Objective To track and evaluate the implementation and application of the occupational health standard Radiation shielding requirements for radiotherapy room—Part 4: Radiotherapy room of ²⁵²Cf neutron afterloading (GBZ/T 201.4-2015) by radiation health technical service agencies, medical institutions, health supervision agencies, and radiotherapy facility design units, and to provide a scientific basis for the further revision and implementation of this standard. Methods Following the Guideline for health standards tracking evaluation (WS/T 536-2017) and the project implementation plan, relevant practitioners were randomly selected for a questionnaire survey. The survey primarily focused on their awareness, standard training, application, and revision suggestions of GBZ/T 201.4-2015. The results were summarized and analyzed. Results A total of 168 evaluation questionnaires were collected from relevant practitioners in 28 provinces. Only 31.6% of the respondents reported being “well familiar” or “ familiar” with the standard, 27.4% of the respondents believed that the standard was widely used, and 45.2% of the respondents believed that the standard could meet the needs of their work. Only 14.9% of the respondents had received relevant training on the standard, more than half of the respondents had not applied the standard within the past 10 years, and 45.2% of the respondents believed that the standard "needs to be revised". Conclusion Due to the small number of californium-252 neutron afterloading radiotherapy devices in operation on the market, the overall awareness of the standard is low, suggesting that relevant authorities need to strengthen training and publicity of the standard, and that certain sections of the standard need to be revised or merged.

Organ transplantation is an effective treatment for end-stage organ failure, but postoperative infections and rejection reactions are key factors affecting the survival of the patients. Recently, the incidence of human parvovirus B19 (B19V) infection following transplantation has increased. B19V is a non-enveloped virus that primarily infects the upper respiratory tract and exhibits significant tropism for erythroid progenitor cells in the bone marrow, leading to the lysis of erythrocytes and hematological abnormalities. After B19V viremia, it may further infect other cells, triggering inflammatory responses and tissue damage. B19V infection may lead to chronic anemia in organ transplant patients, thereby affecting the success of the transplant and the survival of the patients. Therefore, it is essential to diagnose and monitor B19V infection post-transplantation. Due to the immunosuppressive therapy following transplantation, traditional serological detection methods, such as IgM and IgG antibody tests, are often unreliable. In contrast, molecular biological detection, especially real-time fluorescent quantitative PCR technology, provides more accurate results. However, the diversity of B19V genotypes may lead to the missed detection of some genotypes. Thus, it is necessary to use different detection techniques to improve the diagnostic accuracy of B19 virus infections. Additionally, there is a need to explore more precise diagnostic methods to enhance the early identification and management of B19V infection, further improving the survival and life quality of the patients.

To develop a milestone-based evaluation system for the core "knowledge and skills" competency of neurology residents that is tailored to China's medical context, so as to provide precise guidance for their training and assessment.

Objective To explore the factors predicting the reliability of platelet-impedance(PLT-I)re-sults through a retrospective analysis of non-aggregated samples with abnormal platelet histograms.Methods A total of 322 samples with abnormal platelet histograms were collected from the Sysmex XN9000 automatic hematology analyzer,all of which showed no platelet aggregation as determined by the DI-60 auto-matic digital image analysis system.Using the platelet count fluorescent(PLT-F)results as a standard,the absolute and relative deviations of PLT-I results were calculated,and the parameters of samples with devia-tions within and outside the allowable range were analyzed.Logistic regression analysis was used to identify potential factors associated with deviations of PLT-I from PLT-F beyond the allowable range.The receiver op-erating characteristic(ROC)curve was used to evaluate the predictive value of these potential factors for devi-ations beyond the allowable range.Results The deviations of PLT-I from PLT-F were within the allowable range in 279 cases(86.65％)and outside the allowable range in 43 cases(13.35％).Comparisons between the two groups revealed statistically significant differences in mean red blood cell valume(MCV),red blood cell distribution width-cuefficient of variation(RDW-SD),DI-60 red cell fragments,platelet distribution width(PDW),and DI-60 large platelet ratio(P＜0.05).Logistic regression indicated that DI-60 red cell fragments and DI-60 large platelet ratio were independent potential factors for deviations of PLT-I from PLT-F beyond the allowable range(P＜0.05).The cut off values for predicting deviations beyond the allowable range were 1.75 for DI-60 red cell fragments and 66％for DI-60 large platelet ratio.The area under the curve(AUC)for the combined diagnosis of the two factors was 0.813,with a sensitivity of 88.4％and a specificity of 66.3％,indicating a higher predictive value than individual factors(P＜0.05).Conclusion When platelet histograms are abnormal,DI-60 large platelet ratio and DI-60 red cell fragments are independent potential factors predic-ting the reliability of PLT-I results,and their combination has a high predictive value.

