Objective:To investigate the impact of different target sites, number of treatments, and age on setup errors in dual-isocenter radiotherapy for breast cancer, and to provide a basis for planning target volume (PTV) margin expansion.Methods:A retrospective analysis was conducted on data from 15 patients with left-sided breast cancer who underwent dual-isocenter breath-hold radiotherapy in the Department of Radiotherapy Oncology at the Second Hospital of Hebei Medical University from May 2021 to May 2023. Setup errors were acquired using a Varian TrueBeam STX linear accelerator. Patients were grouped by target site (supraclavicular/chest wall), treatment phase (early/late), and age (younger/older). Non-parametric tests were used to analyze differences in setup errors in : vertical (Vrt), longitudinal (Lng), lateral (Lat) directions, and pitch, roll, and rotation (Rtn) angles. The formula proposed by van Herk was applied to calculate PTV margins.Results:The Vrt direction setup error in the supraclavicular region (0.2 cm) was smaller than that in the chest wall region (0.26 cm), but errors and margin expansions in other directions were larger ( P<0.05 for Lng and Lat directions). No significant correlation was observed in Vrt direction errors between the two sites ( P=0.062), while significant correlations were found in the other directions and angles (all P<0.05). As treatment progressed, setup errors increased in the Vrt and Rtn directions for the supraclavicular region, and in the Vrt, Lng, Lat directions and Rtn angle for the chest wall region. Among these, only the increase in Lat direction error for the chest wall region was statistically significant ( P=0.028). The PTV margins in the late phase group (except for the Lat direction of the supraclavicular region) were greater than or equal to those in the early phase group. Elderly patients had significantly larger setup errors than younger patients in Vrt, Lng, and Lat directions for the supraclavicular region, as well as in Vrt and Lat directions for the chest wall region (all P<0.05). Conclusions:In dual-isocenter radiotherapy for breast cancer, the supraclavicular region requires larger PTV margins than the chest wall region, and elderly patients require greater margins overall. Mid-course rescanning is recommended. If cone-beam CT guidance cannot be ensured for every session, expansion of PTV margins should be considered for the supraclavicular region and elderly patients to reduce the risk of geographic miss.

OBJECTIVES: To compare the anti-inflammatory, antibacterial and analgesic effects of Yinqiao Powder (YQS) formulated granules and decoction. METHODS: We first evaluated the anti-inflammatory effects of the two dosage forms of YQS in a LPS-induced RAW 264.7 cell model using RT-qPCR and Western blotting. We further constructed zebrafish models of inflammation by copper sulfate exposure, caudal fin transection, or LPS and Poly (I:C) microinjection, and evaluated anti-inflammatory effects of YQS granules and decoction by examining neutrophil aggregation and HE staining findings. In a mouse model of acute lung injury (ALI) induced by intratracheal LPS instillation, the effects of YQS gavage at 10, 15, and 20 g/kg on lung pathologies were evaluated by calculating lung wet-dry weight ratio and using HE staining, ELISA and Western blotting. The microbroth dilution method was used to evaluate the antibacterial effect of YQS. Mouse pain models established by hot plate and intraperitoneal injection of glacial acetic acid were used to evaluate the analgesic effects of YQS at 10, 15, and 20 g/kg. RESULTS: Both YQS granules and decoction significantly reduced TNF-α, IL-6, and IL-1β expressions and p-STAT3 (Tyr 705) phosphorylation level in LPS-induced RAW 264.7 cells, and obviously inhibited neutrophil aggregation in the zebrafish models. In ALI mice, YQS granules and decoction effectively ameliorated lung injury, lowered lung wet-dry weight ratio, and reduced p-STAT3 (Tyr 705) expression and TNF-α and IL-6 levels. YQS produced obvious antibacterial effect at the doses of 15.63 and 31.25 mg/mL, and significantly reduced body torsion and increased pain threshold in the mouse pain models. CONCLUSIONS The two dosage forms of TQS have similar anti-inflammatory, antibacterial and analgesic effects with only differences in their inhibitory effect on TNF-α, IL-6 and IL-1β mRNA expressions in LPS-induced RAW 264.7 cells.
Animals ; Mice ; Drugs, Chinese Herbal/pharmacology* ; Anti-Inflammatory Agents/pharmacology* ; Analgesics/pharmacology* ; RAW 264.7 Cells ; Zebrafish ; Anti-Bacterial Agents/pharmacology* ; Powders ; Tumor Necrosis Factor-alpha/metabolism* ; Acute Lung Injury/drug therapy* ; Interleukin-6/metabolism* ; Lipopolysaccharides

