Objective To quantitatively compare the dosimetric differences among 4 volumetric modulated arc therapy(VMAT)plans by analyzing the number of arcs and collimator angle settings,aiming to establish a standardized planning template for hippocampal-sparing prophylactic cranial irradiation(HS-PCI)in clinic and improve both planning quality and clinical efficiency.Methods Twenty HS-PCI patients were enrolled,with 4 VMAT plans(V2c,V2p,V3,and V4)for each patient.The differences in target dose,organs-at-risk dose,and monitor units were compared.Results V4 plan had the highest PTV D98%and V95%,and the differences of PTV D98%in V2c vs V2p,V2c vs V4,and PTV V95%in V2c vs V4 were statistically significant(P<0.05).Meanwhile,V4 plan had the lowest PTV Dmax and Dmin doses.Specifically,statistically significant differences were observed in PTV Dmax in V4 vs V2c,V4 vs V2p,V4 vs V3,as well as PTV Dmin in V2c vs V2p,V2c vs V3,V2c vs V4,V2p vs V4(P<0.05).The PTV Dmean was the highest in V2p plan,with statistically significant differences observed in V2c vs V2p,V2c vs V4,V2p vs V3,and V3 vs V4(P<0.05).The highest PTV D2%dose was observed in V2p plan,and the differences in V2c vs V2p,V2c vs V4,V2p vs V3,V3 vs V4 were statistically significant(P<0.05).The homogeneity index and conformity index were close in 4 plans(P=0.946,P=0.380).V4 plan had the lowest Dmax,Dmean,and Dmin of the hippocampus,with significant differences in hippocampal Dmax in V4 vs V2c,V4 vs V2p,hippocampal Dmean in V4 vs V2c,V4 vs V2p,V3 vs V2c,and hippocampal Dmin in V2c vs V2p/V3/V4,and V4 vs V2p(P<0.05).V3 plan had the lowest Dmax for bilateral lenses,and V4 plan showed the lowest Dmax for lenses with a 3 mm expansion,with significant differences between V2c and V2p/V3/V4(P<0.05).V4 plan had the lowest dose for the right optic nerve,with significant differences in V4 vs V2p,and V4 vs V3(P<0.05).No significant differences were observed for the left optic nerve and optic chiasm.The monitor units in V2p plan was the lowest.Conclusion When differences in organs-at-risk doses and plan quality parameters are insignificant,V2p plan is recommended as it can ensure treatment quality while reducing delivery time.

Objective:To investigate the correlation between the location of stroke lesions and the severity of post-stroke dysphagia(PSD),aiming to identify early predictors of dysphagia.Method:From January 2021 to September 2023,125 patients with PSD were divided into supratentorial and infratentorial groups according to their lesions.The correlation between the severity of dysphagia and the severi-ty of complications was compared.VFSS was used to evaluate the severity of swallowing and PAS and CT-CAE5.0 were used to evaluate the severity of complications.Binary and multivariate logistic regression analysis was used to determine the independent influencing factors of dysphagia and complications.Result:There was a significant correlation between the severity of dysphagia(whole process,oral stage,phar-ynx and larynx)and the lesion locations(P＜0.01,P＜0.014,P＜0.02).Damage under the tentorium of the cere-bellum and increase in age are more likely to cause more severe dysphagia.The correlation between the focus and the severity of complications after stroke was statistically significant.The correlation between the focus and the severity of complications after stroke was statistically significant(P=0.005,P=0.001).The focus under the tentorium of the cerebellum was more likely to aggravate the severity of complications.Conclusion:The severity of dysphagia after stroke is related to the location of stroke focus,and the severity of dysphagia is related to the severity of aspiration and the occurrence of pneumonia.

Objective:To carry out a systematic review of the development, introduction or validation of drug literacy assessment tools for adults at home and abroad, and to summarize and analyze the characteristics of the assessment tools.Methods:The research framework of the scoping review was used to systematically search 8 Chinese and English databases, such as China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Web of Science, and Embase. The search period was from database establishment to October 31, 2023. Studies on adult drug literacy assessment tools were screened and included, tool characteristics were extracted and analyzed, and ultimately the extracts were standardized for reporting.Results:A total of 31 articles that met the criteria were included, of which 26 were on the development and validation of assessment tools, three were on the localization and application of assessment tools, and two were on the revision of assessment tools, covering 33 assessment tools.Conclusions:It is needed to recognize the importance of drug literacy assessment, actively explore the diversity of drug literacy assessment tools, clarify the limitations of existing drug literacy assessment tools, further improve the reliability and validity of existing tools, continue to develop and introduce assessment tools suitable for China's national conditions, so as to increase the accuracy of drug literacy assessment.

