Objective:To investigate the efficacy of the Scarf osteotomy in treating adolescents with metatarsus adductus-type hallux valgus.Methods:A retrospective analysis was conducted on 20 patients (30 feet) treated with the Scarf osteotomy for metatarsus adductus-type hallux valgus at the Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, from July 2022 to August 2023. This group included 10 patients with bilateral conditions and 10 with unilateral, comprising 4 males and 16 females, with an average of 16.2±2.4 years (range, 14-19 years). The procedure involved the release of the lateral capsule, sesamoid ligaments, and adductor hallucis before osteotomy. After osteotomy, shortening and wedge resection were performed, along with translation and rotation of the distal osteotomy to reposition the first metatarsal beside the second and thereby reduce metatarsus adductus. The outcomes included preoperative, immediate postoperative, and final follow-up angles: hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal adduction angle (MAA), and the angle between the second to fifth metatarsals.Results:All 20 patients successfully underwent surgery with good wound healing and no infections; the average clinical healing time of osteotomy site was 5.1±0.7 weeks (range, 4.1-6.6 weeks). Follow-up lasted for 12.0±5.4 months (range, 2-18 months). Significant differences were observed in HVA, which was from 35.40°±5.45° preoperatively to 6.93°±3.60° immediately postoperatively, and 9.83°±2.65° at final follow-up; IMA, which was from 11.50°(9.75°, 14.00°) preoperatively to 1.50°(0.00°, 2.00°) immediately postoperatively, and at final follow-up; MAA, which was from 22.80°±2.60° preoperatively to 20.63°±2.27° immediately postoperatively, and 20.67°±2.20° at final follow-up; the angle between the second to fifth metatarsals,which was from 19.03°±1.85° preoperatively to 15.37°±1.33° immediately postoperatively, and 16.03°±1.73° at final follow-up. Visual analogue scale (VAS) also significantly decreased from 2.60±1.64 preoperatively to 1.30±0.92 at 6-8 weeks postoperatively. No cases of transfer metatarsalgia or recurrence of hallux valgus were reported.Conclusion:The Scarf osteotomy for metatarsus adductus-type hallux valgus effectively corrects the first metatarsal adduction and improves the adduction state of the remaining metatarsals to various degrees.

【Objective】 To analyze the predictive value of serum β-defensin-3 (HBD-3) and decoy receptor 3 (DCR3) for urinary tract infection after percutaneous nephrolithotomy (PCNL) in patients with complex kidney calculi. 【Methods】 A prospective study was conducted on 112 patients treated with PCNL at our hospital during Jan.2020 and Dec.2022.The patients were divided into the non-infection group (52 cases) and infection group (60 cases).The general data, HBD-3 and DCR3 levels of the two groups were compared.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of C reactive protein (CRP), procalcitonin (PCT), HBD-3 and DCR3 levels for postoperative urinary tract infection. 【Results】 Compared with the non-infection group, the infection group had higher levels of HBD-3 [(0.77±0.08) ng/mL vs. (1.36±0.25) ng/mL, P=0.001] and DCR3 [(4.68±0.53) ng/mL vs.(13.21±0.28) ng/mL, P=0.001].Multivariate logistic regression showed that a history of urinary tract surgery, preoperative urinary tract infection, operation time, catheterization time, stone load, type of antibiotics, concomitant renal dysfunction, intraoperative channel type, CRP, PCT, HBD-3 and DCR3 were risk factors of postoperative urinary tract infection (P<0.05).The ROC curve showed that the accuracy of CRP, PCT, and CRP plus PCT were 70.54%, 72.32%, and 78.57%, respectively; the accuracy of HBD-3, DCR3, and HBD-3 plus DCR3 were 69.64%, 75.89%, and 86.61%, respectively. 【Conclusion】 Postoperative urinary tract infection in patients with complex kidney calculi is associated with multiple factors, especially high expression levels of HBD-3 and DCR3.Combined detection has high predictive value.

Objective:To analyze human factors in radiotherapy safety incidents and identify their correction for the purpose of mining the latent incident chains.Methods:A total of 60 radiotherapy safety incidents were included in the Radiation Oncology Incident Learning System (ROILS) for cause identification and frequency statistics using the Human Factors Analysis and Classification System (HFACS). Latent class analysis (LCA) was performed for the result to correlate the incident causes.Results:Incidents in the protocol design stage were the most common, accounting for 35%. Adverse organizational climate, inadequate supervision, and personnel factors were the primary causes of incidents at each level of the HFACS, accounting for 4.66%, 15.68%, and 16.20%, respectively. Three latent incident chains were identified through LCA, comprising two originating from organizational climate issues and one from organizational process issues, which were passed down via various human factors or " loopholes"Conclusions:HFACS assists in tracing the human factors at all levels that lead to radiotherapy safety incidents. The high-frequency causes and three latent chains of radiotherapy incidents found in this study can provide a guide for the development of targeted safety and defense measures.

