ObjectiveTo examine the impact of Toll-like receptor 4 （TLR4）-mediated neutrophil extracellular traps （NETs） formation on isoproterenol （ISO）-induced heart failure （HF） in aged mice. MethodsThe mice were randomly divided into Control group， Model group， TAK-242 （TLR4 inhibitor） group， LPS （TLR4 agonist） group and LPS+DNaseⅠ （NETs inhibitor） group， with 8 mice in each group. The HF model was established by continuous infusion of ISO through an osmotic pump， and TAK-242， LPS， and LPS+DNaseⅠ interventions were administered during the last week of infusion for 7 consecutive days. ELISA was used to detect the N-terminal pro-B-type natriuretic peptide （NT-pro BNP）， cardiac troponin I （cTnI）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and serum and myocardial tissue myeloperoxidase-DNA （MPO-DNA） and neutrophil elastase-DNA （NE-DNA） levels. HE staining was used to observe the pathological changes of myocardial tissue. Masson staining was used to observe the deposition of collagen fibers in myocardial tissue. Immunofluorescence was used to observe the colocalization of Ly6G and MPO in myocardial tissue. The protein expressions of TLR4， MPO， NE and cit-H3 in myocardial tissue were detected by Western blot. ResultsCompared with the Control group， the end-diastolic interventricular septal thickness （IVSD）， left ventricular end-diastolic diameter （LVEDD） and left ventricular end-systolic diameter （LVESD） in the Mode group significantly increased （P<0.01）， fractional shortening （FS） and ejection fraction （EF） significantly decreased （P<0.01）， and the myocardial structure was significantly damaged. The myocardial collagen fiber precipitation， serum NT-pro BNP， cTnI， IL-1β， IL-6 and TNF-α contents， MPO-DNA and NE-DNA contents in serum and myocardial tissue significantly increased （P<0.01）. The co-localization of Ly6G and MPO and the expression of TLR4， MPO， NE and cit-H3 proteins in myocardial tissue significantly increased （P<0.01）. After TAK-242 intervention， the above indicators were significantly reversed， while the injury was further aggravated in LPS group. DNaseⅠ treatment could partially alleviate the deterioration of myocardial structure and function induced by LPS. ConclusionTLR4 and NETs are abnormally elevated in the myocardial tissue of aged HF mice. Treatment with the TLR4 inhibitor TAK-242 effectively suppresses NET formation， attenuates inflammatory responses， and enhances cardiac function in aged HF mice.

AIM:To investigate the compositional and structural differences in the ocular surface microbiota of patients with primary pterygium during the progressive and stationary stages, and to identify key microbial biomarkers associated with pterygium progression.METHODS: A cross-sectional study design was adopted. Patients with progressive pterygium(PPG group), stationary pterygium(SPG group), and age- and sex-matched healthy volunteers(HCG group)were enrolled. Conjunctival swabs were collected from the affected eye(or the healthy eye in controls)of each participant. 16S rRNA gene amplicon sequencing of the V3V4 region was performed. The analytical workflow encompassed rarefaction curve analysis, Alpha/Beta diversity analyses, ASV analysis. LEfSe analysis and the Kruskal-Wallis H test were used to screen differential microbiota.RESULTS: Final enrollment included 28 patients(28 eyes)in each group: PPG(11 males, 17 females; mean age 60.54±8.44 y), SPG(10 males, 18 females; mean age 61.82±10.21 y), and HCG(12 males, 16 females; mean age 64.07±7.27 y). No significant differences were found among the three groups in baseline characteristics(all P>0.05). The number of valid sequences and the rarefaction curves confirmed sufficient sequencing depth. Alpha/Beta diversity analyses showed no statistically significant differences among the three groups(all P>0.05), indicating that the overall structure of the ocular surface microbiota was relatively stable. LEfSe analysis(LDA score>3.0)revealed that the Propionibacteriales, the Propionibacteriaceae, the Cutibacterium and the Comamonadaceae were significantly enriched in the PPG group. Following Kruskal-Wallis H tests with Bonferroni correction for multiple comparisons, the relative abundances of Propionibacteriales, Propionibacteriaceae, and Cutibacterium were significantly higher in PPG group than in the HCG group(all PSymbol|@@0.05), but did not differ significantly between the PPG and SPG groups(all P>0.05). The abundance of Comamonadaceae was significantly higher in SPG group than in HCG group(PSymbol|@@0.05), whereas PPG group not differ from either group(all P>0.05).CONCLUSION: Cutibacterium, the representative genus of the propionibacterial group, tends to be enriched in eyes with progressive pterygium, indicating a potential association between this genus and pterygium progression.