Objective To investigate the clinical characteristics and traditional Chinese medicine(TCM)syndrome types of colorectal polyp(CP)and to explore their correlation with hyperlipidemia and other related risk factors.Methods From January 2022 to December 2023,174 patients with CP(polyp group)and 87 patients without intestinal abnormalities(non-polyp group)who underwent colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital of Guangzhou University of Chinese Medicine were selected.Their data of medical records were collected,including gender,age,body mass index(BMI),history of diabetes mellitus,history of hypertension,blood lipid indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and arteriosclerosis index(AI)],the presence of fatty liver or not,and the foci,number,size,and pathological types of polyps.Moreover,TCM syndrome differentiation of patients in the polyp group was carried out,and then the clinical characteristics and TCM syndrome types of CP as well as their correlation with hyperlipidemia were statistically analyzed.Results(1)The age group of 41-60 years old accounted for a higher percentage in patients of the polyp group and non-polyp group,59.8％in the polyp group and 49.4％in the non-polyp group,and the comparison of ages between the two groups showed statistically significant difference(P＜0.05).(2)The polyp foci of CP were mostly located in the left colon,accounting for 63.2％;single polyp was common,accounting for 69.0％;the size of polyps was usually 1-10 mm,accounting for 90.2％;the polyps were predominated by non-adenomatous polyps,accounting for 51.1％.(3)In the polyp group,spleen deficiency and dampness retention syndrome was the predominated syndrome type,accounting for 44.8％,and then followed by syndrome of damp-heat in large intestine,which accounted for 30.5％.(4)Comparison of the distribution of BMI and history of diabetes mellitus among various TCM syndrome types showed statistically significant differences(P＜0.05),while no statistically significant differences were presented in the comparison of gender,age,history of hypertension,and history of fatty liver,as well as the polyp foci,number,size,and pathological types among patients with various TCM syndrome types(P＞0.05).(5)The percentage of complication of hyperlipidemia in the polyp group was significantly higher than that in the non-polyp group,and the difference was statistically significant(P＜0.01).The levels of TC,TG,LDL-C,and Al in the polyp group were significantly higher than those in the non-polyp group,the differences being statistically significant(P＜0.05 or P＜0.01).However,the difference of the HDL-C level between the two groups was not statistically significant(P＞0.05).(6)Comparison of TC and LDL-C levels among the patients with different polyp foci and LDL-C level among the patients with various TCM syndrome types showed statistically significant differences(P＜0.05 or P＜0.01),while no statistically significant differences of blood lipid indicators were presented among the patients with various foci,number,sizes,and pathological types of the polyp and among the patients with various TCM syndrome types(P＞0.05).Conclusion Age is a risk factor for CP.CP patients are usually differentiated as the syndrome of spleen deficiency and dampness retention and the syndrome of damp-heat in large intestine,and the distribution of TCM syndrome types exert a certain correlation with BMI and history of diabetes mellitus.Hyperlipidemia is also a risk factor for the onset of CP,and abnormal levels of TC,TG,LDL-C,and Al exert certain correlation with the occurrence of polyps.TC and LDL-C have a certain correlation with the polyp foci,and LDL-C may also be related to the distribution of TCM syndrome types.

Objective:To explore the effects of Ziyu Ointment on granulation tissue,TGF-β and downstream Smad protein in the process of wound healing in rats by constructing a rat model of back trauma.Methods:A rat model of back trauma was constructed,and 100 SD male rats were separated into healthy group,back trauma group,Ziyu Ointment treatment group,petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group,with 20 per group.Wound formation surgery was performed,and wound healing of rats in each group was recorded at 5th,10th,and 15th day after operation;the levels of IL-6,IL-1β and TNF-α in the serum of rats in each group were detected;the granulation tissue formed by wound healing at 15th day was selected for HE and Masson staining,the proportion of blood vessel area and collagen area of granulation tissue of rats in each group were analyzed and calculated;the mRNA expression levels of TGF-β1 and Smad3 in granulation tissues of rats in each group were detected by fluorescence quantitative PCR;the expression levels of TGF-β1,Smad3 and p-Smad3 in granulation tissues of rats in each group were detected by Western blot.Results:The healthy group rats had complete epidermal tissue;the levels of serum IL-6,IL-1β,TNF-α,the expression of TGF-β1 mRNA and protein in the wound granulation tissue,and the phosphorylation of Smad3 in the back trauma group were obviously higher than the healthy group(P<0.05);compared with back trauma group,the wound healing rate,proportion of collagen area,and propor-tion of blood vessel area in Ziyu Ointment treatment group and petrolatum treatment group were obviously increased,the serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression,and Smad3 phosphorylation were obviously decreased(P<0.05);compared with Ziyu Ointment treatment group,the petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group had obviously lower wound healing rate,collagen area percentage,and blood vessel area percentage,and obviously lower serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression and Smad3 phosphorylation(P<0.05).Conclusion:Ziyu Ointment can inhibit the expression of related genes and proteins by regulating the TGF-β/Smad signal pathway,thereby alleviating inflammation and promoting wound healing.