Objective:To carry out a systematic review of the development, introduction or validation of drug literacy assessment tools for adults at home and abroad, and to summarize and analyze the characteristics of the assessment tools.Methods:The research framework of the scoping review was used to systematically search 8 Chinese and English databases, such as China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Web of Science, and Embase. The search period was from database establishment to October 31, 2023. Studies on adult drug literacy assessment tools were screened and included, tool characteristics were extracted and analyzed, and ultimately the extracts were standardized for reporting.Results:A total of 31 articles that met the criteria were included, of which 26 were on the development and validation of assessment tools, three were on the localization and application of assessment tools, and two were on the revision of assessment tools, covering 33 assessment tools.Conclusions:It is needed to recognize the importance of drug literacy assessment, actively explore the diversity of drug literacy assessment tools, clarify the limitations of existing drug literacy assessment tools, further improve the reliability and validity of existing tools, continue to develop and introduce assessment tools suitable for China's national conditions, so as to increase the accuracy of drug literacy assessment.

Objective To quantitatively compare the dosimetric differences among 4 volumetric modulated arc therapy(VMAT)plans by analyzing the number of arcs and collimator angle settings,aiming to establish a standardized planning template for hippocampal-sparing prophylactic cranial irradiation(HS-PCI)in clinic and improve both planning quality and clinical efficiency.Methods Twenty HS-PCI patients were enrolled,with 4 VMAT plans(V2c,V2p,V3,and V4)for each patient.The differences in target dose,organs-at-risk dose,and monitor units were compared.Results V4 plan had the highest PTV D98%and V95%,and the differences of PTV D98%in V2c vs V2p,V2c vs V4,and PTV V95%in V2c vs V4 were statistically significant(P<0.05).Meanwhile,V4 plan had the lowest PTV Dmax and Dmin doses.Specifically,statistically significant differences were observed in PTV Dmax in V4 vs V2c,V4 vs V2p,V4 vs V3,as well as PTV Dmin in V2c vs V2p,V2c vs V3,V2c vs V4,V2p vs V4(P<0.05).The PTV Dmean was the highest in V2p plan,with statistically significant differences observed in V2c vs V2p,V2c vs V4,V2p vs V3,and V3 vs V4(P<0.05).The highest PTV D2%dose was observed in V2p plan,and the differences in V2c vs V2p,V2c vs V4,V2p vs V3,V3 vs V4 were statistically significant(P<0.05).The homogeneity index and conformity index were close in 4 plans(P=0.946,P=0.380).V4 plan had the lowest Dmax,Dmean,and Dmin of the hippocampus,with significant differences in hippocampal Dmax in V4 vs V2c,V4 vs V2p,hippocampal Dmean in V4 vs V2c,V4 vs V2p,V3 vs V2c,and hippocampal Dmin in V2c vs V2p/V3/V4,and V4 vs V2p(P<0.05).V3 plan had the lowest Dmax for bilateral lenses,and V4 plan showed the lowest Dmax for lenses with a 3 mm expansion,with significant differences between V2c and V2p/V3/V4(P<0.05).V4 plan had the lowest dose for the right optic nerve,with significant differences in V4 vs V2p,and V4 vs V3(P<0.05).No significant differences were observed for the left optic nerve and optic chiasm.The monitor units in V2p plan was the lowest.Conclusion When differences in organs-at-risk doses and plan quality parameters are insignificant,V2p plan is recommended as it can ensure treatment quality while reducing delivery time.

Objective:To investigate the correlation between the location of stroke lesions and the severity of post-stroke dysphagia(PSD),aiming to identify early predictors of dysphagia.Method:From January 2021 to September 2023,125 patients with PSD were divided into supratentorial and infratentorial groups according to their lesions.The correlation between the severity of dysphagia and the severi-ty of complications was compared.VFSS was used to evaluate the severity of swallowing and PAS and CT-CAE5.0 were used to evaluate the severity of complications.Binary and multivariate logistic regression analysis was used to determine the independent influencing factors of dysphagia and complications.Result:There was a significant correlation between the severity of dysphagia(whole process,oral stage,phar-ynx and larynx)and the lesion locations(P＜0.01,P＜0.014,P＜0.02).Damage under the tentorium of the cere-bellum and increase in age are more likely to cause more severe dysphagia.The correlation between the focus and the severity of complications after stroke was statistically significant.The correlation between the focus and the severity of complications after stroke was statistically significant(P=0.005,P=0.001).The focus under the tentorium of the cerebellum was more likely to aggravate the severity of complications.Conclusion:The severity of dysphagia after stroke is related to the location of stroke focus,and the severity of dysphagia is related to the severity of aspiration and the occurrence of pneumonia.

Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.