Objective To explore the value of pulmonary perfusion SPECT/CT imaging for diagnosing pulmonary embolism(PE)and combining with clinical and laboratory indicators for predicting prognosis.Methods Totally 260 patients with suspected PE were retrospectively collected,and PE was clinically confirmed in 237 cases.The diagnostic efficacy of pulmonary perfusion SPECT/CT imaging and CT pulmonary angiography(CTPA)were compared.Among 237 patients with clinically confirmed PE,160 cases were initially diagnosed who underwent standard anticoagulant therapy and were regularly followed up to 3 months after discharge,and their prognosis were analyzed.Logistic regression was used to analyze clinical data,laboratory indicators and pulmonary perfusion defect scores based on pulmonary perfusion SPECT/CT imaging to screen the independent predictors of poor prognosis of PE of the above patients,and a prediction model was then constructed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of this model for predicting prognosis of PE.Results The positive rate of PE diagnosed with pulmonary perfusion SPECT/CT was higher than that with CTPA(66.54％[173/260]vs.59.62％[155/260],x2=4.765,P=0.038).Among 160 cases of clinically confirmed PE,poor prognosis was observed in 51 cases,while good prognosis was noticed in 109 cases.Patients' age,blood urea nitrogen,serum creatinine,uric acid,D-dimer level and pulmonary perfusion defect score were all independent predictors for poor prognosis of PE(all P＜0.05),and AUC of the established combined model was 0.731.Conclusion Pulmonary perfusion SPECT/CT imaging could be used for diagnosing PE,and combining with clinical and laboratory indicators could effectively predict prognosis of PE.

Objective To investigate the clinical efficacy of Shangke Huangshui medicated gauze in the treatment of small-area deep second-degree burn wounds with fire-heat injuring fluid type.Methods Sixty patients who were diagnosed as small-area deep second-degree burn wounds of fire-heat injuring fluid type in Foshan Hospital of Traditional Chinese Medicine from January 2024 to July 2024,were selected as the research objects.The patients were randomly divided into trial group and control group by random number table method,with 30 cases in each group.The trial group was treated with external application of Shangke Huangshui medicated gauze,and the control group was treated with external application of Silver Sulfadiazine Cream.The treatment lasted for 21 days,and then the patients were followed up for 7 days.The changes of Visual Analogue Scale(VAS)score of wound pain,and serum levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were observed before and after treatment.The wound healing rate,wound healing time,bacterial infection of the wound,and adverse reactions were compared between the two groups.Results(1)During the treatment,there was no fell-off case in the trial group while there was one patient falling off from the control group.Eventually,a total of 59 patients were included in the statistical analysis,including 30 in the trial group and 29 in the control group.(2)On day 14 and 21 of treatment,the wound healing rates of the two groups were significantly higher than those on day 7 of treatment(P＜0.05),and wound healing rates in the trial group on the day 14 and 21 of treatment were significantly superior to those of the control group(P＜0.05).(3)The time for the complete healing of wound in the trial group was(22.07±2.30)days,which was significantly shorter than that of the control group[(27.07±4.10)days],and the difference was statistically significant(P＜0.05).(4)After 7,14 and 21 days of treatment,the VAS scores of wound pain in the two groups were lowered compared with those before treatment(P＜0.05),and the VAS scores in the trial group were significantly lower than those in the control group(P＜0.05).(5)On day 7 of treatment,the levels of serum CRP,IL-6 and TNF-α in the two groups were lowered compared with those before treatment(P＜0.05),and the levels in the trial group were significantly lower than those in the control group(P＜0.05).(6)On day 7 of treatment,the positive rate of bacterial culture for wound discharge in the trial group was 6.67%(2/30),which was significantly lower than 27.59%(8/29)in the control group,and the difference was statistically significant(P＜0.05).(7)There were no serious adverse events or adverse reactions occurring in the two groups during the trial.Conclusion Shangke Huangshui medicated gauze can accelerate the healing of burn wounds,shorten the wound healing time,reduce the wound infection rate and the level of serum inflammatory factors,and has fewer adverse reactions with high safety.