Objective:To investigate the dosimetric effects of complex cardiac-respiratory motion in cardiac stereotactic body radiotherapy (CSBRT).Methods:A cardiac motion phantom was employed to simulate patient-specific cardiac-respiratory motion in 10 cases. The measured doses obtained under the phantom motion state were compared with the calculated doses in radiotherapy treatment planning for clinical patients. Moreover, 18 groups of design-based cardiac-respiratory motion were simulated. The radiation doses under the phantom motion state were measured using radiochromic films and compared with those under the resting state.Results:In the patient-specific cardiac-respiratory motion group, the gamma passing rate (GPR) under the 3%/2 mm standard between the measured and the calculated doses was 90.0% ± 7.0%. The correlation coefficient of the respiratory motion amplitude in the superior-inferior (SI) dimension with the GPR was -0.86 ( P=0.01). In the design-based cardiac-respiratory motion groups, the increase in the amplitude of cardiac-respiratory motion reduced the consistency between the dynamic dose and the static reference dose. Especially, the increase in the respiratory motion amplitude produced the most pronounced effect, reducing the width of the 90% isodose line in the respiratory motion direction, with a mean slope of -1.6. Additionally, the increase in the penumbra corresponds to a mean slope of 1.4. Conclusions:The respiratory motion amplitude serves as a primary factor influencing the dose accuracy of CBSRT. The characteristics and dosimetric effects of cardiac-respiratory motion are patient-specific, thus necessitating the assessment of cardiac-respiratory motion characteristics before CBSRT to individualize the application of motion management techniques for enhanced treatment accuracy.

Objective:To investigate the dosimetric feasibility of cardiac stereotactic body radiotherapy (CSBRT) using volumetric-modulated arc radiotherapy (VMAT)-like technique on the Unity MR-linac.Methods:A retrospective analysis was conducted on 12 refractory arrhythmia patients who underwent CSBRT at West China Hospital, Sichuan University, from April 2021 to December 2022. Four different treatment plans were designed for each patient based on the average phase of 4DCT: VMAT plan based on a linear accelerator, VMAT-like plan with magnetic field based on Unity, VMAT-like plan without magnetic field based on a Unity, and static intensity-modulated radiation therapy (IMRT) plan with 7 beams based on Unity. The VMAT-like plans used static IMRT beams evenly distributed at 30 angles. Evaluation metrics included conformity index (CI), homogeneity index (HI), gradient index (GI), dosimetric parameters of organs at risk (OAR), optimization time, and monitor unit (MU). These metrics among groups were analyzed using the Wilcoxon paired signed-rank test.Results:The CI of the VMAT plan was better than that of the VMAT-like plan with magnetic field (0.84 vs. 0.81, P=0.005). The GI of the VMAT-like plan without magnetic field was significantly lower than that of VMAT-like plan with magnetic field ( P=0.015). The CI and HI of the IMRT plan were both inferior to VMAT-like plan with magnetic field ( P=0.034). The average dose to the heart and lungs in VMAT-like plan with magnetic field was higher than those in the VMAT plan and VMAT-like plan without magnetic field (both P<0.05). The magnetic field significantly increased the dose to the skin, tissue-lung interface, and outside the margins (all P<0.05). The optimization time of the VMAT-like plan with magnetic field was longer than that of the IMRT plan, but it required fewer MUs ( P=0.001). The quality of the IMRT plans was poor and did not meet clinical requirements. Conclusion:The quality of CSBRT plans based on VMAT-like techniques meets clinical requirements, but attention must be paid to the dosimetric effects of the magnetic field.

Purpose/Significance To summarize the common dimensions of data quality evaluation,and to expound the types and characteristics of medical big data quality evaluation and management methods,so as to provide references for medical big data quality e-valuation and management.Method/Process The paper reviews domestic and foreign medical big data quality related literature,and em-phatically analyzes medical big data quality evaluation dimensions,methods and management.Result/Conclusion Data quality standards are conducive to standardized management of medical big data.A scientific and reasonable medical big data quality evaluation system and a whole-process data quality management system in line with national conditions in China should be established and improved as soon as possible to promote the development and application of medical big data in our country.