OBJECTIVE To study the chemical constituents in the root bark of Schisandra sphenanthera and their cytotoxic activ-ities.METHODS The compounds were isolated and purified by silica,Sephadex LH-20 and semi preparative-HPLC and the chem-ical structures were identified by 1 H-NMR,13 C-NMR and MS data analysis.The cytotoxic activities of the compounds were deter-mined by MTT method.RESULTS Twenty lignans were isolated and deduced as:Matairesinol(1),2-Hydroxy-2-(3′,4′-di-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-gamma-butyrolactone(2),(+)-Nortrachelogenin(3),2-Hydroxy-2-(4′-O-β-D-glucopyranosyl-3′-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-γ-butyrolactone(4),Nortracheloside(5),Burselignan(6),(+)-Cycloolivil(7),5-Methoxy-(+)-isolariciresinol(8),(-)-Isolariciresinol 3α-O-β-D-glucopyranoside(9),(+)-9-O-β-D-Glucopyranosyl lyoniresinol(10),(-)-Secoisolariciresinol(11),Licarin A(12),Cedrusin(13),Mataires-inol 4′-O-β-D-glucopyranoside(14),Pregomisin(15),Meso-dihydroguaiaretic acid(16),7S,8R-Erythro-4,9,9′-trihydroxy-3,3′-dimethoxy-8-O-4′-neolignan-7-O-β-D-glucopyranoside(17),Gomisin M2(18),Gomisin M3(19),Pinoresinol(20).Com-pounds 1-3,12,15,16,18 and 19 showed cytotoxic activity against A549,HCT116 and SW620 cell lines with IC50 values ranging from 1.4 to 22.9 μmol·L-1.CONCLUSION Compounds 1-4,6-12,14,17-19 are isolated from the plant for the first time,com-pounds 1-3,12,15,16,18 and 19 exhibit cytotoxic activities.

Objective To investigate whether CD137-CD137 ligand(CD137L)pathway affects foot ulcer wound healing in diabetic mice by regulating phenotypic transformation of macrophages.Methods A total of 24 db/db mice were randomly divided into model(Mod),CD137 and anti-CD137 groups with 8 mice in each group,and 8 db/m mice were selected as control(Con)group.Ulcer wounds were prepared in each group.The wound healing rate was calculated at the 7,14 and 21 day in each group.The pathological changes of the wound were evaluated by HE staining.The levels of serum IL-1β,TNF-α,VEGF and basic fibroblast growth factor(bFGF)were detected by ELISA,and the expression of wound angiogenesis marker CD31 was detected by immunofluorescence staining.The expression of the gene-induced nitric oxide synthase(iNOS),IL-6 in M1-type macrophages and arginase 1(Arg1),mannose receptor(CD206)in M2-type macrophages were detected by qRT-PCR.Flow cytometry was used to detect the proportion of M1 macrophages labeled F4/80 and CD86,and the proportion of M2 macrophages labeled F4/80 and CD206 in peripheral blood of mice in each group.Results Compared with Mod group,the skin tissue structure was more complete,inflammatory cell infiltration was reduced,new hair follicle tissues were increased,the wound healing rate of CD137 group at 7,14 and 21 d,VEGF,bFGF,the relative fluorescence intensity of CD31 in wound tissue,the mRNA expression of Arg1 and CD206,and the proportion of M2-type macrophages were increased(P<0.05),IL-1β,TNF-α,the mRNA expression of iNOS and IL-6 expression,and the proportion of M1-type macrophages in peripheral blood were decreased in CD137 group(P<0.05).Conclusions CD137-CD137L pathway may play a role in promoting wound healing in DFU mice by promoting the transformation of wound macrophage phenotype M1 to M2.

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, emphasizing the utmost importance of early diagnosis, therapeutic monitoring, and pro-gnostic assessment. Circulating tumor DNA (ctDNA), as an innovative liquid biopsy biomarker, has demonstrated unique advantages in HCC management. The authors systematically summarized recent advances in the application of ctDNA for early diagnosis, therapeutic monitoring, and prognostic evaluation of HCC, focusing on its advantages and clinical application value in precision medicine.

