ObjectiveTo develop an assessment tool for apraxia of speech (AOS) of Chinese Putonghua speakers and test its reliability and validity. MethodsThe Chinese Apraxia of Speech Assessment and Diagnostic Tool (CAADT) was developed based on the Apraxia of Speech Rating Scale 3.5, combined with the linguistic characteristics of Chinese and clinical experience. The tool consistsed of eleven items across three sections: articulation, prosody and alternating motion rates. Six experts evaluated the content validity. From November, 2024 to May, 2025, 51 patients with post-stroke AOS (experimental group) and ten patients with post-stroke aphasia without AOS (control group) were recruited from Anhui Wannan Rehabilitation Hospital (the Fifth People's Hospital of Wuhu), and tested with CAADT. Reliability was assessed using Cronbach's α coefficient, Kendall's coefficient of concordance W and Pearson correlation coefficient. Validity was evaluated using the content validity index (CVI) and Spearman correlation coefficient. Discriminative effect was analyzed using the receiver operating characteristic (ROC) curve. ResultsThe Cronbach's α coefficients for the articulation and prosody sections and the total scale were all > 0.9, while it was 0.454 for the alternating motion rates. Inter-rater reliability was good (W ≥ 0.598, P < 0.001). Test-retest reliability showed high positive correlations for the three sections and the total score between the two assessments (r ≥ 0.84, P < 0.001). The scale-level CVI was 0.95, and the item-level CVI ≥ 0.83. The Spearman correlation coefficients among the sections ranged from 0.30 to 0.70. ROC analysis revealed an area under the curve of 0.953, with a cut-off value of 11, yielding a sensitivity of 0.92 and a specificity of 0.90. ConclusionCAADT demonstrates good reliability, validity and discriminative effect, which can be used for clinical assessment and auxiliary diagnosis of Chinese Putonghua speaking patients with post-stroke AOS.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Objective:To investigate the effect of inspiratory muscle training on diaphragm morphology and function in ventilator induced diaphragmatic dysfunction(VIDD)rats,and to explore the mechanism of it.Method:Twenty-four adult female SD rats were randomly divided into 4 groups:①Control group(n=6);②Me-chanical ventilation group(n=6):mechanical ventilation for 24 hours;③Sham training group(n=6):spontane-ous breathing for 1 hour after mechanical ventilation for 24 hours;④Training group(n=6):intermittent inspi-ratory muscle training for 1 hour after mechanical ventilation for 24 hours.Multi-channel physiology signal col-lection and processing system were used to detect the peak twitch tension and peak tetanic force of dia-phragm,as well as the frequency-force effect curve.The cross-sectional area(CSA)of diaphragm was ob-served by hematoxylin and eosin staining method.Western-blot was used to detect the level of microtubule-as-sociated protein 1 light chain 3(LC3)and muscle atrophy F-box(MAFbx).The levels of αII-spectrin break-down products(SBDPs)SBDP145 and SBDP120 in the diaphragm were detected by ELISA.The level of malondialdehyde(MDA)in the diaphragm was detected by thiobarbituric acid(TBA)method.Result:Compared with control group and training group,the peak twitch tension,peak tetanic force and fre-quency-force effect curve of diaphragm in ventilation group and sham training group were decreased significant-ly(P<0.05),but there was no difference between the ventilation group and the sham training group or be-tween the control group and the training group.Compared with the control group,the diaphragm fiber cross-sectional area of ventilation group,sham training group or training group was significantly decreased(P<0.05),and there was no significant difference between the ventilation group and the sham training group.Compared with the ventilation group and the sham training group,the diaphragm fiber cross-sectional area of training group was increased(P<0.05).Compared with the control group,the level of MDA,SBDP120 and LC3II/I ratio in the diaphragm of ventilation group,sham training group and training group were significantly in-creased(P<0.05),and there was no difference between the ventilation group,the sham training group and the training group.Compared with the control group,the expression of MAFbx in ventilation group was signif-icantly increased(P<0.05),and there was no difference between the ventilation group,the sham training group and the training group.Compared with the control group and the training group,SBDP145 level in the diaphragm of ventilation group or sham training group was significantly increased(P<0.05),but there was no difference between the ventilation group and the sham training group.There was no difference in SBDP145 lev-el of diaphragm between the control group and the training group.Conclusion:Inspiratory muscle training can improve the morphology and function of VIDD diaphragm,and the mechanism may be related to the decrease of calpain activity.

