids. The mechanisms by which these compounds function as vaccine adjuvants are then discussed, including their roles in enhancing humoral immunity, cellular immunity, and relieving the immune suppression in the microenvironment. Additionally, we summarize the current strategies for structural modification and platform optimization to adapt to different application scenarios. Finally, we offer insights into the future development directions for these potential adjuvants, highlighting research priorities, technical approaches, and application prospects. In conclusion, natural vaccine adjuvants derived from TCMs present broad application prospects and hold promise for future vaccine development.

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 explore the value of multimodal ultrasound parameters combined with peripheral blood lymphocyte-monocyte ratio (LMR) in predicting recurrence and metastasis after radical breast cancer surgery.Methods:A total of 139 patients with breast cancer admitted to Northwest Women’s and Children’s Hospital from Jan. 2021 to Jan. 2022 were studied. The patients underwent postoperative multimodal ultrasonography and peripheral blood lymphocyte and monocyte examination. Patients were followed up for 2 years after surgery to evaluate postoperative recurrence and metastasis, and analyze the value of multimodal ultrasound parameters combined with LMR in predicting recurrence and metastasis of patients.Results:Among 139 patients, 32 recurrences and metastases occurred during 2-year follow-up; The peak systolic velocity (PSV), resistance index (RI), maximum lesion diameter, elasticity score, area under the curve (AUC) and peak intensity (PI) in patients with recurrent metastasis were higher than those without recurrent metastasis ( t=7.37, 4.75, 4.75, 5.46, 4.24, 5.22, P<0.05), and the LNR in patients with recurrent metastasis was lower. Pearson correlation analysis showed that PSV, RI, maximum lesion diameter, elasticity score, AUC, PI were negatively correlated with LMR ( r=-0.418, -0.502, -0.633, -0.526, -0.448, -0.482). P<0.05) ; The ROC curve showed that the AUC of PSV, RI, maximum lesion diameter, elasticity score, AUC, PI and LMR for predicting recurrence and metastasis were 0.852, 0.784, 0.791, 0.789, 0.615, 0.725 and 0.728, respectively, and the combined AUC value of each index was 0.992. Conclusions:The use of multimodal ultrasound parameters combined with LMR can improve the prediction value of recurrence and metastasis after radical breast cancer surgery.

To fulfill the calibration requirements for absorbed dose to water in external beam radiotherapy,the summary offers a streamlined calibration procedure and recommendations in accordance with TRS-398(version 7)published by International Atomic Energy Agency in 2024.It addresses various considerations for reference measurement conditions in external beam radiotherapy and defines the appropriate scope for ionization chambers.In terms of ionization chamber measurements,it elaborates on the methods for measuring various correction factors and provides a table of beam quality conversion factors.The calibration uncertainty is examined by comparing the contributions of different factors before and after the update.The results demonstrate that using IBA FC65-G ionization chamber to calibrate high-energy photon beams,high-energy electron beams,proton beams and light ion beams results in relative deviations of-0.4％,0.5％,-1.7％and-1.3％as compared with the earlier versions,with relative standard uncertainties of 1.0％,1.1％,1.7％and 2.6％,respectively.The guideline which is tailored to the national radiotherapy dose calibration standards and practices presents an optimized calibration approach for TRS-398,allowing clinicians to conduct absolute dose calibration more efficiently and accurately.

Objective:To measure the magnetic field correction factor of reference ionization chamber in a 1.5 T magnetic field and to explore the response of the ionization chamber among different angles between magnetic field and ionization chamber axis.Methods:A home-made magnetic compatible one-dimensional water tank was used to measure the response of PTW30013 and IBA FC65-G in 7 MV photon beam of Elekta Unity with and without magnetic field. The ionizing current was collected by PTW UNIDOS Tango electrometer. The effective measurement point of ionization chamber was positioned to the isocenter of MR-linac using electronic portal image device. The influence on water absorbed dose of reference point was obtained by Monte Carlo calculations.Results:The response of ionization chambers in strong magnetic field was related to the angle between chamber axis and magnetic field. The response of ionization chamber was significantly affected in perpendicular magnetic field with a deviation up to 4.54% compared to parallel magnetic field. The deviation between the magnetic field correction factors measured for parallel or reverse-parallel was 0.03%-0.24%. The magnetic field correction factors for PTW30013 and FC65-G measured in parallel magnetic field were 0.9934±0.0077 and 0.9990±0.0076, respectively.Conclusions:This study experimentally verifies that positioning the ionization chamber axis parallel to the magnetic field direction in MR-linac reference dosimetry can minimize the magnetic field impact. The determined magnetic field correction factor and uncertainty in 1.5 T magnetic field can provide necessary data for establishing an MR-linac reference dosimetry protocol.

