In order to understand the characteristics of avian leukosis virus(ALV)infection and the polymorphisms of receptor genes Tva,Tvb and NHE1 sequences in different Qingyuan Ma chick-en breeding farms,the isolation and identification of exogenous ALV virus,receptor gene amplifi-cation and sequencing analysis were carried out in five Qingyuan Ma chicken breeding farms.The results of virus isolation and subtype identification showed that the positive rate of exogenous ALV virus isolation in farms A,B and C was less than 5％,among which there was ALV-J infection alone in farm A,mixed infection with ALV-J and ALV-K in farm B,ALV-K infection a-lone in farm C,and no exogenous ALV infection was detected in farm D and E.Polymorphism anal-ysis of recipient genes showed that there were different frequencies of Tvar3,Tvar4 and Tvbr3 re-sistance alleles in A-E farms,and the distribution frequency of Tvar3 was 0.2-0.6,the distribution frequency of Tvar4 was 0.3-0.7,and the distribution frequency of Tvbr3 was 0.1-0.7.In addition,there were Tvar5 resistance alleles in both B and D farms,with a distribution frequency of 0.2.A to-tal of 18 SNP mutations occurred in the NHE1 receptor gene sequence,and further analysis showed that positions 1 279,1 361,1 369,1 406,1 442,and 1 912 were non-synonymous mutations,which could cause changes in amino acids.The study suggested that there were differences in the exogenous ALV and its subtypes among the five Qingyuan Ma chicken breeders,and each farm should have a more targeted and unique purification strategy.The distribution of Tva and Tvb re-sistance alleles at different frequencies,along with the occurrence of 6 non-synonymous mutations in the NHE1 gene,indicate that Qingyuan Ma chicken have the potential of genetic resistance breeding.

Radiation therapy is an essential component of comprehensive treatment for breast cancer. In comparison to photons, proton beam, with its unique Bragg peak, limits the dose distribution to normal tissues around the tumor while improving dose coverage within the target area. Therefore, it could be an appealing therapeutic option for breast cancer treatment. Current researches indicate that proton therapy for breast cancer treatment has a distinct dosimetric advantage in protecting the heart and lungs. However, there are potentially increased risks of side-effects such as skin reactions and rib fractures, etc. Future Subsequent studies should seek a better understanding of the relative biological effectiveness changes along the proton beam range to improve the proton plan evaluation. Additionally, efforts should be directed towards identifying patients who would derive maximum benefit from proton therapy, addressing concerns related to its limited accessibility and high cost. This review provides an overview of the current clinical experiences, research progress and controversies in proton therapy for breast cancer.

Objective:This study aimed to compare the dosimetric differences in unintended irradiation to the ipsilateral axillary region between intensity-modulated radiation therapy(IMRT)and intensity-modulated proton therapy(IMPT)in patients receiving whole breast irradiation(WBI). Methods:A total of 20 patients with early breast cancer who received WBI at our center between August and September 2022 were included in this study.One IMPT plan and one IMRT plan were formulated for each patient,with prescription dose of 4005 cGy(RBE)in 1 5 fractions.Dosimetric parameters of axillary lymph nodes(ALN)level Ⅰ,Ⅱ,Ⅲ,Rotter's lymph nodes(RN),and the axillary-lateral thoracic vascular junction(ALTJ)were compared between IMPT and IMRT plans. Results:All plans met the criteria of CTV V95％Dose≥95％.IMPT showed significantly better conformity index(0.97 vs 0.95,P=0.0003)and homogeneity index(0.05 vs 0.07,P=0.0301)compared to IMRT.The mean dose of the heart[27.48 vs 114.74 cGy(RBE),P＜0.0001]and ipsilateral lung[356.66 vs 498.89 cGy(RBE),P＜0.0001]were significantly lower in the IMPT plan compared to the IMRT plan.The mean dose,V50％Dose,V80％Dose,V90％Dose,and V95％Dose of ALNⅠ,ALN Ⅱ,ALN Ⅲ and RN in the IMPT plan were significantly lower than those in the IMRT plan(all P＜0.01),with the most significant difference observed in the dosimetric parameters of the axillary region inferior to the axillary vein[mean dose:79.75 vs 995.31 cGy(RBE),P＜0.0001].The mean dose and serial dosimetric parameters(V5,V10,V15,V20,V25,V30,and V35)of the ALTJ were also significantly lower in IMPT plans compared to IMRT plans. Conclusion:IMPT demonstrates lower unintended irradiation dose in the inferior axillary region and reduces dose volume in the ALTJ region compared to IMRT.When employing IMPT,the clinical target volume(CTV)should be delineated based on the individual locoregional recurrence risk for patients with positive sentinel lymph nodes who omitted axillary lymph node dissection.For high-risk patients,the axillary region should be included in the CTV to ensure efficacy,while for low-risk patients,excluding the axillary region can help mitigate the risk of breast cancer-related lymphedema.