Objective To investigate whether CD137-CD137 ligand(CD137L)pathway affects foot ulcer wound healing in diabetic mice by regulating phenotypic transformation of macrophages.Methods A total of 24 db/db mice were randomly divided into model(Mod),CD137 and anti-CD137 groups with 8 mice in each group,and 8 db/m mice were selected as control(Con)group.Ulcer wounds were prepared in each group.The wound healing rate was calculated at the 7,14 and 21 day in each group.The pathological changes of the wound were evaluated by HE staining.The levels of serum IL-1β,TNF-α,VEGF and basic fibroblast growth factor(bFGF)were detected by ELISA,and the expression of wound angiogenesis marker CD31 was detected by immunofluorescence staining.The expression of the gene-induced nitric oxide synthase(iNOS),IL-6 in M1-type macrophages and arginase 1(Arg1),mannose receptor(CD206)in M2-type macrophages were detected by qRT-PCR.Flow cytometry was used to detect the proportion of M1 macrophages labeled F4/80 and CD86,and the proportion of M2 macrophages labeled F4/80 and CD206 in peripheral blood of mice in each group.Results Compared with Mod group,the skin tissue structure was more complete,inflammatory cell infiltration was reduced,new hair follicle tissues were increased,the wound healing rate of CD137 group at 7,14 and 21 d,VEGF,bFGF,the relative fluorescence intensity of CD31 in wound tissue,the mRNA expression of Arg1 and CD206,and the proportion of M2-type macrophages were increased(P<0.05),IL-1β,TNF-α,the mRNA expression of iNOS and IL-6 expression,and the proportion of M1-type macrophages in peripheral blood were decreased in CD137 group(P<0.05).Conclusions CD137-CD137L pathway may play a role in promoting wound healing in DFU mice by promoting the transformation of wound macrophage phenotype M1 to M2.

OBJECTIVE To study the chemical constituents in the root bark of Schisandra sphenanthera and their cytotoxic activ-ities.METHODS The compounds were isolated and purified by silica,Sephadex LH-20 and semi preparative-HPLC and the chem-ical structures were identified by 1 H-NMR,13 C-NMR and MS data analysis.The cytotoxic activities of the compounds were deter-mined by MTT method.RESULTS Twenty lignans were isolated and deduced as:Matairesinol(1),2-Hydroxy-2-(3′,4′-di-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-gamma-butyrolactone(2),(+)-Nortrachelogenin(3),2-Hydroxy-2-(4′-O-β-D-glucopyranosyl-3′-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-γ-butyrolactone(4),Nortracheloside(5),Burselignan(6),(+)-Cycloolivil(7),5-Methoxy-(+)-isolariciresinol(8),(-)-Isolariciresinol 3α-O-β-D-glucopyranoside(9),(+)-9-O-β-D-Glucopyranosyl lyoniresinol(10),(-)-Secoisolariciresinol(11),Licarin A(12),Cedrusin(13),Mataires-inol 4′-O-β-D-glucopyranoside(14),Pregomisin(15),Meso-dihydroguaiaretic acid(16),7S,8R-Erythro-4,9,9′-trihydroxy-3,3′-dimethoxy-8-O-4′-neolignan-7-O-β-D-glucopyranoside(17),Gomisin M2(18),Gomisin M3(19),Pinoresinol(20).Com-pounds 1-3,12,15,16,18 and 19 showed cytotoxic activity against A549,HCT116 and SW620 cell lines with IC50 values ranging from 1.4 to 22.9 μmol·L-1.CONCLUSION Compounds 1-4,6-12,14,17-19 are isolated from the plant for the first time,com-pounds 1-3,12,15,16,18 and 19 exhibit cytotoxic activities.

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, emphasizing the utmost importance of early diagnosis, therapeutic monitoring, and pro-gnostic assessment. Circulating tumor DNA (ctDNA), as an innovative liquid biopsy biomarker, has demonstrated unique advantages in HCC management. The authors systematically summarized recent advances in the application of ctDNA for early diagnosis, therapeutic monitoring, and prognostic evaluation of HCC, focusing on its advantages and clinical application value in precision medicine.