Objective To construct and verify Nomogram model for individualized prediction of the risk of infectious complications in patients with complex kidney stones after percutaneous nephrolithotripsy(PCNL).Methods A total of 585 patients with complex kid-ney stones admitted to Cangzhou Hospital of Integrated Traditional and Western Medicine from March 2021 to June 2023 were collected as the study subjects,and divided into modeling group(n=410)and validation group(n=175)at 7∶3.The modeling group was further di-vided into non-complication group(n=342)and complication group(n=68)according to whether there were infectious complications after PCNL surgery.The clinical data were collected and multivariate Logistic regression analysis was applied to determine the factors that affected the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones,and Nomogram model was constructed to predict the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones.Results There were no statistically significant differences in gender,age,body mass index,surgical time,interleukin-6(IL-6)level,C-re-active protein(CRP)level,location and number of stone between the modeling group and the validation group(P＞0.05);compared with the non-complication group,the operation time and stone diameter,the levels of IL-6,CRP in the complication group was higher(t were 5.084,6.727,5.936,7.869,P＜0.05),and the proportions of diabetes and preoperative urinary tract infection were higher(x2 were 12.520,35.117,P＜0.05).The results of multivariate Logistic regression analysis showed that operation time(OR=1.077),stone diameter(OR=1.303),IL-6(OR=1.334),CRP(OR=1.381),diabetes(OR=3.288),preoperative urinary tract infection(OR=5.458)were all independent risk factors for infection complications after PCNL surgery in patients with complex kidney stones(P＜0.05).The area under the curve for the modeling group and validation group were 0.919(95％CI:0.889-0.949)and 0.939(95％CI:0.882-0.996),respectively.The results of the Hosmer-Limeshow goodness of fit test showed that the modeling group x2=5.484,P=0.705;validation group x2=10.101,P=0.258.Conclusion Operation time,stone diameter,IL-6,CRP,diabetes and preoperative urinary tract infection are independent risk factors for infectious complications after PCNL in patients with complex kidney stones.The Nomogram model based on these factors has high degree of discrimination and consistency.

This study aims to obtain two whole-genome sequences of enzootic nasal tumor virus of goats(ENTV-2)from Anhui Province and analyzed the genetic diversity of ENTV-2 gene.Nasal secretion samples and blood samples of six goats with enzootic nasal adenocarcinoma(ENA)were collected from a goat farm in Anhui Province.The total RNA was extracted by the TRIzol method.The DNA interference was removed by the two-step reverse transcription.The ENTV-2 was detec-ted by PCR.Then,two positive samples were selected and five pairs of primers were used to ampli-fy the whole-genome sequences of ENTV-2.After sequencing and splicing,two sequences were up-loaded to the database for comparative analysis with the sequences in the NCBI database.Finally,the genetic evolution tree was constructed.ENTV-2 was detected in the nasal secretion samples,but not in the blood of the six ENA goats.The ENTV-2 genes were approximately 7 400 bp in length,named ENTV-2AH1(DDBJ accession no.:LC762616)and ENTV-2AH2(DDBJ accession no.:LC762617),respectively.Two sequences showed 99.2％and 99.1％homology with the Fujian strain(ENTV-2FJ)and Guangxi strain(ENTV-2-DA0),respectively.They were in the same evo-lutionary branch.In this study,two whole-genome sequences of ENTV-2 were obtained in Anhui for the first time,which can help to further study the genetic diversity of ENTV-2 in China.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

As a representative chemotherapeutic drug, docetaxel (DTX) has been used for breast cancer treatment for decades. However, the poor solubility of DTX limits its efficacy, and the DTX based therapy increases the metastasis risk due to the upregulation of C-X-C chemokine receptor type 4 (CXCR4) expression during the treatment. Herein, we conjugated CXCR4 antagonist peptide (CTCE) with DTX (termed CTCE-DTX) as an anti-metastasis agent to treat breast cancer. CTCE-DTX could self-assemble to nanoparticles, targeting CXCR4-upregulated metastatic tumor cells and enhancing the DTX efficacy. Thus, the CTCE-DTX NPs achieved promising efficacy on inhibiting both bone-specific metastasis and lung metastasis of triple-negative breast cancer. Our work provided a rational strategy on designing peptide-drug conjugates with synergistic anti-tumor efficacy.