Objective To identify latent profiles of digital health technophobia among elderly patients with breast cancer and to examine differences in demand for on-line nursing care services.Methods Convenient sampling was used in this cross-sectional study.A total of 350 consecutive perioperative elderly patients with primary breast cancer were recruited from the Departments of General Surgery,affiliated to three Tier-IIIA hospitals in Shijiazhuang from June 2022 to June 2023.Data were collected with a general-information questionnaire,technophobia scale,and demand scale for online appointment nursing service.Results All 348 patients completed the survey.Digital health technophobia in elderly patients with primary breast cancer were categorised into four latent profiles:low technophobia(n=65,18.68%),high technophobia with moderate privacy-security concern(n=96,27.59%),moderate technophobia with high privacy security concern(n=85,24.43%),and high technophobia(n=102,29.31%).There was significant difference in demand for online nursing care services regarding the four latent profiles(F=446.149,P<0.05).Conclusion Elderly patients with breast cancer exhibit four profiles regarding digital health technophobia.It is found that each profile associates with specific demands of online nursing care services.Nursing staff should take tailored interventions to target specific digital health technophobia profiles to meet the demands of online nursing care services among the elderly patients with breast cancer.

With the increasing use of nirmatrelvir-ritonavir in older COVID-19 patients, adverse drug reactions due to drug-drug interactions have become more frequent. This report describes a patient who experienced severe bradycardia and hypotension following the concurrent use of heart rate-control medications and nirmatrelvir-ritonavir during an active COVID-19 infection. This suggests that clinicians should be cautious when dealing with nirmatrelvir-ritonavir and try their best to avoid serious adverse reactions.

Objective To investigate the predictive value of the combination of cell cycle protein-dependent kinase inhibitor 3(CDKN3)and serum chitosanase 3-like protein 1(CHI3L1),and microRNA-106b(miR-106b)assays in hepatocellular carcinoma metastasis.Methods One hundred patients with hepatocellular carcinoma admitted to the hospital between September 2019 and December 2023 were selected as study subjects and included in the hepatocellular carcinoma group,87 patients with cirrhosis were included as the cirrhosis group during the same period,96 patients with chronic hepatitis B as the chronic hepatitis B group,and 98 healthy persons under-going routine physical examination were included in the healthy control group,and the groups were compared with respect to the serum CHI3L1,the cell-cycle molecule CDKN3,and the miR-106b levels.The hepatocellular carci-noma group was divided into 26 metastatic cases,63 non-metastatic cases,and 11 cases lost to follow-up according to whether they metastasized during the 1-year follow-up period,and baseline data,cell cycle molecules CDKN3,miR-106b,and serum CHI3L1 levels were compared between the two groups.Risk factors for hepatocellular carci-noma metastasis were analyzed using multifactorial logistic,and the predictive value of the combined detection of miR-106b,the cell cycle molecule CDKN3,and serum CHI3L1 for hepatocellular carcinoma metastasis was analyzed using ROC curves.Results Compared with the healthy control group,the levels of CHI3L1,cell cycle molecule CDKN3,and serum miR-106b were elevated in the hepatocellular carcinoma group,chronic type B group,and cirrhosis group,and the chronic type B group3 cm,CHI3L1,cytokinin A2(CCNA2),percentage of tumors with stage>Ⅲ,the cell cycle molecule CDKN3,abnormal plasminogen,glutamyltransferase(GGT),miR-106b,total bile acids(TBA),alpha-fetoprotein(AFP),number of tumors percentage of multiple occurrences,and glutamyltransferase(AST)levels were elevated,and the difference was statistically significant(P<0.05).The results of multifactorial logistics analysis showed that the risk factors for hepatocellular carcinoma metastasis included ALT,CCNA2,tumor>3 cm,AST,GGT,tumor stage>Ⅲ,AFP,CHI3L1,multiple tumors,abnormally high blood plasminogen,miR-106b,cell cycle molecule CDKN3,TBA.the results of the ROC curve analysis showed that miR-106b,serum CHI3L1,cell cycle molecule CDKN3 combined detection sensitivity was 93.65％,accuracy was 84.27％,and AUC value was 0.776 higher than the sensitivity,accuracy,and AUC value of single detection,and the difference was statistically significant(P<0.05).Conclusions Elevated levels of cell cycle molecule CDKN3,serum CHI3L1,and miR-106b are risk factors for liver cancer metastasis.It can be used to predict the occurrence of liver cancer metastasis,and the combined detection has significant predictive efficacy.