Objective:To propose a novel radiotherapy marking method-the"#"-character method,which aimed at improving the accuracy and repeatability of positioning during radiotherapy.Methods:A specially"cross-shaped"stamp was designed by this study,which consisted of a handheld square base with a"cross-shaped"protrusion.Using this stamp,the extreme positions of end-expiration and end-inspiration were marked respectively at the laser-guided regions on the directly above and bilateral sides of the patient's body,and each position was printed a"+"character.Finally,a"#-shaped"signal was formed,which represented the full range of respiratory motion of patients.The study included two parts:surface displacement caused by respiration was simulated through a three-dimensional(3D)motion platform,which was used to conduct a phantom experiment for anthropomorphic dummy,A randomized controlled study involving 40 patients,who were treated between January and June 2024 at the Department of Radiotherapy,Cancer Hospital,Chinese Academy of Medical Sciences,were conducted.The cohort included 20 patients with breast tumor(Positioning the outer contour by exposing the chest)and 20 patients with thoracic tumor(fixed position of using thermoplastic film).These patients were divided into two groups for comparison,which received respectively the"#-shaped"method and the conventional"+-shaped"method.The cone-beam computed tomography(CBCT)images before treatment were used to compare the influences of the two kinds of marking methods on the positioning errors of patients with breast tumor and patients with thoracic tumor.Then,the statistical analysis was used to assess precision and accuracy of positioning.Results:The result of phantom experiment indicated that the positioning error of the"#-shaped"method was significantly better than that of the"+-shaped"method under various parameters of respiratory movement.Under three kinds of different respiratory cycles(3,4,and 5 seconds)and amplitudes(8,12,and 15 mm),the positioning errors of the"#-shaped"method were respectively(0.15±0.04)cm,(0.19±0.05)cm and(0.35±0.14)cm,while the"+-shaped"method were respectively(0.42±0.16)cm,(0.64±0.28)cm and(0.88±0.37)cm,and the differences were statistically significant(t=8.347,3.416,2.901,P<0.05).The results of actual patients indicated the positioning error[(0.97±0.32)cm]of the"#-shaped"method was significantly lower than[(1.62±0.47)cm]of the"+-shaped"method for patients with breast tumor(Positioning the outer contour by exposing the chest),and the difference was significant(t=3.615,P<0.05).On the other hand,the positioning error[(0.69±0.24)cm]of the"#-shaped"method was significantly lower than[(0.97±0.39)cm]of the"+-shaped"method for patients with thoracic tumor(fixed position of using thermoplastic film),and the difference also was significant(t=1.934,P<0.05).Conclusion:Compared to the conventional"+-shaped"method,the"#-shaped"method appears higher accuracy and repeatability during the positioning process of radiotherapy,which especially is suitable to the treatment for breast tumor and thoracic tumor that need accurately control the influences of respiratory motion.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Objective:To investigate the effect of inspiratory muscle training on diaphragm morphology and function in ventilator induced diaphragmatic dysfunction(VIDD)rats,and to explore the mechanism of it.Method:Twenty-four adult female SD rats were randomly divided into 4 groups:①Control group(n=6);②Me-chanical ventilation group(n=6):mechanical ventilation for 24 hours;③Sham training group(n=6):spontane-ous breathing for 1 hour after mechanical ventilation for 24 hours;④Training group(n=6):intermittent inspi-ratory muscle training for 1 hour after mechanical ventilation for 24 hours.Multi-channel physiology signal col-lection and processing system were used to detect the peak twitch tension and peak tetanic force of dia-phragm,as well as the frequency-force effect curve.The cross-sectional area(CSA)of diaphragm was ob-served by hematoxylin and eosin staining method.Western-blot was used to detect the level of microtubule-as-sociated protein 1 light chain 3(LC3)and muscle atrophy F-box(MAFbx).The levels of αII-spectrin break-down products(SBDPs)SBDP145 and SBDP120 in the diaphragm were detected by ELISA.The level of malondialdehyde(MDA)in the diaphragm was detected by thiobarbituric acid(TBA)method.Result:Compared with control group and training group,the peak twitch tension,peak tetanic force and fre-quency-force effect curve of diaphragm in ventilation group and sham training group were decreased significant-ly(P<0.05),but there was no difference between the ventilation group and the sham training group or be-tween the control group and the training group.Compared with the control group,the diaphragm fiber cross-sectional area of ventilation group,sham training group or training group was significantly decreased(P<0.05),and there was no significant difference between the ventilation group and the sham training group.Compared with the ventilation group and the sham training group,the diaphragm fiber cross-sectional area of training group was increased(P<0.05).Compared with the control group,the level of MDA,SBDP120 and LC3II/I ratio in the diaphragm of ventilation group,sham training group and training group were significantly in-creased(P<0.05),and there was no difference between the ventilation group,the sham training group and the training group.Compared with the control group,the expression of MAFbx in ventilation group was signif-icantly increased(P<0.05),and there was no difference between the ventilation group,the sham training group and the training group.Compared with the control group and the training group,SBDP145 level in the diaphragm of ventilation group or sham training group was significantly increased(P<0.05),but there was no difference between the ventilation group and the sham training group.There was no difference in SBDP145 lev-el of diaphragm between the control group and the training group.Conclusion:Inspiratory muscle training can improve the morphology and function of VIDD diaphragm,and the mechanism may be related to the decrease of calpain activity.