Objective To investigate the expression of PIK3CA,phosphorylated protein kinase B(p-AKT)and phosphatase and tensin homologue deleted on chromosome 10(PTEN)in sinonasal squamous cell carcinoma(SNSCC).Methods The expressions of PIK3CA and PTEN in head and neck squamous cell carci-noma(HNSCC)were analyzed through the data set of HNSCC in the cancer genome map of UCSC Xena data-base.The immunohistochemical SP method was used to measure the expression of PIK3CA,p-AKT and PTEN in 43 cases of SNSCC tissues,20 cases of normal inferior concha tissues.The relationship between the expressions of PIK3CA,p-AKT and PTEN protein with the clinicopathological features and prognosis of the patients with SNSCC was analyzed.Results The results of bioinformatic analysis showed that PIK3CA mR-NA expression in HNSCC tissues was higher than that in paracancerous tissues(P＜0.01),while the PTEN mRNA expression was lower than that in paracancerous tissues(P＜0.05).The immunohistochemical detec-tion results showed that the positive expressions rates of PIK3CA and p-AKT proteins in normal nasal mucosa tissues were significantly lower than those in SNSCC tissues,while the positive expression rate of PTEN pro-tein in SNSCC tissues was significantly higher than that in normal inferior nasal concha mucosa tissues,and the differences were statistically significant(P＜0.01).The expressions of PIK3CA and p-AKT protein were related to the clinical stage,differentiation degree and primary site(P＜0.05),but were not related to age,gender,smoking and drinking(P＞0.05);the PTEN protein expression was not related with the clinical stage,differentiation degree,primary site,age,smoking and drinking(P＞0.05).The Spearman analysis showed that the expression of PIK3CA in SNSCC tissues was positively correlated with p-AKT protein ex-pression(r=0.664,P＜0.01),and PIK3CA was negatively correlated with PTEN protein(r=-0.414,P＜0.01).The expression of p-AKT was negatively correlated with PTEN protein(r=-0.453,P＜0.01).The Kaplan-Meier analysis showed that the median survival time of the patients with PIK3CA and p-AKT protein positive expression was shorter than that of the patients with negative expression(P＜0.01).There was no statistically significant difference in median survival between the patients with PTEN protein positive expres-sion and those with negative expression.Conclusion The overexpressions of PIK3CA and p-AKT accompa-nied by the loss of PTEN expression participate in the development and progression of SNSCC,moreover the PIK3CA and p-AKT expressions are related to the poor prognosis of the patients.

Objective To evaluate the clinical effect of using a new cross buccal tube(XBT)to close the extraction gap of the maxillary second premolar and control the anchorage.Methods Fifteen adolescent patients with moderate to severe crowding,skeletal Class Ⅰ,missing maxillary second premolars or difficult to retain during clinical examination were selected.PASS orthodontic technique was used to reduce the number of maxillary second premolars to relieve crowding and retract the anterior teeth.Before and after treatment,head lateral images were taken and cephalometric measurements were taken.Changes of bone and dental indexes related to molar anchorage and anterior adduction were observed.Results After treatment,teeth of all patients were arranged neatly,the occlusion relationship was good and the profile was improved.Before and after treatment,there were no significant changes in bone indicators such as ∠SNA,∠SNB and ∠ANB(P＞0.05).There was no significant change in vertical height ∠MP-SN(P＞0.05).The angle of the upper and lower central incisors,∠U1-SN,∠U1-NA,∠ L1-MP and ∠L1-NB decreased significantly,while ∠U1-L1 increased significantly(P＜0.05).The upper incisor margin point moving towards the distal(P＜0.05),and there was no significant change in the position of the upper incisor root apex and first molar(P＞0.05).Conclusion The application of the new cross buccal tube is beneficial for adolescent patients to control the occlusion of the extraction gap of the maxillary second premolar.

Objective To determine the optimal conditions for CXCR4 upregulation by comparing the expression levels of chemokine(C-X-C motif)receptor 4(CXCR4)in MSCs cultured with varying concentrations of oxygen and hydrogen peroxide(H2O2).Methods MSCs were cultured with 0.1％,1％,or 3％O2 and 50 μmol/L H2O2 for different lengths of time(3,6,12,and 24 h).The mRNA and protein expressions of CXCR4 in MSCs were measured by real-time quantitative PCR(qPCR),Western blotting,and immunofluorescence staining.The viability and chemotactic ability of MSCs were measured using CCK-8,wound-healing and Transwell migration assays.Results Both hypoxia and H2O2 treatment were found to upregulate MSC expressions of CXCR4 to some extent.The mRNA and protein levels of CXCR4 were higher after 6-12 h of culture of MSCs with 3％O2,and significantly higher when treated with H2O2 for 6 h.Cell viability was significantly increased after culture with 3％O2 compared with the control group and both 3％O2 and H2O2 pretreatment could enhance chemotactic migration in MSCs.Conclusion Culture with 3％O2 and H2O2 pretreatment can upregulate CXCR4 expressions in MSCs and enhance migration in cells,with superior effects observed with 3％O2.Therefore,treatment with 3％O2 represents the best choice for upregulating the chemotactic ability of MSCs.