Objective:To investigate the efficacy and safety of ab externo or ab interno transluminal trabeculotomy in the treatment of secondary glaucoma following pars plana vitrectomy (PPV).Methods:An observational case series method was performed.Seventeen eyes of 17 patients with glaucoma following PPV were enrolled in Henan Eye Hospital and Beijing Tongren Hospital from May 2016 to Feburary 2022.Primary conditions of patients receiving PPV included retinal detachment in 13 eyes, vitreous hemorrhage in 3 eyes, and entophthalmia in 1 eye.All the subjects underwent ab externo (11 eyes) or ab interno (6 eyes) transluminal trabeculotomy.The scope of all cases accepted trabeculotomy was ≥300°(11 cases of 360°, 4 cases of 330° and 2 cases of 300°).Before and at 1 week, 1 month, 6 months and 12 months after surgery, the intraocular pressure (IOP) was evaluated by Goldmann Tonometer and the best corrected visual acuity (BCVA) was measured using a standard visual acuity chart and converted to logrithm of minimal angle of resolution (LogMAR).The number of anti-glaucoma drug applications and surgery-related complications were recorded.The primary outcomes evaluated were IOP and surgical success rate.Secondary outcomes were medication quantity, BCVA (LogMAR) changes, and complications.Surgical success was defined as IOP reduction to <21 mmHg (1 mmHg=0.133 kPa) with or without the use of IOP-lowering medication.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[41]).Written informed consent was obtained from each subject.Results:Preoperative, 1-week, 1-month, 6-month, and 12-month postoperative mean IOP was (34.41±5.11), (21.88±11.72), (20.77±7.67), (19.50±7.01), and (16.32±4.68)mmHg, respectively, with an statistically significant overall difference ( F=20.779, P<0.001).IOP at difference time points after surgery were lower than that before surgery, showing statistically significant differences (all at P<0.01).Compared with before surgery, IOP was reduced more than 40% at 12 months after surgery in 14 eyes.Surgical success rates at 6 and 12 months after surgery were both 76.5%.The number of IOP-lowing drugs decreased significantly after operation ( Z=-4.580, P<0.001).The difference in BCVA between before and 6 months after surgery was not statistically significant ( Z=-1.311, P=0.190).No serious complications were seen in any of the operated eyes postoperatively. Conclusions:Ab externo or ab interno transluminal trabeculotomy is safe and effective in the treatment of secondary glaucoma after PPV.

Objective:To study the influence of intensive magnet fields on radiation dose measurement, and to demonstrate the feasibility of measuring magnet field correction factor by a combination of medical linac with variable magnet fields in view of needing for accurate measurement of the doses from reference beam arising in MR image-guided radiotherapy.Methods:A photon radiation field and a variable field with 6 MV nominal high voltage were produced by using conventional medical electron linear accelerator equipped with a pair of electromagnets with magnetic field strength up to 1.5 T. Both PTW30013 and PTW31010 ionization chambers were used to test the responses of ionization chambers under different magnetic field strengths at four orientations in which the angles between ionization chamber axis and magnetic field direction were 0°, 180°, 90° and 270°, respectively. The magnetic factors, kB, M was calculated and compared with the reported values in literature. Results:The response of ionization chamber was proportional to the magnetic field strength before it reached to a peak around 1 T, and then fell down as the magnetic field continued to rise. When the magnetic field was 0.35 T, the magnetic factors of PTW31010 were 0.988 2±0.000 3 and 0.997 4±0.000 4 corresponding to 90° and 0° directions, the discrepancy between 0° scenario and literature was 0.05% ± 0.04%. When the magnetic field reached 1.5 T, the magnetic factor of PTW30013 was 0.958 9±0.000 5 at the situation of 90°, which was 0.60% ± 0.05% different from the literature value.Conclusions:Conventional 6 MV medical accelerator equipped with electromagnet can be used to measure the magnetic field factor of reference dosimetry for MRIgRT.

Recent insights collectively suggest the important roles of lysyl oxidase (LysOX) in the pathological processes of several acute and chronic neurological diseases, but the molecular regulatory mechanisms remain elusive. Herein, we explore the regulatory role of LysOX in the seizure-induced ferroptotic cell death of neurons. Mechanistically, LysOX promotes ferroptosis-associated lipid peroxidation in neurons via activating extracellular regulated protein kinase (ERK)-dependent 5-lipoxygenase (Alox5) signaling. In addition, overexpression of LysOX via adeno-associated viral vector (AAV)-based gene transfer enhances ferroptosis sensitivity and aggravates seizure-induced hippocampal damage. Our studies show that pharmacological inhibition of LysOX with β-aminopropionitrile (BAPN) significantly blocks seizure-induced ferroptosis and thereby alleviates neuronal damage, while the BAPN-associated cardiotoxicity and neurotoxicity could further be reduced through encapsulation with bioresponsive amorphous calcium carbonate-based nanocarriers. These findings unveil a previously unrecognized LysOX-ERK-Alox5 pathway for ferroptosis regulation during seizure-induced neuronal damage. Suppressing this pathway may yield therapeutic implications for restoring seizure-induced neuronal injury.