Objective:To propose a novel radiotherapy marking method-the"#"-character method,which aimed at improving the accuracy and repeatability of positioning during radiotherapy.Methods:A specially"cross-shaped"stamp was designed by this study,which consisted of a handheld square base with a"cross-shaped"protrusion.Using this stamp,the extreme positions of end-expiration and end-inspiration were marked respectively at the laser-guided regions on the directly above and bilateral sides of the patient's body,and each position was printed a"+"character.Finally,a"#-shaped"signal was formed,which represented the full range of respiratory motion of patients.The study included two parts:surface displacement caused by respiration was simulated through a three-dimensional(3D)motion platform,which was used to conduct a phantom experiment for anthropomorphic dummy,A randomized controlled study involving 40 patients,who were treated between January and June 2024 at the Department of Radiotherapy,Cancer Hospital,Chinese Academy of Medical Sciences,were conducted.The cohort included 20 patients with breast tumor(Positioning the outer contour by exposing the chest)and 20 patients with thoracic tumor(fixed position of using thermoplastic film).These patients were divided into two groups for comparison,which received respectively the"#-shaped"method and the conventional"+-shaped"method.The cone-beam computed tomography(CBCT)images before treatment were used to compare the influences of the two kinds of marking methods on the positioning errors of patients with breast tumor and patients with thoracic tumor.Then,the statistical analysis was used to assess precision and accuracy of positioning.Results:The result of phantom experiment indicated that the positioning error of the"#-shaped"method was significantly better than that of the"+-shaped"method under various parameters of respiratory movement.Under three kinds of different respiratory cycles(3,4,and 5 seconds)and amplitudes(8,12,and 15 mm),the positioning errors of the"#-shaped"method were respectively(0.15±0.04)cm,(0.19±0.05)cm and(0.35±0.14)cm,while the"+-shaped"method were respectively(0.42±0.16)cm,(0.64±0.28)cm and(0.88±0.37)cm,and the differences were statistically significant(t=8.347,3.416,2.901,P<0.05).The results of actual patients indicated the positioning error[(0.97±0.32)cm]of the"#-shaped"method was significantly lower than[(1.62±0.47)cm]of the"+-shaped"method for patients with breast tumor(Positioning the outer contour by exposing the chest),and the difference was significant(t=3.615,P<0.05).On the other hand,the positioning error[(0.69±0.24)cm]of the"#-shaped"method was significantly lower than[(0.97±0.39)cm]of the"+-shaped"method for patients with thoracic tumor(fixed position of using thermoplastic film),and the difference also was significant(t=1.934,P<0.05).Conclusion:Compared to the conventional"+-shaped"method,the"#-shaped"method appears higher accuracy and repeatability during the positioning process of radiotherapy,which especially is suitable to the treatment for breast tumor and thoracic tumor that need accurately control the influences of respiratory motion.

