Objective To investigate the impact of two different algorithms, AAA and AXB, on the dose distribution of postoperative radiotherapy for left-sided breast cancer after breast-conserving surgery. Methods A total of 96 target volumes from patients who underwent breast-conserving surgery for left-sided breast cancer were selected for dose verification using a two-dimensional matrix system. The planned dose distributions were simulated using both AAA and AXB algorithms. Dosimetric differences in organs at risk and the target volumes were then compared to identify the algorithm that could reduce the radiation dose to organs at risk without compromising the dose distribution to the target volume. Dose verification was performed on the plans generated by both algorithms, and the pass rates of plans for each target volume using both algorithms were compared to provide a quantitative basis for the precise selection of subsequent radiotherapy plans. Results Both AAA and AXB plans met the radiotherapy requirements. The AXB algorithm demonstrated significant advantages in the D₉₈, D₂, homogeneity index, and conformity index for the planning target volume, as well as in the V₅ and V₂₀ for the left lung. The AXB algorithm showed advantages in the V₃₀ for the heart and the maximum and mean doses for the skin. With the 2 mm/2% criterion in dose verification, the gamma pass rate was higher for the AXB algorithm. Conclusion Through a comparative analysis of the two algorithms, this study revealed that the AXB algorithm offers certain advantages in the dose distribution of radiotherapy after breast-conserving surgery for left-sided breast cancer. These findings provide an important reference for the rational selection of algorithms in clinical practice and are expected to improve radiotherapy efficacy and patient prognosis.

Aim To systematically analyze the risk factors for comorbid ischemic cardiovascular and cerebrovas-cular diseases using principal component analysis.It seeks to identify key risk factors influencing comorbidity and to con-struct a predictive model to serve as a screening tool for the prevention and management of comorbidities.Methods This retrospective study included patients diagnosed with coronary artery disease from December 1,2009 to June 30,2020,at the First Affiliated Hospital of Xinjiang Medical University,using data from the hospital's integrated coronary heart dis-ease prevention platform.Patients were divided into two groups:those with both cardiovascular and cerebrovascular disea-ses and those with only coronary artery disease based on inclusion and exclusion criteria.Clinical indicators during hospi-tal admission were collected.The sample was randomly divided into a modeling set and a validation set in a 7∶3 ratio.In the modeling set,principal component analysis was used to explore the distribution differences in risk factors between the comorbid group and the single-disease group.By analyzing factor load contributions,the most significant variables were i-dentified.Logistic regression was then used to construct a predictive model,and a nomogram was generated.The model's predictive ability and robustness were evaluated in the validation set.Results A total of 11 808 participants were included,with 2 781(23.6%)in the comorbid group and 9 027(76.4%)in the coronary heart disease-only group.Compared with the single-disease group,the comorbid group had a higher average age,a greater proportion of females,and higher systolic blood pressure levels at admission(P<0.001).Additionally,thelevelsof hemoglobin,platelet distri-bution width,low density lipoprotein,and blood sodium were significantly higher in the comorbid group(P<0.05).A total of 8 265 participants were randomly assigned to the modeling set.Principal component analysis identified seven key factors with factor load contributions greater than 5:sodium level,systolic blood pressure,diastolic blood pressure,age,hemoglobin concentration,platelet distribution width,and total bilirubin level.Using these factors,a nomogram was con-structed via Logistic regression.The nomogram's area under the receiver operating characteristic curve for predicting co-morbid ischemic cardiovascular and cerebrovascular diseases was 0.630(95%CI:0.600～0.768,P<0.001).A total of 3 543 participants were randomly assigned to the validation set.In the validation set,the receiver operating characteristic curve was 0.628.Conclusion Elevated sodium level,higher systolic and diastolic blood pressure at admission,older age,increased hemoglobin concentration,higher platelet distribution width,and lower total bilirubin level are risk factors for comorbid ischemic cardiovascular and cerebrovascular diseases.The nomogram constructed has clinical value for screening patients with such comorbidities.