Objective To investigate the modification effect of atmospheric temperature on outpatient visits caused by O₃ in Linzhi City. Methods The daily outpatient data, the daily O₃ concentration and daily meteorological data (including daily average temperature, average relative humidity, etc.) in Linzhi City from 2018 to 2019 were collected. The distributed lag non-liner-model (DLNM) was used to quantitatively evaluate the impact of O₃ in different temperature layers on the risk of outpatient visits. Results At low temperature layers, the cumulative relative risk (CRR) of total outpatient visits and non-injury outpatient visits increased by 53.8%（4.2% -126.9%) and 59.1%（5.8% -139.2%）for every 10 μg/m³ increase of O₃ concentration, respectively. The subgroup analysis showed that for every 10 μg/m³ increase of O₃ concentration at low temperature, the CRR of patients with circulatory diseases, men, women, and people being <14 years old and 14-65 years old increased by 152.1% (15.1% - 451.9%), 58.3% (2.1%-145.5%), 49.2% (3.0% -116.1%), 39.6% (2.5% - 90.3%), and 61% (0.8%-157.1%), respectively. Conclusion The average temperature may have a modifying effect on the outpatient visits caused by O₃ in Linzhi City. In general, the cumulative risk increases as the temperature decreases.

Objective:To provide a reference for the choice of electronic data capture system used in clinical research, the function and performance of some tool software were expounded and compared.Methods:We selected three freely available systems of REDCap, Commcare, and OpenEDC as research objects, describing and comparing their user license acquisition path, data capture related functions, and information security assurance measures. This article reflected how the three kinds of tool software ensure research data privacy and scientificity, and presented the consideration of system security and accessibility.Results:REDCap was the most mature system of the three, which had a fairly comprehensive design in functional integrity, data security, user friendliness, and system scalability. Commcare system featured in the mobile collection, and supported the most abundant types of collected data, while OpenEDC was characteristic of low threshold and flexible deployment.Conclusions:REDCap system is widely applicable to small and medium scale medical research, including clinical trials, retrospective studies, cohort studies, and translational research. Commcare system is the preferred option for medical investigations represented by epidemiologic surveys, while OpenEDC is particularly suitable for investigator initiated studies.

Objective:To explore the effect of "321" health education model in elderly patients with osteoporotic thoracolumbar fractures (OTF) .Methods:From January 2019 to June 2021, convenience sampling was used to select 112 elderly patients after OTF surgery in Hefei First People's Hospital as the research object. The patients were divided into the experimental group and the control group by random number table method, 56 cases in each group. The control group was given routine nursing and health education for patients after OTF surgery, while the experimental group was given "321" health education. The scores of Health Behavior Questionnaire, incidence of complications, and quality of life scores were compared between the two groups before intervention and after 6 months follow-up.Results:There were 54 and 51 patients in the experimental group and the control group, respectively, who completed the study. After 6 months of follow-up, the total score and the dimension scores of the Health Behavior Questionnaire in the two groups were higher than those before the intervention, except for the other behavior dimension, the total score of the Health Behavior Questionnaire and the scores of other dimensions in the experimental group were higher than those in the control group, all differences were statistically significant ( P<0.05) . The incidence of complications in the experimental group (3.70%, 2/54) was lower than that in the control group (15.69%, 8/51) , and the difference was statistically significant (χ 2=4.669, P=0.031) . The total score and the dimension scores of quality of life in the two groups were lower than those before education, and the total score and the dimension scores of quality of life in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "321" health education model in elderly patients after OTF surgery is beneficial to promote the osteoporosis prevention and health behavior of elderly patients after OTF surgery, reduce the occurrence of complications after OTF surgery, and improve the quality of life of patients.