Objective Calculus Bovis(CB)is a kind of valuable traditional Chinese medicine,which has been used in clinic for a long time.It has been shown to have significant anti-stroke,anti-inflammatory and anti-tumor effects.But its mechanism for treating Prostate cancer(PCa)remains unclear.The purpose of this study was to explore the target and mechanism of its action in the treatment of prostate cancer throμgh network pharmacology and in vitro and in vivo experiments.Methods The effective compounds of Calculus Bovis were collected by TCM pharmacology database and analysis platform(TCMSP).Search for potential compound targets in TCMSP.Search the Drμgbank,GeneCards,OMIM,PharmGkb,and TTD databases for disease targets associated with prost cancer.Disease and compound targets were integrated in the STRING database to construct their interaction network(PPI)to reveal the key targets of compound treatment for prostate cancer.In order to elucidate the mechanism of Calculus Bovis in the treatment of prostate cancer,GO functional enrichment and KEGG pathway enrichment analysis were conducted using Cytoscape software.The mechanism of treating prostate cancer with Calculus Bovis was studied in vitro and in vivo.Results A total of 11 compounds with anti-prostate cancer activity were identified.Oleanolic acid,ursolic acid,ergosterol,deoxycorticosterone,methylcholine and cholverdin were potential effective components.A total of 367 targets of Calculus Bovis compounds and 2152 targets of prostate cancer were found.The core targets of Calculus Bovis in the treatment of prostate cancer included TP53,STAT3,AKT1,HSP90AA1,ESR1,SRC,JUN,RELA,CCND1,CDKN1A,EGFR,AR,etc.The biological functions of Calculus Bovis mainly involve oxidative stress response,response to steroid hormones,cell response to chemical stress,peptide-serine modification and phosphorylation,and protein serine/threonine kinase activity.Calculus Bovis treatment of prostate cancer mainly involves PI3K-AKT signaling pathway,TNF signaling pathway,MAPK signaling pathway,etc.In vitro and in vivo experiments showed that Calculus Bovis promoted apoptosis of PC3 cells of prostate cancer by inhibiting PI3K-AKT signaling pathway.Conclusion Calculus Bovis has a therapeutic effect on prostate cancer,and its function is related to inhibiting PI3K-AKT signaling pathway and promoting apoptosis of cancer cells.

Objective : To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19. Methods : All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. Results : By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts. Conclusions The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Objective To improve the efficiency of result reporting and ensure the accuracy of the results by establishing autoverification system in Clinical Chemistry and Immunology Laboratory.Methods The study followed the requirements of the Clinical Laboratory Standards Institute(CLSI)AUTO-10A and ISO 15189:2012.In addition,seven categories of verification rules were encoded using the autoverification function of the CentraLink?Data Management System on the Aptio?Automation platform.These rules included Clinical Diagnostic Standard(CS), Sample Status(SS), Quality Control Severity(QS), Instrument Error Flags Severity(IS), Normal Severity(NS), Delta Check Severity(DS), and Logical Assessment Standard(LS).Various modules of Aptio Automation,laboratory information system(LIS)and hospital information system(HIS)were integrated using the CentraLink system to establish the autoverification system.Results The autoverification system was set up and tested from August 2015 to April 2016.In total, the system ran 4 496 425 tests on 366 180 chemistry specimens.The overall autoverification rate for tests performed increased from 53.4% to 87.0%.Glucose had the highest rate (98.3%)while CKMB had the lowest rate(63.6%).Average TAT for result verification decreased by 97.7%,from 46.3 minutes to 3.7 minutes.The system ran 410,040 tests on 160 119 chemiluminescence specimens.The autoverification rate for tests performed increased from 40.2%to 89%.C-P had the highest rate(98.4%)while A-TPO had the lowest rate(58.7%).Average TAT for result verification decreased by 77.4%,from 14.6 minutes to 3.3 minutes.From May 2016 to January 2017(when autoverification was employed),compared with the same period in 2014(when manual verification was employed),the following changes were observed with no increase in staff capacity:a)Volume of routine chemistry tests increased by 46.4%,and median TAT for tests decreased by 41.9%, from 118 minutes to 83 minutes; b)Volume of chemiluminescence tests increased by 24.5%and median median TAT for tests decreased by 52.4%, from 131 minutes to 86 minutes;c)Median TAT for critical values decreased by 50.5%; d)Rates of tests that did not go through autoverification were 88.2% for NS,6.05% for SS, 2.40% for DS,2.00% for LS, 0.97%for IS,and 0.43% for CS; e)Rates of abnormal specimen status identified by Aptio Automation were 7.13‰for jaundice,5.39‰ for blood lipids,2.20‰ for hemolysis,0.17‰ for barcode error, and 0.15‰ for insufficiency;f)Error rate decreased to 0.00%;and g)staff satisfaction increased from 85%to 100%.Conclusion Autoverification of results by using the CentraLink Data Management System can achieve quality control over the entire process of clinical laboratory testing, ensure accuracy of test results, improve work efficiency, decrease TAT, minimize the error rate, avoid skill variation of staff, reduce the pressure of performing manual verification,and improve medical security.