Objective:To analyze the effects of the disease and injury spectrum on health-adjusted life expectancy (HALE) among permanent residents aged 55 and above in Shenzhen from 2016 to 2030.Methods:Based on the mortality surveillance data and the permanent resident population data in Shenzhen from 2016 to 2022, the Sullivan method was used to calculate the HALE during 2016—2022. The Bayesian age-period-cohort model and the grey system model were used to predict the HALE during 2023—2030. The HALE changes in the two periods were decomposed into the contributions of 20 categories of diseases and injuries, respectively.Results:From 2016 to 2022, the HALE increased from 31.41 years (95% CI: 30.50-32.32) to 33.57 years (95% CI: 32.47-34.67). During this period, the mortality effect of neurological disorders slowed the increase of HALE, with a reduction of 0.27 years. By 2030, it is anticipated that the HALE will reach 36.40 years (95% CI: 34.78-38.01). This is expected to be influenced by the mortality effects of nutritional deficiencies (-0.40 years) and mental disorders (-0.29 years), as well as the disability effects of musculoskeletal disorders (-0.66 years), skin and subcutaneous diseases (-0.21 years) and nutritional deficiencies (-0.13 years). Conclusion:The HALE of permanent residents aged 55 years and above in Shenzhen demonstrated an increasing trend over time. Greater attention should be paid to the adverse effects of neurological disorders, nutritional deficiencies, mental disorders, musculoskeletal disorders, and skin and subcutaneous diseases on the continuous increase of HALE in this population.

The aim of this study is to establish a rapid,efficient,and sensitive method for detecting the infectious laryngotracheitis virus(ILTV).The DNA of ILTV was extracted and used as a tem-plate to develop a recombinant enzyme-mediated isothermal amplification(RAA)fluorescence de-tection method for ILTV through optimization of conditions,sensitivity analysis,and repeatability assessment.Additionally,the nucleic acids of avian influenza virus(AIV),IBV,and Newcastle dis-ease virus(NDV)were detected to verify the specificity of this method.Finally,this method was applied to analyze 59 clinical samples collected from multiple large-scale chicken farms in Hebei Province,and the results were compared with those obtained from real-time fluorescence quantifi-cation(qPCR)and PCR methods according to national standards.The results showed that the RAA detection method established in this study had a reaction system of 25.0 μL buffer,2.1 μL primer,0.6 μL probe,5.0 μL magnesium acetate,and 5.0 μL template.The reaction temperature was 39 ℃ and the amplification time was within 20 minutes.The sensitivity of this method was 101 copies/μL,and the specificity detection was 100％.Testing of 59 clinical samples showed that 17 were detected positive by both RAA fluorescence and qPCR,and 12 were detected by PCR,and the detection rate of RAA(fluorescence)was consistent with real-time fluorescence quantification and qPCR,which was higher than that of the PCR assay.The research results indicate that the RAA fluorescence method has a short detection time,good specificity and sensitivity,and can be used for rapid detection of ILTV.

Aim To systematically analyze the risk factors for comorbid ischemic cardiovascular and cerebrovas-cular diseases using principal component analysis.It seeks to identify key risk factors influencing comorbidity and to con-struct a predictive model to serve as a screening tool for the prevention and management of comorbidities.Methods This retrospective study included patients diagnosed with coronary artery disease from December 1,2009 to June 30,2020,at the First Affiliated Hospital of Xinjiang Medical University,using data from the hospital's integrated coronary heart dis-ease prevention platform.Patients were divided into two groups:those with both cardiovascular and cerebrovascular disea-ses and those with only coronary artery disease based on inclusion and exclusion criteria.Clinical indicators during hospi-tal admission were collected.The sample was randomly divided into a modeling set and a validation set in a 7∶3 ratio.In the modeling set,principal component analysis was used to explore the distribution differences in risk factors between the comorbid group and the single-disease group.By analyzing factor load contributions,the most significant variables were i-dentified.Logistic regression was then used to construct a predictive model,and a nomogram was generated.The model's predictive ability and robustness were evaluated in the validation set.Results A total of 11 808 participants were included,with 2 781(23.6%)in the comorbid group and 9 027(76.4%)in the coronary heart disease-only group.Compared with the single-disease group,the comorbid group had a higher average age,a greater proportion of females,and higher systolic blood pressure levels at admission(P<0.001).Additionally,thelevelsof hemoglobin,platelet distri-bution width,low density lipoprotein,and blood sodium were significantly higher in the comorbid group(P<0.05).A total of 8 265 participants were randomly assigned to the modeling set.Principal component analysis identified seven key factors with factor load contributions greater than 5:sodium level,systolic blood pressure,diastolic blood pressure,age,hemoglobin concentration,platelet distribution width,and total bilirubin level.Using these factors,a nomogram was con-structed via Logistic regression.The nomogram's area under the receiver operating characteristic curve for predicting co-morbid ischemic cardiovascular and cerebrovascular diseases was 0.630(95%CI:0.600～0.768,P<0.001).A total of 3 543 participants were randomly assigned to the validation set.In the validation set,the receiver operating characteristic curve was 0.628.Conclusion Elevated sodium level,higher systolic and diastolic blood pressure at admission,older age,increased hemoglobin concentration,higher platelet distribution width,and lower total bilirubin level are risk factors for comorbid ischemic cardiovascular and cerebrovascular diseases.The nomogram constructed has clinical value for screening patients with such comorbidities.