Objective:To investigate and analyze basic status of radiotherapy units in Hebei Province in 2024.Methods:Led by the Fourth Hospital of Hebei Medical University, the Radiation Oncology Branch of the Hebei Medical Association, and the Radiation Oncology Expert Committee of the Hebei Society of Clinical Oncology, a province-wide survey was conducted using structured questionnaires. The survey covered key aspects such as basic information of radiotherapy institutions, personnel allocation, equipment configuration, and implementation of radiotherapy techniques. Collected data were summarized and descriptively analyzed comparing with a 2013 survey of radiotherapy in Hebei Province.Results:All 158 radiotherapy institutions across Hebei Province participated in the survey. A total of 2273 radiotherapy professionals were reported, including 1317 radiation oncologists (57.94%), 332 medical physicists (14.61%), 71 radiotherapy engineers (3.12%), and 553 radiotherapy technologists (24.33%). The number of radiotherapy devices significantly increased from 121 in 2013 to 237 in 2024, including 68 domestic radiotherapy equipment. The current inventory includes 195 medical linear accelerators (2.61 units per million population), 2 cobalt-60 units, 27 afterloading machines, 9 tomotherapy (TOMO) systems, 3 CyberKnife units, and 1 proton therapy system. Three-dimensional conformal radiotherapy and stati intensity-modulated radiotherapy have been widely adopted across the province, while advanced techniques such as volumetric-modulated arc therapy, stereotactic body radiotherapy, and respiration-gated technology, and respiratory gating are gradually being implemented.Conclusions:In recent years, the configuration of radiotherapy personnel in Hebei Province has become more balanced, and the availability of precision radiotherapy equipment has significantly improved. There is a growing trend in the adoption of domestically manufactured radiotherapy equipment, marking substantial progress in the development of radiation oncology services in the region.

Objective To explore the effects of combined exposure to bisphenol A (BPA) and high-fat diet on liver lipid metabolism and hepatocyte senescence in mice, and to elucidate the potential mechanisms of the onset and development of non-alcoholic fatty liver disease (NAFLD). Methods Specific pathogen free C57BL/6J mice were randomly divided into six groups, with 10 mice with equal numbers of each sex in each group. The mice in the control group and the simple BPA group were fed with regular diet, while others four groups of mice were fed with high-fat diet. At the same time, the mice in the simple BPA group were intragastric administered with BPA at a dose of 50 μg/kg body weight, while the mice in the low-, medium- and high-dose BPA+high-fat groups were intragastric administered with BPA at doses of 5, 50 and 500 μg/kg body weight respectively. The mice in the control group and the high-fat group were intragastric administered with the same volume of corn oil once per day for 90 consecutive days. Liver tissues were subjected to hematoxylin-eosin (HE) and Oil Red O staining. Liver coefficients and lipid-stained area ratios were calculated. Serum level of total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and the activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using an automatic biochemical analyzer. The hepatic tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-10 levels were quantified by enzyme-linked immunosorbent assay. The relative expression of cholesterol regulatory element binding protein 1 (SREBP1), CCAAT enhancer binding protein α, P16, and phosphorylated histone H2AX (γ-H2AX) in liver tissues was detected using Western blotting. The interaction effect of the combined exposure to BPA and high-fat diet was observed based on the result of mice in the control group, the simple high-fat group, the simple BPA group, and the medium-dose BPA group+high-fat group (the combined exposure group) using a 2×2 factorial design. The results of mice in the simple high-fat group and the low-, medium-, and high-dose BPA+high-fat groups were used to observe the effect of BPA exposure dose under high-fat diet conditions. Results i) The interactive effect of combined exposure to BPA and high fat. The HE and Oil Red O staining results indicated that the combined exposure to BPA and high-fat diet successfully established NAFLD in mice. The interactive effect of combined exposure to BPA and high-fat diet on serum ALT activity and the relative expression of P16 in the liver tissue of female mice, as well as the serum ALT and AST activities and the relative expression of SREBP1 in the liver tissue of male mice was significant (all P<0.05). Specifically, the serum ALT activity of male mice in the combined exposure group was higher than that in the simple high-fat group (P<0.05), while the ALT activity in the serum of female mice in the combined exposure group was lower than that in the simple BPA group (P<0.05). The relative expression of SREBP1 protein in the liver tissue of male mice in the combined exposure group was higher than that in the control group, the simple high-fat group, and the simple BPA group (all P<0.05). For the other indicators, there were no significant differences in the interactive effect of combined exposure to BPA and high-fat diet (all P>0.05). ii) Dose effects of BPA exposure. The HE and Oil Red O staining result showed that the degree of vacuolar steatosis in the liver of female and male mice of medium- and high-dose BPA + high-fat groups was aggravated, and the range of inflammatory cell infiltration was expanded when compared with same-sex mice in the simple high-fat group. The serum ALT activity and the fat stained area ratio, as well as the relative expression of P16 in liver tissue of female mice in high-dose BPA + high-fat group increased (all P<0.05), while the level of IL-10 in liver tissue decreased (P<0.05), compared with the female mice in simple high-fat group. The serum ALT activity, the TNF-α level in liver tissue, and the relative expression of SREBP1, P16 and γ-H2AX proteins in liver tissue of male mice in high-dose BPA + high-fat group increased (all P<0.05), while the IL-6 level in liver tissue decreased (P<0.05), compared with the male mice in simple high-fat group. For the female or male mice in the low- and medium-dose BPA + high-fat groups, only some of the above indicators showed significant changes (all P<0.05). Conclusion The combined exposure to BPA and high-fat diet has a synergistic effect on the onset and development of NAFLD. The mechanism may be related to inducing cellular senescence and modulation of lipid synthesis pathways, thereby affecting liver steatosis. The exposure dose of BPA may affect the synergistic effect.