Objective To explore the association between estimated glomerular filtration rate (eGFR) and prognosis of acute ischemic stroke (AIS) patients who were treated by intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA).Methods We consecutively screened AIS patients who were treated by intravenous thrombolysis with rt-PA from January 2006 to September 2016 in Tangshan Gongren Hospital.According to eGFR value of patients at admission,the eligible patients were divided into two groups:normal eGFR group (eGFR ≥ 90 ml ? min-1 ? 1.73 m-2) and decreased eGFR group (eGFR ＜ 90 ml? min-1 ? 1.73 m-2).The incidence of symptomatic intracerebral hemorrhage (SICH),early neurological deterioration (END) at 24 hours and seven days after thrombolysis,mortality within seven days and 90 days,and excellent recovery at 90 days were compared between the two groups.The OR with 95％ CI and the adjusted OR with 95％ CI were analyzed by univariate and multivariate Logistic regression models.Results A total of 258 patients were enrolled,including 182 cases in the normal eGFR group and 76 cases in the decreased eGFR group.After adjusting for the potential confounders,multivariate Logistic regression analysis showed that the rates of SICH (13.2％ (10/76) vs 3.3％ (6/182),OR =3.859,95％ CI 1.313-11.341),END at 24 hours (21.1％ (16/76) vs 8.2％ (15/182),OR =2.958,95％ CI 1.347-6.495) and seven days (32.9％ (25/76) vs 12.6％ (23/182),OR =3.129,95％ CI 1.555-6.293),mortality within seven days (22.4％ (17/76) vs 6.0％ (11/182),OR =4.079,95％ CI 1.588-10.477) and 90 days (23.7％ (18/76) vs 9.9％ (18/182),OR =2.457,95％ CI 1.050-5.749) were higher in the decreased eGFR group than in the normal eGFR group.On the other hand,the chance of excellent recovery at 90 days (22.4％ (17/76) vs 43.4％ (79/182),OR =0.435,95％ CI 0.229-0.824) was less in the decreased eGFR group than in the normal eGFR group.Conclusion Decreased eGFR may not only increase the risks of SICH,END and death,but also reduce the chance of 90-day excellent recovery in AIS patients after intravenous thrombolysis with rt-PA.

Objective To investigate the influencing factors of in-hospital delay using alteplase for intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods From January 2006 to May 2015,220 consecutive patients with acute ischemic stroke admitted to the Department of Neurology,Tangshan Gongren Hospital Affiliated to North China University of Science and Technology were enrolled retrospectively.They all received alteplase for intravenous thrombolytic therapy.Their mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 16±8.According to door-to-needle time (DNT),they were divided into either a delay group (DNT >60 min;n=151) or a non-delay group (DNT ≤60 min;n=69).The baseline data,laboratory tests,onset-to-door (OTD) time,imaging,and etiology classification of trial of org 10172 in acute stroke treatment (TOAST) of both groups were recorded.Univariate analysis was performed on both groups,and further multivariate logistic analysis was performed.Results (1) The proportion of the past history of transient ischemic attack,blood glucose level on admission,time from onset to hospital in the non-delay group were significantly higher than those of the delay group.There were significant differences between the two groups (43.5%[30/69] vs.3.3%[5/151],7.9±3.0 mmol/L vs.6.9±2.1 mmol/L,95±53 min vs.80±34 min,all P<0.05).There were significant differences in the constituent ratio of TOAST classification between the two groups (P<0.05).There were no significant differences in other baseline data and clinical features between the two groups (all P>0.05).(2) Multivariate Logistic regression analysis showed that the risks of patients with the past history of transient ischemic attack (OR,0.330,95%CI 0.109-0.998,P=0.046),elevated blood glucose levels on admission (OR,0.775,95%CI 0.657-0.914,P=0.005),prolonged onset-to-door time (OR,0.648,95%CI 0.504-0.831,P=0.013),internal carotid artery lesions (OR,0.192,95%CI 0.038-0.960,P=0.044) for occurring in-hospital delay after thrombolysis were low.Systolic pressure on admission(OR,1.275,95%CI 1.091-1.491,P=0.027)and cardioembolism(OR,3.892,95%CI 1.661-9.112,P=0.006) for occurring in-hospital delay after thrombolysisin were high.Conclusion The patients with past history of transient ischemic attack,higher blood glucose,prolonged onset-to-door time,and having internal carotid artery lesions may be cause the attention of family members and doctors,and were less prone to having thrombolytic in-hospital delay,whereas those with higher systolic blood pressure on admission and cardioembolism were prone to having in-hospital delay.