Objective:To investigate the safety and efficacy of the artery-first approach pancreaticoduo-denectomy (PD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic head malignancies.Methods:A retrospective analysis was conducted on 322 patients who underwent PD with PV/SMV resection and reconstruction at the Hepatobiliary Pancreatic Surgery Department of the First Hospital Affiliated to Naval Medical University between January 2016 and December 2022. Patients were divided into the artery-first approach PD group (AFA-PD group, n=165) and standard PD group (SPD group, n=157) based on surgical approach. Baseline characteristics, surgical outcomes, postoperative outcomes, pathological results and survival data were compared between two groups. Results:Compared to the SPD group, the AFA-PD group exhibited significantly reduced intraoperative blood loss (500 ml vs 600 ml), lower rates of obvious intraoperative blood loss (≥1 000 ml: 25.45% vs 40.13%), and decreased transfusion requirements (26.67% vs 52.87%). Postoperatively, the AFA-PD group demonstrated lower incidence of grade B/C pancreatic fistula (10.30% vs 19.75%) and higher textbook outcome achievement (78.79% vs 66.24%). Pathologically, the AFA-PD group achieved superior lymph node yield (20 nodes vs 18 nodes) and higher R 0 resection rates (79.39% vs 64.33%), particularly at the posterior pancreatic margin (96.97% vs 91.72%, P=0.040), SMA margin (92.07% vs 82.17%), and SMV margin (88.48% vs 78.98%). Multivariate logistic regression identified arterial invasion >180°, venous invasion >180°, lymph node metastasis, and the artery-first approach as independent predictors of R 0 resection. The AFA-PD group showed prolonged median survival (19.17 month vs 15.73 month). All aforementioned differences were statistically significant (all P value <0.05). Conclusions:The artery-first approach PD combined with PV/SMV resection and reconstruction is safe and effective for pancreatic head malignancies, significantly improving R 0 resection rates and patients' survival outcomes.

ObjectiveTo investigate the effect and potential mechanism of caffeic acid （CA） on severe acute pancreatitis （SAP） induced by caerulein combined with lipopolysaccharide （LPS）， and to provide a basis for the research on novel drugs for the treatment of SAP. MethodsC57BL/6J mice， aged 6 weeks， were divided into control group， model group， CA group， and octreotide acetate （OA） group， with 6 mice in each group. The mice in the control group were given injection of normal saline， and those in the other groups were given intraperitoneal injection of caerulein combined with LPS to establish a mouse model of SAP. At 1 hour after the first injection of caerulein， the mice in the CA group and the OA group were given intraperitoneal injection of CA or subcutaneous injection of OA at an interval of 8 hours. The general status of the mice was observed after 24 hours of modeling， and serum， pancreas， lung， and colon samples were collected. HE staining was used to observe the histopathological changes of the pancreas and lungs， and the serum levels of α-amylase， lipase， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， alanine aminotransferase， aspartate aminotransferase， and creatinine were measured. RT-PCR was used to measure the expression of proinflammatory factors in the pancreas and lungs； myeloperoxidase （MPO） immunohistochemistry was used to observe the degree of neutrophil infiltration； Western blot was used to measure the activation of nuclear factor-kappa B （NF-κB） and the level of citrullinated histone H3 （CitH3）， a marker for the formation of neutrophil extracellular traps （NETs）， in the pancreas and lungs， as well as the expression level of ZO-1 in colon tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the Dunnett’s t-test was used for further comparison between two groups. ResultsCompared with the control group， the model group had severe injury in the pancreas and lungs and significant increases in the activity of serum α- amylase and lipase and the levels of the proinflammatory cytokines IL-6， interleukin-1β （IL-1β）， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant increases in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. Compared with the model group， the CA group had alleviated pathological injury of the pancreas and lungs and significant reductions in the activity of serum α-amylase and the levels of the proinflammatory cytokines IL-6， IL-1β， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant reductions in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. ConclusionCA can alleviate SAP induced by caerulein combined with LPS in mice， possibly by inhibiting neutrophil recruitment and the formation of NETs.