Objective To explore the value of pulmonary perfusion SPECT/CT imaging for diagnosing pulmonary embolism(PE)and combining with clinical and laboratory indicators for predicting prognosis.Methods Totally 260 patients with suspected PE were retrospectively collected,and PE was clinically confirmed in 237 cases.The diagnostic efficacy of pulmonary perfusion SPECT/CT imaging and CT pulmonary angiography(CTPA)were compared.Among 237 patients with clinically confirmed PE,160 cases were initially diagnosed who underwent standard anticoagulant therapy and were regularly followed up to 3 months after discharge,and their prognosis were analyzed.Logistic regression was used to analyze clinical data,laboratory indicators and pulmonary perfusion defect scores based on pulmonary perfusion SPECT/CT imaging to screen the independent predictors of poor prognosis of PE of the above patients,and a prediction model was then constructed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of this model for predicting prognosis of PE.Results The positive rate of PE diagnosed with pulmonary perfusion SPECT/CT was higher than that with CTPA(66.54％[173/260]vs.59.62％[155/260],x2=4.765,P=0.038).Among 160 cases of clinically confirmed PE,poor prognosis was observed in 51 cases,while good prognosis was noticed in 109 cases.Patients' age,blood urea nitrogen,serum creatinine,uric acid,D-dimer level and pulmonary perfusion defect score were all independent predictors for poor prognosis of PE(all P＜0.05),and AUC of the established combined model was 0.731.Conclusion Pulmonary perfusion SPECT/CT imaging could be used for diagnosing PE,and combining with clinical and laboratory indicators could effectively predict prognosis of PE.

Objective:To investigate and analyze basic status of radiotherapy units in Hebei Province in 2024.Methods:Led by the Fourth Hospital of Hebei Medical University, the Radiation Oncology Branch of the Hebei Medical Association, and the Radiation Oncology Expert Committee of the Hebei Society of Clinical Oncology, a province-wide survey was conducted using structured questionnaires. The survey covered key aspects such as basic information of radiotherapy institutions, personnel allocation, equipment configuration, and implementation of radiotherapy techniques. Collected data were summarized and descriptively analyzed comparing with a 2013 survey of radiotherapy in Hebei Province.Results:All 158 radiotherapy institutions across Hebei Province participated in the survey. A total of 2273 radiotherapy professionals were reported, including 1317 radiation oncologists (57.94%), 332 medical physicists (14.61%), 71 radiotherapy engineers (3.12%), and 553 radiotherapy technologists (24.33%). The number of radiotherapy devices significantly increased from 121 in 2013 to 237 in 2024, including 68 domestic radiotherapy equipment. The current inventory includes 195 medical linear accelerators (2.61 units per million population), 2 cobalt-60 units, 27 afterloading machines, 9 tomotherapy (TOMO) systems, 3 CyberKnife units, and 1 proton therapy system. Three-dimensional conformal radiotherapy and stati intensity-modulated radiotherapy have been widely adopted across the province, while advanced techniques such as volumetric-modulated arc therapy, stereotactic body radiotherapy, and respiration-gated technology, and respiratory gating are gradually being implemented.Conclusions:In recent years, the configuration of radiotherapy personnel in Hebei Province has become more balanced, and the availability of precision radiotherapy equipment has significantly improved. There is a growing trend in the adoption of domestically manufactured radiotherapy equipment, marking substantial progress in the development of radiation oncology services in the region.