With the increasing use of nirmatrelvir-ritonavir in older COVID-19 patients, adverse drug reactions due to drug-drug interactions have become more frequent. This report describes a patient who experienced severe bradycardia and hypotension following the concurrent use of heart rate-control medications and nirmatrelvir-ritonavir during an active COVID-19 infection. This suggests that clinicians should be cautious when dealing with nirmatrelvir-ritonavir and try their best to avoid serious adverse reactions.

Objective To investigate the predictive value of the combination of cell cycle protein-dependent kinase inhibitor 3(CDKN3)and serum chitosanase 3-like protein 1(CHI3L1),and microRNA-106b(miR-106b)assays in hepatocellular carcinoma metastasis.Methods One hundred patients with hepatocellular carcinoma admitted to the hospital between September 2019 and December 2023 were selected as study subjects and included in the hepatocellular carcinoma group,87 patients with cirrhosis were included as the cirrhosis group during the same period,96 patients with chronic hepatitis B as the chronic hepatitis B group,and 98 healthy persons under-going routine physical examination were included in the healthy control group,and the groups were compared with respect to the serum CHI3L1,the cell-cycle molecule CDKN3,and the miR-106b levels.The hepatocellular carci-noma group was divided into 26 metastatic cases,63 non-metastatic cases,and 11 cases lost to follow-up according to whether they metastasized during the 1-year follow-up period,and baseline data,cell cycle molecules CDKN3,miR-106b,and serum CHI3L1 levels were compared between the two groups.Risk factors for hepatocellular carci-noma metastasis were analyzed using multifactorial logistic,and the predictive value of the combined detection of miR-106b,the cell cycle molecule CDKN3,and serum CHI3L1 for hepatocellular carcinoma metastasis was analyzed using ROC curves.Results Compared with the healthy control group,the levels of CHI3L1,cell cycle molecule CDKN3,and serum miR-106b were elevated in the hepatocellular carcinoma group,chronic type B group,and cirrhosis group,and the chronic type B group3 cm,CHI3L1,cytokinin A2(CCNA2),percentage of tumors with stage>Ⅲ,the cell cycle molecule CDKN3,abnormal plasminogen,glutamyltransferase(GGT),miR-106b,total bile acids(TBA),alpha-fetoprotein(AFP),number of tumors percentage of multiple occurrences,and glutamyltransferase(AST)levels were elevated,and the difference was statistically significant(P<0.05).The results of multifactorial logistics analysis showed that the risk factors for hepatocellular carcinoma metastasis included ALT,CCNA2,tumor>3 cm,AST,GGT,tumor stage>Ⅲ,AFP,CHI3L1,multiple tumors,abnormally high blood plasminogen,miR-106b,cell cycle molecule CDKN3,TBA.the results of the ROC curve analysis showed that miR-106b,serum CHI3L1,cell cycle molecule CDKN3 combined detection sensitivity was 93.65％,accuracy was 84.27％,and AUC value was 0.776 higher than the sensitivity,accuracy,and AUC value of single detection,and the difference was statistically significant(P<0.05).Conclusions Elevated levels of cell cycle molecule CDKN3,serum CHI3L1,and miR-106b are risk factors for liver cancer metastasis.It can be used to predict the occurrence of liver cancer metastasis,and the combined detection has significant predictive efficacy.