Objective:To investigate the safety and efficacy of the artery-first approach pancreaticoduo-denectomy (PD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic head malignancies.Methods:A retrospective analysis was conducted on 322 patients who underwent PD with PV/SMV resection and reconstruction at the Hepatobiliary Pancreatic Surgery Department of the First Hospital Affiliated to Naval Medical University between January 2016 and December 2022. Patients were divided into the artery-first approach PD group (AFA-PD group, n=165) and standard PD group (SPD group, n=157) based on surgical approach. Baseline characteristics, surgical outcomes, postoperative outcomes, pathological results and survival data were compared between two groups. Results:Compared to the SPD group, the AFA-PD group exhibited significantly reduced intraoperative blood loss (500 ml vs 600 ml), lower rates of obvious intraoperative blood loss (≥1 000 ml: 25.45% vs 40.13%), and decreased transfusion requirements (26.67% vs 52.87%). Postoperatively, the AFA-PD group demonstrated lower incidence of grade B/C pancreatic fistula (10.30% vs 19.75%) and higher textbook outcome achievement (78.79% vs 66.24%). Pathologically, the AFA-PD group achieved superior lymph node yield (20 nodes vs 18 nodes) and higher R 0 resection rates (79.39% vs 64.33%), particularly at the posterior pancreatic margin (96.97% vs 91.72%, P=0.040), SMA margin (92.07% vs 82.17%), and SMV margin (88.48% vs 78.98%). Multivariate logistic regression identified arterial invasion >180°, venous invasion >180°, lymph node metastasis, and the artery-first approach as independent predictors of R 0 resection. The AFA-PD group showed prolonged median survival (19.17 month vs 15.73 month). All aforementioned differences were statistically significant (all P value <0.05). Conclusions:The artery-first approach PD combined with PV/SMV resection and reconstruction is safe and effective for pancreatic head malignancies, significantly improving R 0 resection rates and patients' survival outcomes.

The aim of this study is to establish a rapid,efficient,and sensitive method for detecting the infectious laryngotracheitis virus(ILTV).The DNA of ILTV was extracted and used as a tem-plate to develop a recombinant enzyme-mediated isothermal amplification(RAA)fluorescence de-tection method for ILTV through optimization of conditions,sensitivity analysis,and repeatability assessment.Additionally,the nucleic acids of avian influenza virus(AIV),IBV,and Newcastle dis-ease virus(NDV)were detected to verify the specificity of this method.Finally,this method was applied to analyze 59 clinical samples collected from multiple large-scale chicken farms in Hebei Province,and the results were compared with those obtained from real-time fluorescence quantifi-cation(qPCR)and PCR methods according to national standards.The results showed that the RAA detection method established in this study had a reaction system of 25.0 μL buffer,2.1 μL primer,0.6 μL probe,5.0 μL magnesium acetate,and 5.0 μL template.The reaction temperature was 39 ℃ and the amplification time was within 20 minutes.The sensitivity of this method was 101 copies/μL,and the specificity detection was 100％.Testing of 59 clinical samples showed that 17 were detected positive by both RAA fluorescence and qPCR,and 12 were detected by PCR,and the detection rate of RAA(fluorescence)was consistent with real-time fluorescence quantification and qPCR,which was higher than that of the PCR assay.The research results indicate that the RAA fluorescence method has a short detection time,good specificity and sensitivity,and can be used for rapid detection of ILTV.

Objective:To analyze the current status of the research in two emerging fields-digital health and digital medicine,and the distinctions and interconnections between them,and to explore critical cognitionfor benign development of this field.Methods:Based on bibliometric method,this study analyzed 1 747 papers published in two Q1 journals categorized under"medical informatics"in Chinese Academy of Sciences Journal Citation Reports between January 1st,2019,and June 30th,2024.A biclustering analysis of highly cited and source article was conducted using a"co-cited literature clustering and all articles citing this cluster"approach.Results:In 1 747 literature,a total of 28 classic high cited articles in digital medicinejournals and digital health journals were screened out afterthe literatures of irrelevant citations were deleted,and then,they were further analyzed.The clustering performancesof similar clusters for high cited articles of two kinds of journals were similar,and the difference of intra-cluster similarity(Isim)between them was not statistically significant(P>0.05).The inter-cluster similarity(Esim)of digital health journal was 0.0480,which was significantly higher than that of digital health journal,and the difference of that between them wasstatistically significant(t=-3.925,P<0.05).The clustering result of digital medicine was better,which whole research direction could be divided into deep learning-based ophthalmic medical image analysis,image recognition with artificial intelligence(AI),algorithm model of using AI,reporting standard and assessment method of digital medicine and scientific research by using AI.However,the contents of high cited literatures of digital health field had a lot of overlap with digital medicine field,and various clusters of literature have inconsistent themesafter these literatures were clustered.Conclusions:Research of digital medicine is tending towards two primary directions:specific application of AI,and theimprovement of digital medical standards and processes.Meanwhile,the articles and literatures with high quality in digital health still cannot divorce the medical field,and the discipline system still is immature.