Objective: To evaluate the efficacy and safety of adding toripalimab to bevacizumab and platinum-based chemotherapy as first-line treatment for refractory recurrent or metastatic (R/M) cervical cancer (CC). Methods: Patients were administered toripalimab (240 mg) + bevacizumab (7.5 mg/kg) combined with platinum-based chemotherapy once every three weeks for six cycles, followed by the maintenance therapy involving toripalimab + bevacizumab once every 3 weeks for 12 months or when disease progression or intolerable toxicity occurred. The primary endpoint was the objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1. The secondary endpoints were safety profiles, disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). Results: Twenty-four patients were enrolled in this study and in the final analysis. The median follow-up duration was 18.6 (range, 3.3–28.5) months. The ORR was 83.3% (95% confidence interval [CI]=62.6–95.3) and the DCR was 95.8% (95% CI=78.9–99.9); 9 (37.5%) patients achieved complete response, 11 (45.8%) achieved partial response, and 3 (12.5%) had stable disease. The median PFS was 22.6 (95% CI=10.4–34.7) months and the median OS was not reached. The most common grade 3 treatment-related adverse events (AEs) were neutropenia (41.7%) and leukopenia (16.7%). The most common immune-related AEs (irAEs) were thyroid dysfunction (37.5%) and increased adrenocorticotropic hormone (37.5%) and serum cortisol levels (33.3%). No grade ≥3 irAEs were observed. Conclusion Toripalimab combined with bevacizumab and platinum-based chemotherapy show promising clinical efficacy and favorable safety profile, providing an alternative firstline treatment option for patients with R/M CC.

Objective: To explore the intervention effect of group counseling integrating teadrinking on depression, social avoidance and distress, coping styles and selfesteem among college students, so as to provide references for promoting the psychological health of students. Methods: From March to June 2021, a convenience sampling method was used to recruit 46 college students from a university in Nanjing for intervention project. There were 23 students in intervention group and control group, respectively. The intervention was conducted for 2.5 hours per week across a 6 week period. The intervention group received two sessions of group counseling that incorporated teadrinking experience, and the sessions involved tea knowledge explanation, observation and learning, embodied experience, emotional expression, interpersonal assistance and emotional support, cultural customs and life integration. After the intervention was completed, the control group received onetime group counseling that integrated teadrinking. The Wilcoxon difference test and Mann-Whitney U test were performed to compare the scores of each scale within and between the groups, and the χ2 test was used to compare the detection rates. Results: There were no statistically significant differences in the scores of positive coping, negative coping, selfesteem, social avoidance and distress between the intervention group and the control group (Z=-1.20, -0.33, -0.35, 1.31,P>0.05). There were statistically significant differences in positive coping styles, selfesteem, social avoidance and distress between the intervention group and the control group after the intervention(27.70±5.60，22.05±4.30；30.52±3.63，28.27±4.06；7.43±7.38，13.64±6.79) (Z=-3.31, -2.10, 3.22, P<0.05). The intervention group showed statistically significant differences in social avoidance and distress scores before and after the intervention(11.96±7.47,7.43±7.38) (Z=-2.88), and the depression detection rate decreased(60.9%，30.4%) (χ2=4.29) (P<0.05). There were no statistically significant differences in positive coping, negative coping, selfesteem, social avoidance and distress scores, and depression detection rate between the control group before and after the intervention (Z/χ2=-0.28, -0.42, -1.24, -1.25；1.39, P>0.05). The followup results 1year later showed that there was a statistically significant difference in social avoidance and distress(6.57±6.21,14.16±9.22), and in the detection rates of depression(21.7%,52.2%) between the intervention group and the control group (Z/χ2=2.70,4.57,P<0.05). Conclusions Group counseling integrating teadrinking could improve interpersonal relationships, emotional states, selfesteem levels and coping strategies among college students. Group psychological counseling that incorporates teadrinking can be adopted to improve the mental health status of college students.