Objective To investigate the clinical effect of butylphthalide combined with naloxone in the treatment of elderly patients with cerebral hemorrhage.Methods A total of one hundred and thirty elderly patients with cerebral hemorrhage were selected in North China University of Science and Technology Affiliated Hospital from December 2012 to December 2014,and were randomly divided into two groups,each group 65 cases.Naloxone was used in the control group,while the observation group adopted butylphthalide combined with naloxone in its treatment.The curative effects were compared between two groups.Results After treatment,homocysteine,C reactive protein,hypoxia inducible factor,neurological function defect score were all significantly decreased in two groups (P<0.05).Homocysteine,C reactive protein,hypoxia inducible factor and neurological function defect score in the observation group were much lower than those of the control group ((10.2±1.3) μmol/L vs.(14.0±1.8) μmol/L,(3.9±1.1) mg/L vs.(6.9±1.4) mg/L,(51.6±10.3) pg/ml vs.(82.5±17.6) pg/ml,(3.7±1.0) points vs.(4.4±0.9) points,t=7.134,10.692,9.078,4.892,P<0.05).The total effective rate in the observation group was significantly higher than that of the control group (98.5% vs.89.2%,χ2=4.795,P<0.05).Compared the complications in two groups,the differences were not statistically significant (P>0.05).Conclusion Butylphthalide combined with naloxone is effective in the treatment of elderly patients with cerebral hemorrhage,which can significantly improve their clinical signs and neurological function.

Objective To evaluate the safety and effectiveness of Pipeline embolization device (PED) for the treatment of large and giant intracranial aneurysms.Methods Frorn November 2014 to May 2016,the clinical and radiological data of 33 patients with intracranial aneurysm confirmed by DSA or head CT angiography (CTA) or head magnetic resonance angiography (MRA) at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.Its safety and effectiveness were evaluated.Results The Pipelines were successfully released in 33 patients with 35 aneurysms,10 aneurysms were implanted by using PED alone,25 were implanted by using PED combined with coil embolization (including 2 were implanted by using Pipeline bridging technology).During the perioperative period,1 thrombotic event(one aneurysm) occurred and had hemorrhagic transformation.One(one aneurysm) died of fatal aneurysm delayed bleeding.Thirty-one patients (33 aneurysms) were followed up clinically,the follow-up time was 4-18 months,no bleeding or thrombosis events occurred.Eighteen aneurysms received a short-term postoperative imaging follow-up (3-5 months,enhanced MRA or DSA),of which 10 had neck residue or aneurysm development,and 8 aneurysms did not have development at all,and 19 achieved postoperative mid-term imaging follow-up (6-16 months,enhanced MRA or DSA).Two of them had neck residue and 17 did not develop at all.Conclusion Pipeline for the treatment of intracranial large and giant aneurysms may be safe and effective.However,the complications of intracranial hemorrhage cannot be ignored after implantation of embolization device.Its related mechanism needs to be further studied.